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From Slices to Surfaces: The Feasibility of Fetal Brain Biometry Using 3D Slice-to-Volume MRI in Clinical Practice
Nicole Steinhardt1, Darragh Brady1, Anna Baer1
1From the Department of Radiology and Imaging Sciences (N.S., D.B., A.B., K.R., A.R. M.-R., A.E.G.-Y.), Pediatrics (Z.H.), Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology (D.B., A.B., K.R., E.D., B.S., A.R.M.-R., A.E.G.-Y.), Children's Healthcare of Atlanta, Atlanta, GA, USA and University of South Florida Health Morsani College of Medicine (A.V.), Tampa, FL, USA.
Background And Purpose:
Fetal brain biometry on magnetic resonance imaging (MRI) is essential for assessing neurodevelopment, but the standard-of-care two-dimensional (2D) acquisitions are susceptible to motion artifact and planar obliquity, which can compromise measurement accuracy. This study aimed to evaluate the feasibility, reliability, and efficiency of performing standard fetal brain biometry on multiplanar reconstructions (MPRs) generated with slice-to-volume reconstruction (SVR) compared with the conventional 2D approach.
Materials And Methods:
This IRB-approved retrospective study included twenty consecutive fetal MRI examinations with normal-appearing brains and indications other than central nervous system abnormalities. Three fellowship-trained pediatric neuroradiologists independently measured eight key biometric parameters on both standard 2D Half-Fourier Acquisition Single-shot Turbo spin-Echo (HASTE) images and on MPRs from SVR volumes. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC). Measurement differences, subjective image quality (0-3 scale), and measurement time were compared using the paired Wilcoxon signed-rank test.
Results:
Excellent inter-rater reliability was observed for all biometric parameters on both 2D (ICC range, 0.87-0.99) and SVR images (ICC range, 0.93-0.99). The median image quality score was significantly higher for 3D SVR images (3) compared with 2D images (2) across all raters (p <0.001). Measurement time was significantly shorter with SVR than with 2D images. While overall 2D and SVR measurements were similar across raters, corpus callosum length was consistently and significantly smaller on SVR images for all raters.
Conclusions:
Fetal brain biometry using SVR is a feasible, reliable, and efficient alternative to standard 2D imaging. The technique provides superior image quality and reduces measurement time while maintaining excellent inter-rater reliability. The systematic difference in corpus callosum measurements suggests that 3D SVR may improve accuracy by correcting for measurement bias inherent in oblique 2D acquisitions.
