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Hennocq Q, Garcelon N, Bongibault T, Bouygues T, Marlin S, Amiel J, Boutaud L, Douillet M, Lyonnet S, Pingault V, Picard A, Rio M, Attie-Bitach T, Khonsari RH, Roux N. Artificial intelligence-based diagnosis in fetal pathology using external ear shapes. Prenat Diagn 2024. [PMID: 38635411 DOI: 10.1002/pd.6577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 03/28/2024] [Accepted: 04/07/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Here we trained an automatic phenotype assessment tool to recognize syndromic ears in two syndromes in fetuses-=CHARGE and Mandibulo-Facial Dysostosis Guion Almeida type (MFDGA)-versus controls. METHOD We trained an automatic model on all profile pictures of children diagnosed with genetically confirmed MFDGA and CHARGE syndromes, and a cohort of control patients, collected from 1981 to 2023 in Necker Hospital (Paris) with a visible external ear. The model consisted in extracting landmarks from photographs of external ears, in applying geometric morphometry methods, and in a classification step using machine learning. The approach was then tested on photographs of two groups of fetuses: controls and fetuses with CHARGE and MFDGA syndromes. RESULTS The training set contained a total of 1489 ear photographs from 526 children. The validation set contained a total of 51 ear photographs from 51 fetuses. The overall accuracy was 72.6% (58.3%-84.1%, p < 0.001), and 76.4%, 74.9%, and 86.2% respectively for CHARGE, control and MFDGA fetuses. The area under the curves were 86.8%, 87.5%, and 90.3% respectively for CHARGE, controls, and MFDGA fetuses. CONCLUSION We report the first automatic fetal ear phenotyping model, with satisfactory classification performances. Further validations are required before using this approach as a diagnostic tool.
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Affiliation(s)
- Quentin Hennocq
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
- Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Laboratoire 'Forme et Croissance Du Crâne', Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Thomas Bongibault
- Imagine Institute, INSERM UMR1163, Paris, France
- Laboratoire 'Forme et Croissance Du Crâne', Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Thomas Bouygues
- Imagine Institute, INSERM UMR1163, Paris, France
- Laboratoire 'Forme et Croissance Du Crâne', Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sandrine Marlin
- Imagine Institute, INSERM UMR1163, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jeanne Amiel
- Imagine Institute, INSERM UMR1163, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Lucile Boutaud
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | | | - Stanislas Lyonnet
- Imagine Institute, INSERM UMR1163, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Vèronique Pingault
- Imagine Institute, INSERM UMR1163, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Arnaud Picard
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
- Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Marlèe Rio
- Imagine Institute, INSERM UMR1163, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Tania Attie-Bitach
- Imagine Institute, INSERM UMR1163, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Roman H Khonsari
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
- Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Laboratoire 'Forme et Croissance Du Crâne', Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nathalie Roux
- Imagine Institute, INSERM UMR1163, Paris, France
- Faculté de Médecine, Université de Paris Cité, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
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Yu QX, Zhen L, Li DZ. Fetal Phenotype of CHARGE Syndrome with a Molecular Confirmation: A Series of 13 Cases. Fetal Diagn Ther 2024:1-7. [PMID: 38631314 DOI: 10.1159/000538949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/12/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION CHARGE syndrome is an autosomal dominant genetic disorder with known pattern of features. The aim of the study was to present the fetal features of CHARGE syndrome to gain awareness that the antenatal characteristics can be very nonspecific. CASE PRESENTATION This was a retrospective study of 13 cases with CHARGE syndrome diagnosed by prenatal or postnatal genetic testing and physical examination. Two (15.4%; 2/13) had normal ultrasound scans during pregnancy. One (7.7%; 1/13) with first-trimester cystic hygroma presented intrauterine fetal demise at 16 weeks gestation. The remaining 10 (76.9%; 10/13) cases had abnormal ultrasound features in utero; among these, 1 had an increased nuchal translucency in the first trimester, 5 had second-trimester abnormal ultrasounds including micrognathia, cardiac defects, and facial defects, and 4 third-trimester abnormal ultrasounds including micrognathia, isolated fetal growth restriction, and polyhydramnios. Among the 11 cases with abnormal prenatal ultrasound scans, no fetus could reach the diagnostic criteria of CHARGE syndrome if only based on the results of ultrasound. However, the diagnosis was made in all cases when CHD7 defects were detected. DISCUSSION/CONCLUSION The CHARGE syndrome presents non-specific abnormal ultrasound markers in utero. Exome sequencing in the genetic workup will aid in prenatal diagnosis of this syndrome.
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Affiliation(s)
- Qiu-Xia Yu
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Li Zhen
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Dong-Zhi Li
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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Lesieur E, Riccardi F, Bault JP, Levaillant JM, Torrents J, Paternostre A, Couly G, Quarello E. [Antenatal ear examination: When, how and why?]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:624-637. [PMID: 35817342 DOI: 10.1016/j.gofs.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/30/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
Antenatal ear examination is an integral part of the thorough examination of the fetal face. The discovery of an anomaly, whether it is made by chance or during a complementary in-depth examination, leads the practitioner to determine its isolated or associated character, in order to characterise its possible belonging to a syndromic entity. In this context, the realization of genetic analysis more precise and wider allowing a return of the results in a time compatible with an evolutive pregnancy, gives to the geneticist a central role in the management of these couples. The main challenge lies in obtaining a set of concordant clinical and biological clues, enabling the genetic results identified to be interpreted correctly, the optimised functioning of the ultrasound practitioner - geneticist duo is therefore fundamental. This results in a complex information to deliver, in the fact that the clinical translation of an ear anomaly in antenatal can go from an isolated aesthetic anomaly to a genetic syndrome with neurodevelopmental disorder. The objective of this work is to describe, from a methodological analysis of antenatal ears, the accessible malformative entities, isolated or associated, and to discuss the problems in the need or not to propose their screening.
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Affiliation(s)
- E Lesieur
- Department of obstetrics and gynaecology, Prenatal Diagnosis Center, La Conception hospital, Aix Marseille university, boulevard Baille, 13005 Marseille, France; UMR 7268 ADES, Aix-Marseille université, CNRS, EFS, Marseille, France.
| | - F Riccardi
- MMG, Inserm, Aix-Marseille université, Marseille, France
| | - J-P Bault
- Department of gynaecology and obstetrics, CHI Poissy-St-Germain, 78300 Poissy, France; Centre d'échographie Ambroise-Paré, 68/70, rue Aristide-Briand, 78130 Les Mureaux, France; Plateforme Lumière, hôpital Necker-Enfant Malade, Paris, France
| | - J-M Levaillant
- Center for Woman and Fetal Imaging, 59000, France; Hôpital Privé Armand Brillard, Groupe Ramsay Générale De Santé, 94130 Nogent-sur-Marne, France
| | - J Torrents
- Department of Pathology and Neuropathology, La Timone Hospital, Aix Marseille University, Marseille, France
| | - A Paternostre
- Department of gynaecology and obstetrics, CHI Poissy-St-Germain, 78300 Poissy, France; European Center of Diagnosis and Exploration of the Woman, 78150 Le Chesnay, France
| | - G Couly
- Center for Woman and Fetal Imaging, 59800 Lille, France
| | - E Quarello
- Department of obstetrics and gynecology, screening and diagnosis unit, Saint Joseph hospital, 26, boulevard de Louvain, 13008 Marseille, France; IMAGE2 Center, 6, rue Rocca, 13008 Marseille, France
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