Fetal Diagnosis and Therapy
Original Paper
Calculating Observed-to-Expected Total Fetal Lung Volume in CDH Fetuses in Twin Gestation: Is There a Better Way?Kim A.G.a,b · Mon R.A.a · Karmakar M.a · Kreutzman J.a,b · Ladino-Torres M.b,c · Treadwell M.C.b,d · Mychaliska G.B.a,b · Perrone E.E.a,baDepartment of Surgery, Section of Pediatric Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
bFetal Diagnosis and Treatment CenterUniversity of Michigan, Michigan Medicine, Ann Arbor, MI, USA cDepartment of Radiology, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA dDepartment of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA |
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Article / Publication Details
Received: May 02, 2019
Accepted: October 31, 2019
Published online: December 20, 2019
Issue release date: July 2020
Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 5
ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)
For additional information: https://www.karger.com/FDT
Abstract
Background: Congenital diaphragmatic hernia (CDH) is a potentially lethal birth defect, and identifying prenatal predictors of outcome is important. Observed-to-expected total fetal lung volume (o/e TFLV) has been shown to be a predictor of severity and useful in risk stratification but is variable due to different TFLV formulas. Objectives: To calculate o/e TFLV for CDH patients part of a twin gestation using the unaffected sibling as an internal control and comparing these values to those calculated using published formulas for TFLV. Methods: Seven twin gestations with one fetus affected by CDH were identified between 2006 and 2017. The lung volume for each twin was calculated using magnetic resonance imaging (MRI), and o/e TFLV was calculated using the unaffected twin’s TFLV. This percentage was then compared to the o/e TFLV calculated using published formulas. Results: Lung volumes in the unaffected twins were within normal ranges at the lower end of the spectrum. No single TFLV formula was found to correlate perfectly. Intraclass correlation coefficient estimate was most consistent for o/e TFLV calculated with the Meyers formula and supported by Bland-Altman plots. Conclusions: O/e TFLV measured in CDH/non-CDH twin gestations using the unaffected sibling demonstrated agreement with o/e TFLV calculated using the Meyers formula. We urge the fetal community to standardize the method, use, and interpretation of fetal MRI in the prenatal evaluation of CDH.
© 2019 S. Karger AG, Basel
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References
- Morini F, Valfrè L, Bagolan P. Long-term morbidity of congenital diaphragmatic hernia: A plea for standardization. Semin Pediatr Surg. 2017 Oct;26(5):301–10.
- Morini F, Valfrè L, Capolupo I, Lally KP, Lally PA, Bagolan P; Congenital Diaphragmatic Hernia Study Group. Congenital diaphragmatic hernia: defect size correlates with developmental defect. J Pediatr Surg. 2013 Jun;48(6):1177–82.
- Gallot D, Coste K, Francannet C, Laurichesse H, Boda C, Ughetto S, et al. Antenatal detection and impact on outcome of congenital diaphragmatic hernia: a 12-year experience in Auvergne, France. Eur J Obstet Gynecol Reprod Biol. 2006 Apr;125(2):202–5.
- Burgos CM, Frenckner B, Luco M, Harting MT, Lally PA, Lally KP, et al. Prenatally versus postnatally diagnosed congenital diaphragmatic hernia – Side, stage, and outcome. J Pediatr Surg. 2019 Apr;54(4):651–5.
- Wynn J, Krishnan U, Aspelund G, Zhang Y, Duong J, Stolar CJ, et al. Outcomes of congenital diaphragmatic hernia in the modern era of management. J Pediatr. 2013 Jul;163(1):114–9.e1.
- Knox E, Lissauer D, Khan K, Kilby M. Prenatal detection of pulmonary hypoplasia in fetuses with congenital diaphragmatic hernia: a systematic review and meta-analysis of diagnostic studies. J Matern Fetal Neonatal Med. 2010 Jul;23(7):579–88.
- Snoek KG, Peters NC, van Rosmalen J, van Heijst AF, Eggink AJ, Sikkel E, et al. The validity of the observed-to-expected lung-to-head ratio in congenital diaphragmatic hernia in an era of standardized neonatal treatment; a multicenter study. Prenat Diagn. 2017 Jul;37(7):658–65.
- Victoria T, Bebbington MW, Danzer E, Flake AW, Johnson MP, Dinan D, et al. Use of magnetic resonance imaging in prenatal prognosis of the fetus with isolated left congenital diaphragmatic hernia. Prenat Diagn. 2012 Aug;32(8):715–23.
- Oluyomi-Obi T, Kuret V, Puligandla P, Lodha A, Lee-Robertson H, Lee K, et al. Antenatal predictors of outcome in prenatally diagnosed congenital diaphragmatic hernia (CDH). J Pediatr Surg. 2017 May;52(5):881–8.
- Barnewolt CE, Kunisaki SM, Fauza DO, Nemes LP, Estroff JA, Jennings RW. Percent predicted lung volumes as measured on fetal magnetic resonance imaging: a useful biometric parameter for risk stratification in congenital diaphragmatic hernia. J Pediatr Surg. 2007 Jan;42(1):193–7.
- Büsing KA, Kilian AK, Schaible T, Endler C, Schaffelder R, Neff KW. MR relative fetal lung volume in congenital diaphragmatic hernia: survival and need for extracorporeal membrane oxygenation. Radiology. 2008 Jul;248(1):240–6.
- Deshmukh S, Rubesova E, Barth R. MR assessment of normal fetal lung volumes: a literature review. AJR Am J Roentgenol. 2010 Feb;194(2):W212–7.
- Oluyomi-Obi T, Van Mieghem T, Ryan G. Fetal imaging and therapy for CDH-Current status. Semin Pediatr Surg. 2017 Jun;26(3):140–6.
- Rypens F, Metens T, Rocourt N, Sonigo P, Brunelle F, Quere MP, et al. Fetal lung volume: estimation at MR imaging-initial results. Radiology. 2001 Apr;219(1):236–41.
- Osada H, Kaku K, Masuda K, Iitsuka Y, Seki K, Sekiya S. Quantitative and qualitative evaluations of fetal lung with MR imaging. Radiology. 2004 Jun;231(3):887–92.
- Duncan KR, Gowland PA, Moore RJ, Baker PN, Johnson IR. Assessment of fetal lung growth in utero with echo-planar MR imaging. Radiology. 1999 Jan;210(1):197–200.
- Mahieu-Caputo D, Sonigo P, Dommergues M, Fournet JC, Thalabard JC, Abarca C, et al. Fetal lung volume measurement by magnetic resonance imaging in congenital diaphragmatic hernia. BJOG. 2001 Aug;108(8):863–8.
- Meyers ML, Garcia JR, Blough KL, Zhang W, Cassady CI, Mehollin-Ray AR. Fetal Lung Volumes by MRI: Normal Weekly Values From 18 Through 38 Weeks’ Gestation. AJR Am J Roentgenol. 2018 Aug;211(2):432–8.
- Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979 Mar;86(2):420–8.
- Akinkuotu AC, Cruz SM, Abbas PI, Lee TC, Welty SE, Olutoye OO, et al. Risk-stratification of severity for infants with CDH: prenatal versus postnatal predictors of outcome. J Pediatr Surg. 2016 Jan;51(1):44–8.
- Petroze RT, Caminsky NG, Trebichavsky J, Bouchard S, Le-Nguyen A, Laberge JM, et al. Prenatal prediction of survival in congenital diaphragmatic hernia: an audit of postnatal outcomes. J Pediatr Surg. 2019 May;54(5):925–31.
- Deprest JA, Flemmer AW, Gratacos E, Nicolaides K. Antenatal prediction of lung volume and in-utero treatment by fetal endoscopic tracheal occlusion in severe isolated congenital diaphragmatic hernia. Semin Fetal Neonatal Med. 2009 Feb;14(1):8–13.
- Yamoto M, Iwazaki T, Takeuchi K, Sano K, Fukumoto K, Takahashi T, et al. The fetal lung-to-liver signal intensity ratio on magnetic resonance imaging as a predictor of outcomes from isolated congenital diaphragmatic hernia. Pediatr Surg Int. 2018 Feb;34(2):161–8.
- Luke B. Pregnancy and birth outcomes in couples with infertility with and without assisted reproductive technology: with an emphasis on US population-based studies. Am J Obstet Gynecol. 2017 Sep;217(3):270–81.
- Grantz KL, Grewal J, Albert PS, Wapner R, D'Alton ME, Sciscione A, et al. Dichorionic twin trajectories: the NICHD Fetal Growth Studies. Am J Obstet Gynecol. 2016 Aug;215(2):221.e1–e16.
- Jani J, Peralta CF, Van Schoubroeck D, Deprest J, Nicolaides KH. Relationship between lung-to-head ratio and lung volume in normal fetuses and fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol. 2006 May;27(5):545–50.
- Cannie M, Jani JC, De Keyzer F, Devlieger R, Van Schoubroeck D, Witters I, et al. Fetal body volume: use at MR imaging to quantify relative lung volume in fetuses suspected of having pulmonary hypoplasia. Radiology. 2006 Dec;241(3):847–53.
- Whitworth NS, Magann EF, Morrison JC. Evaluation of fetal lung maturity in diamniotic twins. Am J Obstet Gynecol. 1999 Jun;180(6 Pt 1):1438–41.
Article / Publication Details
Received: May 02, 2019
Accepted: October 31, 2019
Published online: December 20, 2019
Issue release date: July 2020
Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 5
ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)
For additional information: https://www.karger.com/FDT
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