Concordance between US and MRI Two-Dimensional Measurement and Volumetric Segmentation in Fetal Ventriculomegaly

George Hadjidekov; Gleb Haynatzki; Petya Chaveeva; Miroslav Nikolov; Gabriele Masselli; Andrea Rossi

doi:10.3390/diagnostics13061183

Concordance between US and MRI Two-Dimensional Measurement and Volumetric Segmentation in Fetal Ventriculomegaly

Diagnostics (Basel). 2023 Mar 20;13(6):1183. doi: 10.3390/diagnostics13061183.

Authors

George Hadjidekov^{1

2}, Gleb Haynatzki³, Petya Chaveeva⁴, Miroslav Nikolov⁵, Gabriele Masselli⁶, Andrea Rossi^{7

8}

Affiliations

¹ Department of Radiology, University Hospital Lozenetz, Koziak 1 Str., 1407 Sofia, Bulgaria.
² Department of Physics, Biophysics and Radiology, Faculty of Medicine, Sofia University "St Kliment Ohridski", 1504 Sofia, Bulgaria.
³ Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
⁴ Department of Fetal Medicine, Shterev Hospital, 1330 Sofia, Bulgaria.
⁵ Department of Theoretical Electrical Engineering, Technical University, 1156 Sofia, Bulgaria.
⁶ Radiology Department, Umberto 1 Hospital Sapienza University, 00161 Rome, Italy.
⁷ Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genoa, Italy.
⁸ Department of Health Sciences, University of Genoa, 16126 Genoa, Italy.

Abstract

We provide a study comparison between two-dimensional measurement and volumetric (3D) segmentation of the lateral ventricles and brain structures in fetuses with isolated and non-isolated ventriculomegaly with 3D virtual organ computer-aided analysis (VOCAL) ultrasonography vs. magnetic resonance imaging (MRI) analyzed with 3D-Slicer software. In this cross-sectional study, 40 fetuses between 20 and 38 gestational weeks with various degrees of ventriculomegaly were included. A total of 71 ventricles were measured with ultrasound (US) and with MRI. A total of 64 sonographic ventricular volumes, 80 ventricular and 40 fetal brain MR volumes were segmented and analyzed using both imaging modalities by three observers. Sizes and volumes of the ventricles and brain parenchyma were independently analyzed by two radiologists, and interobserver correlation of the results with 3D fetal ultrasound data was performed. The semiautomated rotational multiplanar 3D VOCAL technique was performed for ultrasound volumetric measurements. Results were compared to manually extracted ventricular and total brain volumes in 3D-Slicer. Segmentation of fetal brain structures (cerebral and cerebellar hemispheres, brainstem, ventricles) performed independently by two radiologists showed high interobserver agreement. An excellent agreement between VOCAL and MRI volumetric and two-dimensional measurements was established, taking into account the intraclass correlation coefficients (ICC), and a Bland-Altman plot was established. US and MRI are valuable tools for performing fetal brain and ventricular volumetry for clinical prognosis and patient counseling. Our datasets could provide the backbone for further construction of quantitative normative trajectories of fetal intracranial structures and support earlier detection of abnormal brain development and ventriculomegaly, its timing and progression during gestation.

Keywords: 3D-Slicer; 3D-US; VOCAL; fetal MRI; fetal ventricular and brain segmentation; fetal ventriculomegaly; three-dimensional ultrasonography; virtual organ computer-aided analysis.

Grants and funding

This research received no external funding.