Aertsen, Michael

Atkinson, David

Bredaki, Foteini Emmanouella

Chappel, Joanna

David, Anna

De Catte, Luc

De Vloo, Phillippe

Demaerel, Phillipe

Deprest, Jan

Ebner, Michael

Fidon, Lucas

Gaunt, Trevor

Kendall, Giles

Melbourne, Andrew

Mufti, Nada

Ourselin, Sebastien

Pegoretti Baruteau, Kelly

Sokolska, Magdalena

Thomson, Dominic

Vercauteren, Tom

UCL Discovery

 1 ISUOG 2020 Abstract: maximum of 2000 characters  Title: Longitudinal Shape and Volume Analysis of the Fetal Brain in the context of Fetal Spina Bifida Surgery  Authors: Nada Mufti1,3, Joanna Chappell3, Michael Aertsen2, Michael Ebner3, Lucas Fidon3, Trevor Gaunt5, Kelly Pegoretti Baruteau6, Magdalena Sokolska7, Foteini Emmanouella Bredaki8, Giles S. Kendall1,8, David Atkinson9, Tom Vercauteren3,4, Sebastien Ourselin3,4, Dominic Thomson10, Phillippe De Vloo12, Luc De Catte11, Philippe Demaerel2, Jan Deprest1,11, Anna L David1,11, Andrew Melbourne3,4  Affiliations: 1 Elizabeth Garrett Anderson Institute for Women’s Health, University College London, UK 2 Department of Radiology, University Hospitals Katholieke Universiteit (KU) Leuven, Belgium 3 School of Biomedical Engineering and Imaging Sciences (BMEIS), King’s College London, UK 4 Medical Physics and Biomedical Engineering, University College London, UK 5 Radiology Department, Great Ormond Street Hospital for Children, London, UK 6 Radiology Department, University College London Hospitals, UK 7 Department of Medical Physics and Biomedical Engineering, University College London Hospitals, UK 8 Women’s Health Division, University College London Hospitals, London, UK 9 Centre for Medical Imaging, University College London, London, UK  2 10 Paediatric Neurosurgery Department, Great Ormond Street Hospital for Children, London, UK 11 Department of Obstetrics and Gynaecology, University Hospitals Katholieke Universiteit (KU) Leuven 12 Department of Neurosurgery, University Hospitals Katholieke Universiteit (KU) Leuven  Objectives: Fetal myelomeningocele (MMC) repair is a treatment option in fetuses meeting certain criteria to improve long-term outcome. We studied Magnetic Resonance Imaging (MRI) quantification of volume, surface area, and shape of cerebral structures to determine the effect of fetal surgery on brain development.  Methods: We compared MRI images of 29 MMC fetuses before fetal surgery (<26 weeks), one week and six weeks post-surgery, to 36 age-matched normal controls (21-36+6 weeks). Automated super-resolution reconstruction provided optimal 3D isotropic brain volumes. White matter, cerebellum and ventricles were automatically segmented and manually refined; cerebral volume, surface area, and volume/surface area ratio were quantified. Shape parameter, an indication of brain complexity, was defined as volume/surface area.  Results:  Cerebellar volume growth (mm3/week) increased in both groups when imaged <26 weeks. The change was less in MMC fetuses scanned before and one week after surgery compared to controls (median: 419, IQR:188-588 vs 748,IQR:565-838,p<0.001). Six weeks after fetal surgery, MMC cerebellar volume growth was not significantly different to control fetuses. MMC ventricular volume growth (mm3/week) and shape parameter (mm/week) was higher in  3 the six weeks after surgery compared to control fetuses; (median:3400;IQR:1666-3604,vs 708;IQR: 435-966,p<0.001), and (median:0.075;IQR:0.047-0.112 vs 0.022;IQR: 0.009-0.042,p<0.001). In that time period, MMC white matter volume growth (mm3/week) increased, whilst shape parameter change per week decreased compared to controls (median:11446; IQR:10342-11891, vs 10304;IQR: 8254-11192, p=0.048), and (median:0.074;IQR:0.058-0.096 vs 0.1;IQR:0.085-0.140, p= 0.01).  Conclusion: Following fetal MMC repair, fetal brain development differs from that of age-matched normal fetuses.These findings may have neurocognitive implications for postnatal outcomes which require further evaluation.   

English

Longitudinal Shape and Volume Analysis of the Fetal Brain in the context of Fetal Spina Bifida Surgery

https://discovery.ucl.ac.uk/id/eprint/10155452/

Longitudinal Shape and Volume Analysis of the Fetal Brain in the context of Fetal Spina Bifida Surgery

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