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MRI-Derived Fetal Weight Estimation in the Midpregnancy Fetus: A Method Comparison Study
Jacqueline Matthew1, Emily Skelton1, Lisa Story1,2
1School of Biomedical Engineering and Imaging Sciences and School of Life Course Sciences, Faculty of Life Sciences in Medicine, King's College London, London, United Kingdom.
Fetal Diagnosis and Therapy
|November 24, 2021
Summary
Magnetic Resonance Imaging (MRI) estimated fetal weight (EFW) requires formula refinement for mid-pregnancy fetuses. Ultrasound (US) EFW showed a smaller difference compared to actual birthweight in preterm infants.
Area of Science:
- Medical Imaging
- Fetal Development
- Quantitative Analysis
Background:
- Accurate fetal weight estimation is crucial for managing pregnancy complications.
- Standard ultrasound (US) methods for estimated fetal weight (EFW) are widely used.
- Magnetic Resonance Imaging (MRI) offers advanced volumetric capabilities for fetal assessment.
Purpose of the Study:
- To compare the accuracy of standard US EFW with MRI volume-derived EFW in mid-pregnancy fetuses.
- To evaluate the intra- and interobserver variability of both US and MRI EFW methods.
- To assess the performance of MRI-EFW in preterm fetuses compared to actual birthweight.
Main Methods:
- Twenty-five paired US and MRI scans were analyzed for EFW calculation in fetuses between 20-26 weeks gestational age.
- Intra- and interobserver variability were assessed by two operators for both modalities.
- A sub-analysis compared MRI-EFW and US-EFW with actual birthweight in 5 preterm infants.
Main Results:
- Two MRI volumetry EFW formulae significantly under-measured fetal weight compared to US in mid-pregnancy.
- MRI volumetry demonstrated excellent intra- and interobserver agreement (ICC = 0.998 and 0.993).
- In preterm fetuses, MRI-EFW showed a larger mean relative difference from expected birthweight than US-EFW.
Conclusions:
- MRI-derived EFW requires formula refinement for use in the second trimester of pregnancy.
- While MRI volumetry offers high observer agreement, its accuracy for EFW in mid-pregnancy needs improvement.
- Further research is needed to optimize MRI EFW calculations, especially for smaller fetuses and preterm infants, accounting for variations in fetal density.
