Micro-CT yields high image quality in human fetal post-mortem imaging despite maceration.
Human foetuses
Image quality
Maceration
Micro-CT
Post-mortem imaging
Journal
BMC medical imaging
ISSN: 1471-2342
Titre abrégé: BMC Med Imaging
Pays: England
ID NLM: 100968553
Informations de publication
Date de publication:
24 08 2021
24 08 2021
Historique:
received:
18
03
2021
accepted:
01
08
2021
entrez:
25
8
2021
pubmed:
26
8
2021
medline:
22
1
2022
Statut:
epublish
Résumé
Current clinical post-mortem imaging techniques do not provide sufficiently high-resolution imaging for smaller fetuses after pregnancy loss. Post-mortem micro-CT is a non-invasive technique that can deliver high diagnostic accuracy for these smaller fetuses. The purpose of the study is to identify the main predictors of image quality for human fetal post-mortem micro-CT imaging. Human fetuses were imaged using micro-CT following potassium tri-iodide tissue preparation, and axial head and chest views were assessed for image quality on a Likert scale by two blinded radiologists. Simple and multivariable linear regression models were performed with demographic details, iodination, tissue maceration score and imaging parameters as predictor variables. 258 fetuses were assessed, with median weight 41.7 g (2.6-350 g) and mean gestational age 16 weeks (11-24 weeks). A high image quality score (> 6.5) was achieved in 95% of micro-CT studies, higher for the head (median = 9) than chest (median = 8.5) imaging. The strongest negative predictors of image quality were increasing maceration and body weight (p < 0.001), with number of projections being the best positive imaging predictor. High micro-CT image quality score is achievable following early pregnancy loss despite fetal maceration, particularly in smaller fetuses where conventional autopsy may be particularly challenging. These findings will help establish clinical micro-CT imaging services, addressing the need for less invasive fetal autopsy methods.
Sections du résumé
BACKGROUND
Current clinical post-mortem imaging techniques do not provide sufficiently high-resolution imaging for smaller fetuses after pregnancy loss. Post-mortem micro-CT is a non-invasive technique that can deliver high diagnostic accuracy for these smaller fetuses. The purpose of the study is to identify the main predictors of image quality for human fetal post-mortem micro-CT imaging.
METHODS
Human fetuses were imaged using micro-CT following potassium tri-iodide tissue preparation, and axial head and chest views were assessed for image quality on a Likert scale by two blinded radiologists. Simple and multivariable linear regression models were performed with demographic details, iodination, tissue maceration score and imaging parameters as predictor variables.
RESULTS
258 fetuses were assessed, with median weight 41.7 g (2.6-350 g) and mean gestational age 16 weeks (11-24 weeks). A high image quality score (> 6.5) was achieved in 95% of micro-CT studies, higher for the head (median = 9) than chest (median = 8.5) imaging. The strongest negative predictors of image quality were increasing maceration and body weight (p < 0.001), with number of projections being the best positive imaging predictor.
CONCLUSIONS
High micro-CT image quality score is achievable following early pregnancy loss despite fetal maceration, particularly in smaller fetuses where conventional autopsy may be particularly challenging. These findings will help establish clinical micro-CT imaging services, addressing the need for less invasive fetal autopsy methods.
Identifiants
pubmed: 34429085
doi: 10.1186/s12880-021-00658-5
pii: 10.1186/s12880-021-00658-5
pmc: PMC8383392
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
128Subventions
Organisme : Medical Research Council
ID : MR/R002118/1
Pays : United Kingdom
Informations de copyright
© 2021. The Author(s).
Références
BMC Med Imaging. 2011 Jun 15;11:14
pubmed: 21676233
Am J Obstet Gynecol. 2020 Oct;223(4):493-515
pubmed: 32376319
PLoS One. 2018 Aug 9;13(8):e0202023
pubmed: 30092056
Am J Obstet Gynecol. 2018 Apr;218(4):445.e1-445.e12
pubmed: 29410108
Ultrasound Obstet Gynecol. 2014 Nov;44(5):600-9
pubmed: 24585450
Prenat Diagn. 2019 Aug;39(9):818-829
pubmed: 30892705
BMC Med Imaging. 2015 May 19;15:16
pubmed: 25986463
BJOG. 2019 May;126(6):745-753
pubmed: 30576088
Eur Radiol. 2017 Aug;27(8):3542-3553
pubmed: 28116518
Neuroradiology. 2019 Jul;61(7):737-746
pubmed: 30693410
Ultrasound Obstet Gynecol. 2019 Jan;53(1):132-134
pubmed: 30079607
Prenat Diagn. 2018 Jun;38(7):538-542
pubmed: 29748962
Ultrasound Obstet Gynecol. 2016 Jan;47(1):58-64
pubmed: 26415141
Am J Vet Res. 2020 Apr;81(4):326-333
pubmed: 32228254
Nat Protoc. 2021 May;16(5):2594-2614
pubmed: 33854254
BMC Med Imaging. 2019 Jan 23;19(1):10
pubmed: 30674282
Ultrasound Obstet Gynecol. 2020 May;55(5):667-675
pubmed: 31271478
Obstet Gynecol. 1992 Oct;80(4):575-84
pubmed: 1383898
BJOG. 2018 Jan;125(2):172-181
pubmed: 28190300
Prenat Diagn. 2020 Jul;40(8):984-990
pubmed: 32333804
Ultrasound Obstet Gynecol. 2016 Jul;48(1):92-7
pubmed: 26183321
Am J Obstet Gynecol. 2021 Jan;224(1):103.e1-103.e15
pubmed: 32682860
Prenat Diagn. 2020 Jan;40(2):232-243
pubmed: 31743482
Health Technol Assess. 2019 Aug;23(46):1-104
pubmed: 31461397
Insights Imaging. 2019 Aug 21;10(1):81
pubmed: 31432284
Eur Radiol. 2020 Apr;30(4):2280-2292
pubmed: 31834508
BMC Med Imaging. 2018 Oct 30;18(1):38
pubmed: 30376825
Ultrasound Obstet Gynecol. 2019 Dec;54(6):791-799
pubmed: 30644623
Fetal Diagn Ther. 2019;45(4):221-229
pubmed: 29874643
Br J Radiol. 2017 Jul;90(1075):20170113
pubmed: 28368658
Eur J Pediatr. 2018 Jun;177(6):791-803
pubmed: 29675642