Fetal Diagn Ther
. 2026 Jan 29:1-10.
doi: 10.1159/000550698. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/41610064/
Slice-to-Volume Registration of the fetal thorax to assess observed/expected total fetal lungs volume in fetuses with congenital diaphragmatic hernia who underwent Fetoscopic Endoluminal Tracheal Occlusion
Romain Corroenne, Pamela M Ketwaroo, Magdalena Sanz Cortes
- PMID: 41610064
- DOI: 10.1159/000550698
Abstract
Objective: To evaluate the feasibility of slice-to-volume registration (SVR) of the fetal thorax in congenital diaphragmatic hernia (CDH), and to compare observed-to-expected total fetal lung volume (O/E TFLV) obtained from original and SVR MRI volumes for prediction of postnatal survival.
Methods: We retrospectively analyzed 35 fetuses with CDH undergoing MRI before and after fetoscopic endoluminal tracheal occlusion (FETO). High-resolution, motion-corrected SVR volumes were reconstructed using an automated pipeline. O/E TFLV was measured on both original and SVR volumes, and results were compared between survivors and non-survivors at 6 months of age. Agreement, correlation, and predictive accuracy were assessed using Pearson correlation and ROC analysis.
Results: Four cases (11.4%) were excluded due to uncorrectable artifacts or technical issues. SVR reconstruction required only three acquisitions versus a median of six for conventional imaging. Post-processing took a median of 14 minutes, and lung delineation was longer for SVR than for original volumes. O/E TFLV measurements showed good to very good agreement between original and SVR volumes (r=0.75 before and r=0.96 after FETO), with comparable predictive accuracy for survival (AUCoriginal=0.81-0.83 vs AUCSVR=0.83, p>0.7).
Conclusion: SVR of the fetal thorax is feasible in CDH and provides reliable O/E TFLV measurements with prognostic accuracy comparable to conventional MRI, while reducing the need for repeated acquisitions.
S. Karger AG, Basel.
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