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Tract-Specific Group Analysis in Fetal Cohorts Using in utero Diffusion Tensor Imaging
Shadab Khan1, Caitlin K Rollins1, Cynthia M Ortinau2
1Boston Children's Hospital and Harvard Medical School, 360 Longwood Avenue, Boston, MA, USA.
Summary
This study introduces a new framework for fetal diffusion tensor imaging (DTI) analysis, overcoming challenges like fetal motion. It reveals the first in utero DTI evidence of white matter differences in fetuses with congenital heart disease.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Medical Imaging
Background:
- Diffusion tensor imaging (DTI) is crucial for studying white matter injuries across age groups.
- Existing DTI methods face significant challenges in fetal cohorts, including fetal motion, short scan times, and low signal-to-noise ratio, limiting in utero analysis.
Purpose of the Study:
- To present a novel framework for robust group-wise analysis of in utero fetal DTI data.
- To address the technical limitations hindering DTI application in fetal populations.
- To enable systematic evaluation of group differences in fetal white matter development.
Main Methods:
- Developed a motion-robust DTI computation approach.
- Introduced an unbiased DTI template construction method.
- Unified kernel regression with age and tensor-specific registration for unbiased DTI volume normalization.
- Employed a robust statistical approach to map region-specific group differences.
Main Results:
- Successfully applied the framework to analyze in utero DTI data from fetuses with congenital heart disease and healthy controls.
- Demonstrated, for the first time, significant differences in local white matter fractional anisotropy in fetuses with congenital heart disease.
- Validated the framework's capability to detect subtle white matter alterations in utero.
Conclusions:
- The proposed framework effectively overcomes challenges in fetal DTI group analysis.
- Fetal-specific pipelines are essential for accurate DTI-based group analysis in fetal cohorts.
- This work paves the way for early detection and understanding of neurodevelopmental differences in utero.

