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Yeung PH, Hesse LS, Aliasi M, Haak MC, Xie W, Namburete AIL. Sensorless volumetric reconstruction of fetal brain freehand ultrasound scans with deep implicit representation. Med Image Anal 2024; 94:103147. [PMID: 38547665 DOI: 10.1016/j.media.2024.103147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/14/2024] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
Three-dimensional (3D) ultrasound imaging has contributed to our understanding of fetal developmental processes by providing rich contextual information of the inherently 3D anatomies. However, its use is limited in clinical settings, due to the high purchasing costs and limited diagnostic practicality. Freehand 2D ultrasound imaging, in contrast, is routinely used in standard obstetric exams, but inherently lacks a 3D representation of the anatomies, which limits its potential for more advanced assessment. Such full representations are challenging to recover even with external tracking devices due to internal fetal movement which is independent from the operator-led trajectory of the probe. Capitalizing on the flexibility offered by freehand 2D ultrasound acquisition, we propose ImplicitVol to reconstruct 3D volumes from non-sensor-tracked 2D ultrasound sweeps. Conventionally, reconstructions are performed on a discrete voxel grid. We, however, employ a deep neural network to represent, for the first time, the reconstructed volume as an implicit function. Specifically, ImplicitVol takes a set of 2D images as input, predicts their locations in 3D space, jointly refines the inferred locations, and learns a full volumetric reconstruction. When testing natively-acquired and volume-sampled 2D ultrasound video sequences collected from different manufacturers, the 3D volumes reconstructed by ImplicitVol show significantly better visual and semantic quality than the existing interpolation-based reconstruction approaches. The inherent continuity of implicit representation also enables ImplicitVol to reconstruct the volume to arbitrarily high resolutions. As formulated, ImplicitVol has the potential to integrate seamlessly into the clinical workflow, while providing richer information for diagnosis and evaluation of the developing brain.
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Affiliation(s)
- Pak-Hei Yeung
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom; Oxford Machine Learning in NeuroImaging Lab, Department of Computer Science, University of Oxford, OX1 3QD, United Kingdom.
| | - Linde S Hesse
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom; Oxford Machine Learning in NeuroImaging Lab, Department of Computer Science, University of Oxford, OX1 3QD, United Kingdom
| | - Moska Aliasi
- Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Monique C Haak
- Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Weidi Xie
- Shanghai Jiao Tong University, Shanghai, 200240, China; Visual Geometry Group, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Ana I L Namburete
- Oxford Machine Learning in NeuroImaging Lab, Department of Computer Science, University of Oxford, OX1 3QD, United Kingdom
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2
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Harutyunyan R, Jeffries SD, Morse J, Hemmerling TM. Beyond the Echo: The Evolution and Revolution of Ultrasound in Anesthesia. Anesth Analg 2024; 138:369-375. [PMID: 38215715 DOI: 10.1213/ane.0000000000006834] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
This article explores the evolving role of ultrasound technology in anesthesia. Ultrasound emerged decades ago, offering clinicians noninvasive, economical, radiation-free, and real-time imaging capabilities. It might seem that such an old technology with apparent limitations might have had its day, but this review discusses both the current applications of ultrasound (in nerve blocks, vascular access, and airway management) and then, more speculatively, shows how integration of advanced ultrasound modalities such as contrast-enhanced imaging with virtual reality (VR), or nanotechnology can alter perioperative patient care. This article will also explore the potential of robotics and artificial intelligence (AI) in augmenting ultrasound-guided anesthetic procedures and their implications for medical practice and education.
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Affiliation(s)
- Robert Harutyunyan
- From the Department of Experimental Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Sean D Jeffries
- From the Department of Experimental Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Joshua Morse
- From the Department of Experimental Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Thomas M Hemmerling
- From the Department of Experimental Surgery, McGill University Health Center, Montreal, Quebec, Canada
- Department of Anesthesia, McGill University, Montreal, Quebec, Canada
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3
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Kim YM, Seong JS, Kim JH, Lee NM, Choi IH, Jo Y, Nam G, Kim GJ. Improving Prenatal Diagnosis Precision for Congenital Clubfoot by Using Three-Dimensional Ultrasonography. Diagnostics (Basel) 2024; 14:117. [PMID: 38201425 PMCID: PMC10795686 DOI: 10.3390/diagnostics14010117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
Prenatal diagnosis of clubfoot traditionally relied on two-dimensional ultrasonography. To enhance diagnosis and predict postnatal outcomes, we examined the parameters that differentiate pathological clubfoot using three-dimensional ultrasonography. In our retrospective study, we examined the findings of prenatal ultrasound and the postnatal outcomes of pregnancies with suspected congenital clubfoot between 2018 and 2021. Based on the three-dimensional perspective, we measured the angles of varus, equinus, calcaneopedal block, and forefoot adduction and compared the sonographic variables between the postnatal treated and non-treated groups. We evaluated 31 pregnancies (47 feet) with suspected clubfoot using three-dimensional ultrasonography. After delivery, a total of 37 feet (78.7%) underwent treatment involving serial casting only or additional Achilles tenotomy. The treated group showed significantly greater hindfoot varus deviation (60.5° vs. 46.6°, p = 0.026) and calcaneopedal block deviation (65.6° vs. 26.6°, p < 0.05) compared to the non-treated group. The calcaneopedal block had an area under the curve of 0.98 with a diagnostic threshold of 46.2 degrees (sensitivity of 97%, specificity of 90%, positive predictive value of 97%, and negative predictive value of 90%). During prenatal evaluation of clubfoot using three-dimensional ultrasonography, the calcaneopedal block deviation has the potential to predict postnatal treatment.
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Affiliation(s)
- Yoo-min Kim
- Department of Obstetrics and Gynecology, Chung-Ang University Gwang-Myung Hospital, Chung-Ang University College of Medicine, Gwangmyung 14353, Gyeonggi-do, Republic of Korea; (Y.-m.K.); (J.S.S.); (J.H.K.)
| | - Ji Su Seong
- Department of Obstetrics and Gynecology, Chung-Ang University Gwang-Myung Hospital, Chung-Ang University College of Medicine, Gwangmyung 14353, Gyeonggi-do, Republic of Korea; (Y.-m.K.); (J.S.S.); (J.H.K.)
| | - Ji Hoi Kim
- Department of Obstetrics and Gynecology, Chung-Ang University Gwang-Myung Hospital, Chung-Ang University College of Medicine, Gwangmyung 14353, Gyeonggi-do, Republic of Korea; (Y.-m.K.); (J.S.S.); (J.H.K.)
| | - Na Mi Lee
- Department of Pediatrics, Chung-Ang University Gwang-Myung Hospital, Chung-Ang University College of Medicine, Gwangmyung 14353, Gyeonggi-do, Republic of Korea;
| | - In Ho Choi
- Division of Pediatric Orthopedics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea;
| | - Yejin Jo
- Department of Mathematics, Chung-Ang University, Seoul 06974, Republic of Korea;
| | - Gina Nam
- Department of Obstetrics and Gynecology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea;
| | - Gwang Jun Kim
- Department of Obstetrics and Gynecology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea;
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Sinagra L, Orlandi R, Caspanello T, Troisi A, Iannelli NM, Vallesi E, Pettina G, Bargellini P, De Majo M, Boiti C, Cristarella S, Quartuccio M, Polisca A. Contrast-Enhanced Ultrasonography (CEUS) in Imaging of the Reproductive System in Dogs: A Literature Review. Animals (Basel) 2023; 13:ani13101615. [PMID: 37238045 DOI: 10.3390/ani13101615] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
The use of contrast-enhanced ultrasound (CEUS) has been widely reported for reproductive imaging in humans and animals. This review aims to analyze the utility of CEUS in characterizing canine reproductive physiology and pathologies. In September 2022, a search for articles about CEUS in canine testicles, prostate, uterus, placenta, and mammary glands was conducted on PubMed and Scopus from 1990 to 2022, showing 36 total results. CEUS differentiated testicular abnormalities and neoplastic lesions, but it could not characterize tumors. In prostatic diseases, CEUS in dogs was widely studied in animal models for prostatic cancer treatment. In veterinary medicine, this diagnostic tool could distinguish prostatic adenocarcinomas. In ovaries, CEUS differentiated the follicular phases. In CEH-pyometra syndrome, it showed a different enhancement between endometrium and cysts, and highlighted angiogenesis. CEUS was shown to be safe in pregnant dogs and was able to assess normal and abnormal fetal-maternal blood flow and placental dysfunction. In normal mammary glands, CEUS showed vascularization only in diestrus, with differences between mammary glands. CEUS was not specific for neoplastic versus non-neoplastic masses and for benign tumors, except for complex carcinomas and neoplastic vascularization. Works on CEUS showed its usefulness in a wide spectrum of pathologies of this non-invasive, reliable diagnostic procedure.
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Affiliation(s)
- Letizia Sinagra
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Riccardo Orlandi
- Anicura Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100 Terni, Italy
| | - Tiziana Caspanello
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Alessandro Troisi
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Macerata, Italy
| | - Nicola Maria Iannelli
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
- Clinica Veterinaria Camagna-VetPartners, Via Fortunato Licandro 13, 89124 Reggio di Calabria, Italy
| | - Emanuela Vallesi
- Anicura Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100 Terni, Italy
- Anicura CMV Clinica Veterinaria, Via G.B. Aguggiari 162, 21100 Varese, Italy
| | - Giorgia Pettina
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Paolo Bargellini
- Anicura Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100 Terni, Italy
| | - Massimo De Majo
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Cristiano Boiti
- Tyrus Science Foundation, Via Bartocci 1G, 05100 Terni, Italy
| | - Santo Cristarella
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Marco Quartuccio
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Angela Polisca
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
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Fidvi S, Holder J, Li H, Parnes GJ, Shamir SB, Wake N. Advanced 3D Visualization and 3D Printing in Radiology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1406:103-138. [PMID: 37016113 DOI: 10.1007/978-3-031-26462-7_6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Since the discovery of X-rays in 1895, medical imaging systems have played a crucial role in medicine by permitting the visualization of internal structures and understanding the function of organ systems. Traditional imaging modalities including Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasound (US) present fixed two-dimensional (2D) images which are difficult to conceptualize complex anatomy. Advanced volumetric medical imaging allows for three-dimensional (3D) image post-processing and image segmentation to be performed, enabling the creation of 3D volume renderings and enhanced visualization of pertinent anatomic structures in 3D. Furthermore, 3D imaging is used to generate 3D printed models and extended reality (augmented reality and virtual reality) models. A 3D image translates medical imaging information into a visual story rendering complex data and abstract ideas into an easily understood and tangible concept. Clinicians use 3D models to comprehend complex anatomical structures and to plan and guide surgical interventions more precisely. This chapter will review the volumetric radiological techniques that are commonly utilized for advanced 3D visualization. It will also provide examples of 3D printing and extended reality technology applications in radiology and describe the positive impact of advanced radiological image visualization on patient care.
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Affiliation(s)
- Shabnam Fidvi
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
| | - Justin Holder
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Hong Li
- Department of Radiology, Jacobi Medical Center, Bronx, NY, USA
| | | | | | - Nicole Wake
- GE Healthcare, Aurora, OH, USA
- Center for Advanced Imaging Innovation and Research, NYU Langone Health, New York, NY, USA
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Caspi Y, de Zwarte SMC, Iemenschot IJ, Lumbreras R, de Heus R, Bekker MN, Hulshoff Pol H. Automatic measurements of fetal intracranial volume from 3D ultrasound scans. FRONTIERS IN NEUROIMAGING 2022; 1:996702. [PMID: 37555155 PMCID: PMC10406279 DOI: 10.3389/fnimg.2022.996702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/15/2022] [Indexed: 08/10/2023]
Abstract
Three-dimensional fetal ultrasound is commonly used to study the volumetric development of brain structures. To date, only a limited number of automatic procedures for delineating the intracranial volume exist. Hence, intracranial volume measurements from three-dimensional ultrasound images are predominantly performed manually. Here, we present and validate an automated tool to extract the intracranial volume from three-dimensional fetal ultrasound scans. The procedure is based on the registration of a brain model to a subject brain. The intracranial volume of the subject is measured by applying the inverse of the final transformation to an intracranial mask of the brain model. The automatic measurements showed a high correlation with manual delineation of the same subjects at two gestational ages, namely, around 20 and 30 weeks (linear fitting R2(20 weeks) = 0.88, R2(30 weeks) = 0.77; Intraclass Correlation Coefficients: 20 weeks=0.94, 30 weeks = 0.84). Overall, the automatic intracranial volumes were larger than the manually delineated ones (84 ± 16 vs. 76 ± 15 cm3; and 274 ± 35 vs. 237 ± 28 cm3), probably due to differences in cerebellum delineation. Notably, the automated measurements reproduced both the non-linear pattern of fetal brain growth and the increased inter-subject variability for older fetuses. By contrast, there was some disagreement between the manual and automatic delineation concerning the size of sexual dimorphism differences. The method presented here provides a relatively efficient way to delineate volumes of fetal brain structures like the intracranial volume automatically. It can be used as a research tool to investigate these structures in large cohorts, which will ultimately aid in understanding fetal structural human brain development.
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Affiliation(s)
- Yaron Caspi
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Sonja M. C. de Zwarte
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Iris J. Iemenschot
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Raquel Lumbreras
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Roel de Heus
- Department of Obstetrics and Gynaecology, St. Antonius Hospital, Utrecht, Netherlands
- Department of Obstetrics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Mireille N. Bekker
- Department of Obstetrics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Hilleke Hulshoff Pol
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Psychology, Utrecht University, Utrecht, Netherlands
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Qiu Q, Huang Y, Zhang B, Huang D, Chen X, Fan Z, Lin J, Yang W, Wang K, Qu N, Li J, Li Z, Huang J, Li S, Zhang J, Liu G, Rui G, Chen X, Zhao Q. Noninvasive Dual-Modality Photoacoustic-Ultrasonic Imaging to Detect Mammalian Embryo Abnormalities after Prenatal Exposure to Methylmercury Chloride (MMC): A Mouse Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:27002. [PMID: 35108087 PMCID: PMC8809665 DOI: 10.1289/ehp8907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Severe environmental pollution and contaminants left in the environment due to the abuse of chemicals, such as methylmercury, are associated with an increasing number of embryonic disorders. Ultrasound imaging has been widely used to investigate embryonic development malformation and dysorganoplasia in both research and clinics. However, this technique is limited by its low contrast and lacking functional parameters such as the ability to measure blood oxygen saturation (SaO 2 ) and hemoglobin content (HbT) in tissues, measures that could be early vital indicators for embryonic development abnormality. Herein, we proposed combining two highly complementary techniques into a photoacoustic-ultrasound (PA-US) dual-modality imaging approach to noninvasively detect early mouse embryo abnormalities caused by methylmercury chloride (MMC) in real time. OBJECTIVES This study aimed to assess the use of PA-US dual-modality imaging for noninvasive detection of embryonic toxicity at different stages of growth following prenatal MMC exposure. Additionally, we compared the PA-US imagining results to traditional histological methods to determine whether this noninvasive method could detect early developmental defects in utero. METHODS Different dosages of MMC were administrated to pregnant mice by gavage to establish models of different levels of embryonic malformation. Ultrasound, photoacoustic signal intensity (PSI), blood oxygen saturation (SaO 2 ), and hemoglobin content (HbT) were quantified in all experimental groups. Furthermore, the embryos were sectioned and examined for pathological changes. RESULTS Using PA-US imaging, we detected differences in PSI, SaO 2 , HbT, and heart volume at embryonic day (E)14.5 and E11.5 for low and high dosages of MMC, respectively. More important, our results showed that differences between control and treated embryos identified by in utero PA-US imaging were consistent with those identified in ex vivo embryos using histological methods. CONCLUSION Our results suggest that noninvasive dual-modality PA-US is a promising strategy for detecting developmental toxicology in the uterus. Overall, this study presents a new approach for detecting embryonic toxicities, which could be crucial in clinics when diagnosing aberrant embryonic development. https://doi.org/10.1289/EHP8907.
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Affiliation(s)
- Qi Qiu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Yali Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Bei Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Doudou Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Xin Chen
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Zhongxiong Fan
- Department of Biomaterials, College of Materials, Research Center of Biomedical Engineering of Xiamen & Key Laboratory of Biomedical Engineering of Fujian Province & Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen, China
| | - Jinpei Lin
- Department of Integrated TCM & Western Medicine Department, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Wensheng Yang
- Department of Pathology Affiliated Chenggong Hospital, Xiamen University, Xiamen, China
| | - Kai Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Ning Qu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Juan Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Zhihong Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Jingyu Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Shenrui Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Jiaxing Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Gang Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Gang Rui
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Xiaoyuan Chen
- Yong Loo Lin School of Medicine and Faculty of Engineering, National University of Singapore, Singapore, Singapore
| | - Qingliang Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen, China
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Scher MS. "The First Thousand Days" Define a Fetal/Neonatal Neurology Program. Front Pediatr 2021; 9:683138. [PMID: 34408995 PMCID: PMC8365757 DOI: 10.3389/fped.2021.683138] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/27/2021] [Indexed: 01/11/2023] Open
Abstract
Gene-environment interactions begin at conception to influence maternal/placental/fetal triads, neonates, and children with short- and long-term effects on brain development. Life-long developmental neuroplasticity more likely results during critical/sensitive periods of brain maturation over these first 1,000 days. A fetal/neonatal program (FNNP) applying this perspective better identifies trimester-specific mechanisms affecting the maternal/placental/fetal (MPF) triad, expressed as brain malformations and destructive lesions. Maladaptive MPF triad interactions impair progenitor neuronal/glial populations within transient embryonic/fetal brain structures by processes such as maternal immune activation. Destructive fetal brain lesions later in pregnancy result from ischemic placental syndromes associated with the great obstetrical syndromes. Trimester-specific MPF triad diseases may negatively impact labor and delivery outcomes. Neonatal neurocritical care addresses the symptomatic minority who express the great neonatal neurological syndromes: encephalopathy, seizures, stroke, and encephalopathy of prematurity. The asymptomatic majority present with neurologic disorders before 2 years of age without prior detection. The developmental principle of ontogenetic adaptation helps guide the diagnostic process during the first 1,000 days to identify more phenotypes using systems-biology analyses. This strategy will foster innovative interdisciplinary diagnostic/therapeutic pathways, educational curricula, and research agenda among multiple FNNP. Effective early-life diagnostic/therapeutic programs will help reduce neurologic disease burden across the lifespan and successive generations.
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Affiliation(s)
- Mark S Scher
- Division of Pediatric Neurology, Department of Pediatrics, Fetal/Neonatal Neurology Program, Emeritus Scholar Tenured Full Professor in Pediatrics and Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, United States
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Chitty LS, Ghidini A, Deprest J, Van Mieghem T, Levy B, Hui L, Bianchi DW. Right or wrong? Looking through the retrospectoscope to analyse predictions made a decade ago in prenatal diagnosis and fetal surgery. Prenat Diagn 2020; 40:1627-1635. [PMID: 33231306 DOI: 10.1002/pd.5870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 11/21/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Lyn S Chitty
- North Thames Genomic Laboratory Hub, Great Ormond Street NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alessandro Ghidini
- Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, DC.,Antenatal Testing Center, Inova Alexandria Hospital, Alexandria, VA
| | - Jan Deprest
- Department of Obstetrics and Gynaecology, University of Leuven, Leuven, Belgium and the Institute for Women's Health, UCL, London
| | - Tim Van Mieghem
- Fetal Medicine Unit and Ontario Fetal Centre, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Brynn Levy
- Division of Personalized Genomic Medicine, Columbia University Medical Center & the New York Presbyterian Hospital, New York, New York, USA
| | - Lisa Hui
- Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.,Mercy Hospital for Women, Heidelberg, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The Northern Hospital, Epping, Victoria, Australia
| | - Diana W Bianchi
- Division of Prenatal Genomics and Fetal Therapy, Medical Genomics and Metabolic Genetics Branch, National Human Genome Institute, National Human Genome Institute, National Institutes of Health, Bethesda, Maryland, USA
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Munteanu O, Cîrstoiu MM, Filipoiu FM, Neamţu MN, Stavarache I, Georgescu TA, Bratu OG, Iorgulescu G, Bohîlţea RE. The etiopathogenic and morphological spectrum of anencephaly: a comprehensive review of literature. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2020; 61:335-343. [PMID: 33544785 PMCID: PMC7864317 DOI: 10.47162/rjme.61.2.03] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Anencephaly is a severe malformation of the central nervous system (CNS), being one of the most common types of neural tube defects. It is defined as total or partial absence of the calvarium, with absence of the brain. Anencephaly has an incidence of 1 to 5 in every 1000 births, and the mortality rate is 100% during intrauterine life or within hours or days after birth. The etiology of anencephaly remains unclear, but various maternal-related environmental and genetic risk factors have been reported, which include diabetes, obesity, exposure to different drugs or toxins, genetic polymorphisms and mutations, as well as positive family history for neural tube defects. One of the most important nutritional factors in the development of anencephaly is folate deficiency. Methylenetetrahydrofolate reductase (MTHFR) gene codes the enzyme involved in the intracellular metabolism of folic acid; the 677C-T polymorphism of this gene causes the thermolability of the enzyme and decreased enzymatic activity, which is also dependent of folate plasmatic level. Etiopathogenesis of anencephaly includes several mutations in various other genes, such as: platelet-derived growth factor receptor alpha (PDGFRA), cadherin epidermal growth factor (EGF) laminin G (LAG) seven-pass G-type receptor 1 (CELSR1), Vang-like 1 (VANGL1) and Vang-like 2 (VANGL2), the last two being involved in the process of neurulation. Screening tests include maternal serum alpha-fetoprotein level and ultrasound (US) examination. During the first trimester US screening, anencephaly is now detected in all cases, but in order to decrease the complication rate of pregnancy termination, the diagnosis should be established as soon as possible, during the pregnancy confirmation US. We conclude that given that anencephaly is a severe malformation of the CNS, morphological characterization could improve the screening by US that is mandatory in the first trimester in order to plan the best, safe and early management.
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Affiliation(s)
- Octavian Munteanu
- Department of Pathology, Polizu Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; ; Department of Behavioral Sciences, Carol Davila University of Medicine and Pharmacy Bucharest, Romania;
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Menin D, Costabile A, Tenuta F, Oster H, Dondi M. Identifying fetal yawns based on temporal dynamics of mouth openings: A preterm neonate model using support vector machines (SVMs). PLoS One 2019; 14:e0226921. [PMID: 31856250 PMCID: PMC6922391 DOI: 10.1371/journal.pone.0226921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/07/2019] [Indexed: 11/25/2022] Open
Abstract
Fetal yawning is of interest because of its clinical, developmental and theoretical implications. However, the methodological challenges of identifying yawns from ultrasonographic scans have not been systematically addressed. We report two studies that examined the temporal dynamics of yawning in preterm neonates comparable in developmental level to fetuses observed in ultrasound studies (about 31 weeks PMA). In Study 1 we tested the reliability and construct validity of the only quantitative measure for identifying fetal yawns in the literature, by comparing its scores with a more detailed behavioral coding system (The System for Coding Perinatal Behavior, SCPB) adapted from the comprehensive, anatomically based Facial Action Coding System for Infants and Young Children (Baby FACS). The previously published measure yielded good reliability but poor specificity, resulting in over-representation of yawns. In Study 2 we developed and tested a new machine learning system based on support vector machines (SVM) for identifying yawns. The system displayed excellent specificity and sensitivity, proving it to be a reliable and valid tool for identifying yawns in fetuses and neonates. This achievement represents a first step towards a fully automated system for identifying yawns in the perinatal period.
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Affiliation(s)
- Damiano Menin
- Dipartimento di Studi Umanistici, Università degli Studi di Ferrara, Ferrara, Italy
| | - Angela Costabile
- Dipartimento di Culture, Educazione e Società, Università della Calabria, Cosenza, Italy
| | - Flaviana Tenuta
- Dipartimento di Culture, Educazione e Società, Università della Calabria, Cosenza, Italy
| | - Harriet Oster
- School of Professional Studies, New York University, New York City, New York, United States of America
- Department of Psychology, Hunter College, City University of New York, New York City, New York, United States of America
| | - Marco Dondi
- Dipartimento di Studi Umanistici, Università degli Studi di Ferrara, Ferrara, Italy
- * E-mail:
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Grill FD, Behr AV, Rau A, Ritschl LM, Roth M, Bauer FX, Wolff KD, Esser T, Loeffelbein DJ. Prenatal intrauterine maxillary development - An evaluation with three-dimensional ultrasound. J Craniomaxillofac Surg 2019; 47:1077-1082. [PMID: 30885526 DOI: 10.1016/j.jcms.2019.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 01/23/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this prospective study was to investigate normal fetal maxillary development with volume ultrasound during the prenatal phase, for a better estimation of maxillary growth processes. METHODS Some 210 3D volumes were obtained in two measurement series from 38 healthy women (gestational age: 19+2 to 31+4 weeks) using a GE Voluson™ E10 ultrasound system. Maxillary length and width were determined in the axial and sagittal planes. Clearly defined, reproducible landmarks were used for measurements. The results were correlated with gestational age and compared with previously reported studies. RESULTS Total maxillary length ranged from 10.30 to 24.75 mm, total maxillary width from 13.65 to 37.30 mm in an observation period during the second trimester, with high reproducibility for all landmarks. All evaluation results showed steep growth with exponential character. Length growth was determined to be more dominant than width growth. Intra-rater correlation was evaluated to be almost perfect (ICC (3) > 0.8). CONCLUSION This study presents measurements of physiological fetal maxillary development. The defined landmarks proved to be representative for further investigations. This study serves as a baseline for a better understanding of fetal maxillary growth processes, and may be useful for standardising detection of malformations or intrauterine growth restrictions.
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Affiliation(s)
- Florian D Grill
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany
| | - Alexandra V Behr
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany.
| | - Andrea Rau
- Department of Oral and Maxillofacial Surgery, Friedrich Alexander Universität Erlangen-Nürnberg, Germany
| | - Lucas M Ritschl
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany
| | - Maximilian Roth
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany
| | - Franz X Bauer
- Institute of Medical and Polymer Engineering, Technische Universität München, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany
| | | | - Denys J Loeffelbein
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany; Helios Klinik München West, Germany
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Scher MS. Fetal neurology: Principles and practice with a life-course perspective. HANDBOOK OF CLINICAL NEUROLOGY 2019; 162:1-29. [PMID: 31324306 DOI: 10.1016/b978-0-444-64029-1.00001-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Clinical service, educational, and research components of a fetal/neonatal neurology program are anchored by the disciplines of developmental origins of health and disease and life-course science as programmatic principles. Prenatal participation provides perspectives on maternal, fetal, and placental contributions to health or disease for fetal and subsequent neonatal neurology consultations. This program also provides an early-life diagnostic perspective for neurologic specialties concerned with brain health and disease throughout childhood and adulthood. Animal models and birth cohort studies have demonstrated how the science of epigenetics helps to understand gene-environment interactions to better predict brain health or disease. Fetal neurology consultations provide important diagnostic contributions during critical or sensitive periods of brain development when future neurotherapeutic interventions will maximize adaptive neuroplasticity. Age-specific normative neuroinformatics databases that employ computer-based strategies to integrate clinical/demographic, neuroimaging, neurophysiologic, and genetic datasets will more accurately identify either symptomatic patients or those at risk for brain disorders who would benefit from preventive, rescue, or reparative treatment choices throughout the life span.
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Affiliation(s)
- Mark S Scher
- Division of Pediatric Neurology, Case Western Reserve University, Cleveland, OH, United States.
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Wang J, Xia F, Zhou Y, Wei X, Zhuang Y, Huang Y. Association Between Endometrial/Subendometrial Vasculature and Embryo Transfer Outcome: A Meta-analysis and Subgroup Analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:149-163. [PMID: 28715087 DOI: 10.1002/jum.14319] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 03/17/2017] [Accepted: 04/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To examine the association between endometrial/subendometrial vasculature and in vitro fertilization-embryo transfer (IVF-ET) and frozen embryo transfer (FET) outcomes. METHODS A meta-analysis of studies using endometrial/subendometrial 3-dimensional ultrasound and power Doppler angiography was performed to examine the vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) in pregnant and nonpregnant women. Ten articles were analyzed, including 895 pregnant women and 882 nonpregnant women. RESULTS A subgroup analysis of the measuring time showed that the endometrial VI (standardized mean difference [SMD], 0.57; 95% confidence interval [CI], 0.40, 0.74; P < .00001), FI (SMD, 0.56; 95% CI, 0.33, 0.78; P < .00001), and VFI (SMD, 0.45; 95% CI, 0.28, 0.61; P < .00001) measured on the ET day, but not on the human chorionic gonadotropin (hCG) trigger day, were significantly higher in pregnant than nonpregnant women. Additionally, the subendometrial FI was significantly increased in pregnant women on the both hCG day (SMD, 0.68; 95% CI, 0.31, 1.06; P = .004) and ET day (SMD, 0.30; 95% CI, 0.08, 0.52; P = .007). A subgroup analysis of cycle type showed that the endometrial VI (SMD, 0.52; 95% CI, 0.30, 0.74; P < .00001), FI (SMD, 0.44; 95% CI, 0.22, 0.66; P = .0001), and VFI (SMD, 0.45; 95% CI, 0.23, 0.67; P = .03) on the ET day were significantly increased in pregnant women in the FET subgroup. CONCLUSIONS The subendometrial FI on the hCG day and endometrial VI, FI, and VFI on the ET day are potentially associated with pregnancy occurrence during IVF-ET. The endometrial VI, FI, and VFI could help identify appropriate timing for FET. However, the accuracy of these indices in predicting pregnancy occurrence must be further evaluated in additional large-scale studies.
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Affiliation(s)
- Jianing Wang
- Reproductive Center, First Affiliated Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | - Fei Xia
- Reproductive Center, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ying Zhou
- Reproductive Center, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuedong Wei
- Reproductive Center, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yanyan Zhuang
- Reproductive Center, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yingxue Huang
- Reproductive Center, First Affiliated Hospital of Soochow University, Suzhou, China
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