MRI improves detection of abnormalities in unborn babies

Results from newly published study are invaluable in improving care for babies before they are born and after delivery.

Mri babiesA large multidisciplinary study led by King’s College London with Evelina London Children’s Hospital, part of Guy’s and St Thomas’ NHS Foundation Trust, Great Ormond Street Hospital and UCL has determined that MRI scanning can more precisely define and detect head, neck, thoracic, abdominal and spinal malformations in unborn babies.

In the study, published in Lancet Child and Adolescent Health, the team of researchers and clinicians demonstrate the ways that MRI scanning can show malformations in great detail, including their effect on surrounding structures. Importantly, they note that MRI is a very safe procedure for pregnant women and their babies. This work is said to be invaluable both to clinicians caring for babies before they are born and for teams planning care of the baby after delivery.

Recent research has concentrated on correcting fetal movement in fetal brain MRI and, more recently, for imaging the fetal heart. However, there is an increasing demand to assess the entire fetus with MRI and research from King’s College London School of Biomedical Engineering & Imaging Sciences at Evelina London Children’s Hospital, has recently been able to develop a post-acquisition pipeline to motion correct and volume reconstruct images of the whole fetal body.

Lead researcher, Prof Mary Rutherford, from the School of Biomedical Engineering & Imaging Sciences, said ultrasound remains the gold standard for fetal screening and is complementary to these optimised MRI approaches for evaluating abnormalities of the fetal body. She said:

Until now, ultrasound has been the modality of choice to diagnose those anomalies. However, sometimes the ability of ultrasound to define the most detailed anatomy is limited. MRI scanning offers the potential to more precisely define malformations that could help support clinicians in their planning of care and counselling of parents.

MRI is less commonly used in the classification of fetal body anomalies, but advances have led to the validation of its role in the antenatal investigation of several conditions. New approaches to imaging the fetal body with MRI improves visualisation and therefore detection and characterisation of abnormalities. For the investigation of fetuses with spina bifida, for example, imaging of the fetal brain along with the spinal cord is an important factor in evaluating which patients could benefit from fetal surgery.

For fetal neck masses, MRI provides a clear advantage over conventional ultrasound for assessing tumour extension and giving a 3D visualisation of the tumour’s relation to the airway. MRI may also be better than ultrasound for distinguishing between normal and abnormal lung tissue, and in making other diagnoses such as diaphragmatic hernia—particularly in late gestation, when doing so with ultrasound is challenging.

New approaches to imaging the fetal body with MRI allows both motion correction of the fetal images and volume reconstructions of body organs and defects. Researchers say this improves visualisation and therefore detection and characterisation of abnormalities. The project brought together surgeons, fetal medicine specialists, radiologists and physicists to review the use of magnetic resonance imaging to investigate conditions in the unborn baby. This approach has already been integrated into clinical practice at Evelina London Children’s Hospital. Ongoing work is focused on a fully automated process suitable for clinical translation and wider dissemination into clinical practice.

You can view the full article on the King’s College London website.

Our vision is to bring together and build on the extensive strengths of King’s Health Partners to create an Institute of Women and Children’s Health that will improve outcomes for women and children in our local area, nationally and internationally. 

Liked this article? Meet Prof Lucy Chappell, National Institute for Health Research (NIHR) Research Professor in Obstetrics, King’s College London, who has been appointed NIHR Senior Investigator.