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Chappell J, Aughwane R, Clark AR, Ourselin S, David AL, Melbourne A. A review of feto-placental vasculature flow modelling. Placenta 2023; 142:56-63. [PMID: 37639951 PMCID: PMC10873207 DOI: 10.1016/j.placenta.2023.08.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023]
Abstract
The placenta provides the vital nutrients and removal of waste products required for fetal growth and development. Understanding and quantifying the differences in structure and function between a normally functioning placenta compared to an abnormal placenta is vital to provide insights into the aetiology and treatment options for fetal growth restriction and other placental disorders. Computational modelling of blood flow in the placenta allows a new understanding of the placental circulation to be obtained. This structured review discusses multiple recent methods for placental vascular model development including analysis of the appearance of the placental vasculature and how placental haemodynamics may be simulated at multiple length scales.
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Affiliation(s)
- Joanna Chappell
- School of Biomedical Engineering and Imaging Sciences (BMEIS), King's College, London, UK.
| | - Rosalind Aughwane
- Elizabeth Garrett Anderson Institute for Women's Health, University College, London, UK
| | | | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences (BMEIS), King's College, London, UK
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College, London, UK
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences (BMEIS), King's College, London, UK
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2
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Clark A, Flouri D, Mufti N, James J, Clements E, Aughwane R, Aertsen M, David A, Melbourne A. Developments in functional imaging of the placenta. Br J Radiol 2023; 96:20211010. [PMID: 35234516 PMCID: PMC10321248 DOI: 10.1259/bjr.20211010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/26/2022] [Accepted: 02/22/2022] [Indexed: 12/21/2022] Open
Abstract
The placenta is both the literal and metaphorical black box of pregnancy. Measurement of the function of the placenta has the potential to enhance our understanding of this enigmatic organ and serve to support obstetric decision making. Advanced imaging techniques are key to support these measurements. This review summarises emerging imaging technology being used to measure the function of the placenta and new developments in the computational analysis of these data. We address three important examples where functional imaging is supporting our understanding of these conditions: fetal growth restriction, placenta accreta, and twin-twin transfusion syndrome.
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Affiliation(s)
- Alys Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | | | | | - Joanna James
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eleanor Clements
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Rosalind Aughwane
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UK
| | - Michael Aertsen
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Anna David
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UK
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3
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Flouri D, Darby JRT, Holman SL, Cho SKS, Dimasi CG, Perumal SR, Ourselin S, Aughwane R, Mufti N, Macgowan CK, Seed M, David AL, Melbourne A, Morrison JL. Placental MRI Predicts Fetal Oxygenation and Growth Rates in Sheep and Human Pregnancy. Adv Sci (Weinh) 2022; 9:e2203738. [PMID: 36031385 PMCID: PMC9596844 DOI: 10.1002/advs.202203738] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/05/2022] [Indexed: 06/09/2023]
Abstract
Magnetic resonance imaging (MRI) assessment of fetal blood oxygen saturation (SO2 ) can transform the clinical management of high-risk pregnancies affected by fetal growth restriction (FGR). Here, a novel MRI method assesses the feasibility of identifying normally grown and FGR fetuses in sheep and is then applied to humans. MRI scans are performed in pregnant ewes at 110 and 140 days (term = 150d) gestation and in pregnant women at 28+3 ± 2+5 weeks to measure feto-placental SO2 . Birth weight is collected and, in sheep, fetal blood SO2 is measured with a blood gas analyzer (BGA). Fetal arterial SO2 measured by BGA predicts fetal birth weight in sheep and distinguishes between fetuses that are normally grown, small for gestational age, and FGR. MRI feto-placental SO2 in late gestation is related to fetal blood SO2 measured by BGA and body weight. In sheep, MRI feto-placental SO2 in mid-gestation is related to fetal SO2 later in gestation. MRI feto-placental SO2 distinguishes between normally grown and FGR fetuses, as well as distinguishing FGR fetuses with and without normal Doppler in humans. Thus, a multi-compartment placental MRI model detects low placental SO2 and distinguishes between small hypoxemic fetuses and normally grown fetuses.
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Affiliation(s)
- Dimitra Flouri
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonSE1 7EUUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonWC1E 6BTUK
| | - Jack R. T. Darby
- Early Origins of Adult Health Research GroupHealth and Biomedical InnovationUniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSA 5001Australia
| | - Stacey L. Holman
- Early Origins of Adult Health Research GroupHealth and Biomedical InnovationUniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSA 5001Australia
| | - Steven K. S. Cho
- Early Origins of Adult Health Research GroupHealth and Biomedical InnovationUniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSA 5001Australia
- Department of PhysiologyThe Hospital for Sick ChildrenUniversity of TorontoTorontoON M5G 1X8Canada
| | - Catherine G. Dimasi
- Early Origins of Adult Health Research GroupHealth and Biomedical InnovationUniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSA 5001Australia
| | - Sunthara R. Perumal
- South Australian Health & Medical Research InstitutePreclinicalImaging & Research LaboratoriesAdelaideSA 5001Australia
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonSE1 7EUUK
| | - Rosalind Aughwane
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonWC1E 6BTUK
- Elizabeth Garrett Anderson Institute for Women's HealthUniversity College LondonLondonWC1E 6AUUK
| | - Nada Mufti
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonWC1E 6BTUK
- Elizabeth Garrett Anderson Institute for Women's HealthUniversity College LondonLondonWC1E 6AUUK
| | - Christopher K. Macgowan
- Division of Translational MedicineThe Hospital for Sick ChildrenUniversity of TorontoTorontoON M5G 1X8Canada
- Department of Medical BiophysicsUniversity of TorontoTorontoON M5S 1A1Canada
| | - Mike Seed
- Department of PaediatricsDivision of CardiologyThe Hospital for Sick ChildrenUniversity of TorontoTorontoON M5G 1X8Canada
- Department of Diagnostic ImagingThe Hospital for Sick ChildrenUniversity of TorontoTorontoON M5G 1X8Canada
| | - Anna L. David
- Elizabeth Garrett Anderson Institute for Women's HealthUniversity College LondonLondonWC1E 6AUUK
- NIHR Biomedical Research CentreUniversity College London HospitalsLondonW1T 7DNUK
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonSE1 7EUUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonWC1E 6BTUK
- Early Origins of Adult Health Research GroupHealth and Biomedical InnovationUniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSA 5001Australia
| | - Janna L. Morrison
- Early Origins of Adult Health Research GroupHealth and Biomedical InnovationUniSA Clinical and Health SciencesUniversity of South AustraliaAdelaideSA 5001Australia
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4
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Byrne M, Aughwane R, James JL, Hutchinson JC, Arthurs OJ, Sebire NJ, Ourselin S, David AL, Melbourne A, Clark AR. Structure-function relationships in the feto-placental circulation from in silico interpretation of micro-CT vascular structures. J Theor Biol 2021; 517:110630. [PMID: 33607145 DOI: 10.1016/j.jtbi.2021.110630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 10/22/2022]
Abstract
A well-functioning placenta is critical for healthy fetal development, as the placenta brings fetal blood in close contact with nutrient rich maternal blood, enabling exchange of nutrients and waste between mother and fetus. The feto-placental circulation forms a complex branching structure, providing blood to fetal capillaries, which must receive sufficient blood flow to ensure effective exchange, but at a low enough pressure to prevent damage to placental circulatory structures. The branching structure of the feto-placental circulation is known to be altered in complications such as fetal growth restriction, and the presence of regions of vascular dysfunction (such as hypovascularity or thrombosis) are proposed to elevate risk of placental pathology. Here we present a methodology to combine micro-computed tomography and computational model-based analysis of the branching structure of the feto-placental circulation in ex vivo placentae from normal term pregnancies. We analyse how vascular structure relates to function in this key organ of pregnancy; demonstrating that there is a 'resilience' to placental vascular structure-function relationships. We find that placentae with variable chorionic vascular structures, both with and without a Hyrtl's anastomosis between the umbilical arteries, and those with multiple regions of poorly vascularised tissue are able to function with a normal vascular resistance. Our models also predict that by progressively introducing local heterogeneity in placental vascular structure, large increases in feto-placental vascular resistances are induced. This suggests that localised heterogeneities in placental structure could potentially provide an indicator of increased risk of placental dysfunction.
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Affiliation(s)
- Monika Byrne
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Rosalind Aughwane
- Department of Maternal Fetal Medicine, Prenatal Cell and Gene Therapy Group, Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, WC1E 6HX, United Kingdom
| | - Joanna L James
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - J Ciaran Hutchinson
- NIHR GOS Institute of Child Health Biomedical Research Centre, University College, London, United Kingdom; Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Owen J Arthurs
- NIHR GOS Institute of Child Health Biomedical Research Centre, University College, London, United Kingdom; Paediatric Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Neil J Sebire
- NIHR GOS Institute of Child Health Biomedical Research Centre, University College, London, United Kingdom; Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, Kings College London, United Kingdom
| | - Anna L David
- Department of Maternal Fetal Medicine, Prenatal Cell and Gene Therapy Group, Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, WC1E 6HX, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, 149 Tottenham Court Road, London, W1T 7DN, United Kingdom
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences, Kings College London, United Kingdom
| | - Alys R Clark
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
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5
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Couper S, Clark A, Thompson JMD, Flouri D, Aughwane R, David AL, Melbourne A, Mirjalili A, Stone PR. The effects of maternal position, in late gestation pregnancy, on placental blood flow and oxygenation: an MRI study. J Physiol 2021; 599:1901-1915. [PMID: 33369732 DOI: 10.1113/jp280569] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/10/2020] [Indexed: 01/07/2023] Open
Abstract
KEY POINTS Maternal supine sleep position in late pregnancy is associated with an increased risk of stillbirth. Maternal supine position in late pregnancy reduces maternal cardiac output and uterine blood flow. Using MRI, this study shows that compared to the left lateral position, maternal supine position in late pregnancy is associated with reduced utero-placental blood flow and oxygen transfer across the placenta with an average 6.2% reduction in oxygen delivery to the fetus and an average 11% reduction in fetal umbilical venous blood flow. ABSTRACT Maternal sleep position in late gestation is associated with an increased risk of stillbirth, though the pathophysiological reasons for this are unclear. Studies using magnetic resonance imaging (MRI) have shown that compared with lateral positions, lying supine causes a reduction in cardiac output, reduced abdominal aortic blood flow and reduced vena caval flow which is only partially compensated for by increased flow in the azygos venous system. Using functional MRI techniques, including an acquisition termed diffusion-relaxation combined imaging of the placenta (DECIDE), which combines diffusion weighted imaging and T2 relaxometry, blood flow and oxygen transfer were estimated in the maternal, fetal and placental compartments when subjects were scanned both supine and in left lateral positions. In late gestation pregnancy, lying supine caused a 23.7% (P < 0.0001) reduction in total internal iliac arterial blood flow to the uterus. In addition, lying in the supine position caused a 6.2% (P = 0.038) reduction in oxygen movement across the placenta. The reductions in oxygen transfer to the fetus, termed delivery flux, of 11.2% (P = 0.0597) and in fetal oxygen saturation of 4.4% (P = 0.0793) did not reach statistical significance. It is concluded that even in healthy late gestation pregnancy, maternal position significantly affects oxygen transfer across the placenta and may in part provide an explanation for late stillbirth in vulnerable fetuses.
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Affiliation(s)
- Sophie Couper
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Alys Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - John M D Thompson
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.,Department of Paediatrics and Child Health, University of Auckland, Auckland, New Zealand
| | - Dimitra Flouri
- School of Biomedical Engineering and Imaging, Kings College London, London, UK
| | - Rosalind Aughwane
- Elizabeth Garrett Anderson Institute for Women's Health, University College, Huntley Street, London, UK
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College, Huntley Street, London, UK
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging, Kings College London, London, UK
| | - Ali Mirjalili
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Peter R Stone
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
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6
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Aughwane R, Mufti N, Flouri D, Maksym K, Spencer R, Sokolska M, Kendall G, Atkinson D, Bainbridge A, Deprest J, Vercauteren T, Ourselin S, David AL, Melbourne A. Magnetic resonance imaging measurement of placental perfusion and oxygen saturation in early-onset fetal growth restriction. BJOG 2020; 128:337-345. [PMID: 32603546 PMCID: PMC7613436 DOI: 10.1111/1471-0528.16387] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE We hypothesised that a multi-compartment magnetic resonance imaging (MRI) technique that is sensitive to fetal blood oxygenation would identify changes in placental blood volume and fetal blood oxygenation in pregnancies complicated by early-onset fetal growth restriction (FGR). DESIGN Case-control study. SETTING London, UK. POPULATION Women with uncomplicated pregnancies (estimated fetal weight [EFW] >10th centile for gestational age [GA] and normal maternal and fetal Doppler ultrasound, n = 12) or early-onset FGR (EFW <3rd centile with or without abnormal Doppler ultrasound <32 weeks GA, n = 12) were studied. METHODS All women underwent MRI examination. Using a multi-compartment MRI technique, we quantified fetal and maternal blood volume and feto-placental blood oxygenation. MAIN OUTCOME MEASURES Disease severity was stratified according to Doppler pulsatility index and the relationship to the MRI parameters was investigated, including the influence of GA at scan. RESULTS The FGR group (mean GA 27+5 weeks, range 24+2 to 33+6 weeks) had a significantly lower EFW compared with the control group (mean GA 29+1 weeks; -705 g, 95% CI -353 to -1057 g). MRI-derived feto-placental oxygen saturation was higher in controls compared with FGR (75 ± 9.6% versus 56 ± 16.2%, P = 0.02, 95% CI 7.8-30.3%). Feto-placental oxygen saturation estimation correlated strongly with GA at scan in controls (r = -0.83). CONCLUSION Using a novel multimodal MRI protocol we demonstrated reduced feto-placental blood oxygen saturation in pregnancies complicated by early-onset FGR. The degree of abnormality correlated with disease severity defined by ultrasound Doppler findings. Gestational age-dependent changes in oxygen saturation were also present in normal pregnancies. TWEETABLE ABSTRACT MRI reveals differences in feto-placental oxygen saturation between normal and FGR pregnancy that is associated with disease severity.
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Affiliation(s)
- R Aughwane
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - N Mufti
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - D Flouri
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK.,School of Biomedical Engineering and Imaging, Kings College London, London, UK
| | - K Maksym
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - R Spencer
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,University of Leeds, Leeds, UK
| | - M Sokolska
- Medical Physics, University College Hospital, London, UK
| | - G Kendall
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - D Atkinson
- Centre for Medical Imaging, University College London, London, UK
| | - A Bainbridge
- Medical Physics, University College Hospital, London, UK
| | - J Deprest
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,School of Biomedical Engineering and Imaging, Kings College London, London, UK.,University Hospital KU Leuven, Leuven, Belgium
| | - T Vercauteren
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK.,School of Biomedical Engineering and Imaging, Kings College London, London, UK
| | - S Ourselin
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK.,School of Biomedical Engineering and Imaging, Kings College London, London, UK
| | - A L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,University Hospital KU Leuven, Leuven, Belgium.,NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - A Melbourne
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Department of Medical Physics and Biomedical Engineering, University College London, London, UK.,School of Biomedical Engineering and Imaging, Kings College London, London, UK
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7
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Maneas E, Aughwane R, Huynh N, Xia W, Ansari R, Kuniyil Ajith Singh M, Hutchinson JC, Sebire NJ, Arthurs OJ, Deprest J, Ourselin S, Beard PC, Melbourne A, Vercauteren T, David AL, Desjardins AE. Photoacoustic imaging of the human placental vasculature. J Biophotonics 2020; 13:e201900167. [PMID: 31661594 PMCID: PMC8425327 DOI: 10.1002/jbio.201900167] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/02/2019] [Accepted: 10/03/2019] [Indexed: 05/06/2023]
Abstract
Minimally invasive fetal interventions require accurate imaging from inside the uterine cavity. Twin-to-twin transfusion syndrome (TTTS), a condition considered in this study, occurs from abnormal vascular anastomoses in the placenta that allow blood to flow unevenly between the fetuses. Currently, TTTS is treated fetoscopically by identifying the anastomosing vessels, and then performing laser photocoagulation. However, white light fetoscopy provides limited visibility of placental vasculature, which can lead to missed anastomoses or incomplete photocoagulation. Photoacoustic (PA) imaging is an alternative imaging method that provides contrast for hemoglobin, and in this study, two PA systems were used to visualize chorionic (fetal) superficial and subsurface vasculature in human placentas. The first system comprised an optical parametric oscillator for PA excitation and a 2D Fabry-Pérot cavity ultrasound sensor; the second, light emitting diode arrays and a 1D clinical linear-array ultrasound imaging probe. Volumetric photoacoustic images were acquired from ex vivo normal term and TTTS-treated placentas. It was shown that superficial and subsurface branching blood vessels could be visualized to depths of approximately 7 mm, and that ablated tissue yielded negative image contrast. This study demonstrated the strong potential of PA imaging to guide minimally invasive fetal therapies.
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Affiliation(s)
- Efthymios Maneas
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Rosalind Aughwane
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Institute for Women's Health, University College LondonLondonUK
| | - Nam Huynh
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Wenfeng Xia
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences, King's College LondonLondonUK
| | - Rehman Ansari
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | | | - J. Ciaran Hutchinson
- NIHR Great Ormond Street Institute of Child Health Biomedical Research Centre, University College LondonLondonUK
- Department of HistopathologyGreat Ormond Street Hospital for Children NHS TrustLondonUK
| | - Neil J. Sebire
- NIHR Great Ormond Street Institute of Child Health Biomedical Research Centre, University College LondonLondonUK
- Department of HistopathologyGreat Ormond Street Hospital for Children NHS TrustLondonUK
| | - Owen J. Arthurs
- NIHR Great Ormond Street Institute of Child Health Biomedical Research Centre, University College LondonLondonUK
- Paediatric Radiology, Great Ormond Street Hospital for Children NHS TrustLondonUK
| | - Jan Deprest
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Institute for Women's Health, University College LondonLondonUK
- Department of Obstetrics and GynaecologyUniversity Hospitals LeuvenLeuvenBelgium
| | - Sebastien Ourselin
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences, King's College LondonLondonUK
| | - Paul C. Beard
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Andrew Melbourne
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences, King's College LondonLondonUK
| | - Tom Vercauteren
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences, King's College LondonLondonUK
| | - Anna L. David
- Institute for Women's Health, University College LondonLondonUK
| | - Adrien E. Desjardins
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
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8
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Ebner M, Wang G, Li W, Aertsen M, Patel PA, Aughwane R, Melbourne A, Doel T, Dymarkowski S, De Coppi P, David AL, Deprest J, Ourselin S, Vercauteren T. An automated framework for localization, segmentation and super-resolution reconstruction of fetal brain MRI. Neuroimage 2020; 206:116324. [PMID: 31704293 PMCID: PMC7103783 DOI: 10.1016/j.neuroimage.2019.116324] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/26/2019] [Accepted: 10/29/2019] [Indexed: 12/17/2022] Open
Abstract
High-resolution volume reconstruction from multiple motion-corrupted stacks of 2D slices plays an increasing role for fetal brain Magnetic Resonance Imaging (MRI) studies. Currently existing reconstruction methods are time-consuming and often require user interactions to localize and extract the brain from several stacks of 2D slices. We propose a fully automatic framework for fetal brain reconstruction that consists of four stages: 1) fetal brain localization based on a coarse segmentation by a Convolutional Neural Network (CNN), 2) fine segmentation by another CNN trained with a multi-scale loss function, 3) novel, single-parameter outlier-robust super-resolution reconstruction, and 4) fast and automatic high-resolution visualization in standard anatomical space suitable for pathological brains. We validated our framework with images from fetuses with normal brains and with variable degrees of ventriculomegaly associated with open spina bifida, a congenital malformation affecting also the brain. Experiments show that each step of our proposed pipeline outperforms state-of-the-art methods in both segmentation and reconstruction comparisons including expert-reader quality assessments. The reconstruction results of our proposed method compare favorably with those obtained by manual, labor-intensive brain segmentation, which unlocks the potential use of automatic fetal brain reconstruction studies in clinical practice.
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Affiliation(s)
- Michael Ebner
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
| | - Guotai Wang
- School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Chengdu, China; Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
| | - Wenqi Li
- Nvidia, Cambridge, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Michael Aertsen
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Premal A Patel
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK; Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
| | - Rosalind Aughwane
- Institute for Women's Health, University College London, London, UK; Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Tom Doel
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
| | - Steven Dymarkowski
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Paolo De Coppi
- Institute of Child Health, University College London, London, UK
| | - Anna L David
- Institute for Women's Health, University College London, London, UK; Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK; Department of Obstetrics and Gynaecology, University Hospitals KU Leuven, Leuven, Belgium
| | - Jan Deprest
- Department of Obstetrics and Gynaecology, University Hospitals KU Leuven, Leuven, Belgium; Institute for Women's Health, University College London, London, UK; Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
| | - Sébastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK; Department of Obstetrics and Gynaecology, University Hospitals KU Leuven, Leuven, Belgium
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9
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Aughwane R, Ingram E, Johnstone ED, Salomon LJ, David AL, Melbourne A. Placental MRI and its application to fetal intervention. Prenat Diagn 2020; 40:38-48. [PMID: 31306507 PMCID: PMC7027916 DOI: 10.1002/pd.5526] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/18/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Magnetic resonance imaging (MRI) of placental invasion has been part of clinical practice for many years. The possibility of being better able to assess placental vascularization and function using MRI has multiple potential applications. This review summarises up-to-date research on placental function using different MRI modalities. METHOD We discuss how combinations of these MRI techniques have much to contribute to fetal conditions amenable for therapy such as singletons at high risk for fetal growth restriction (FGR) and monochorionic twin pregnancies for planning surgery and counselling for selective growth restriction and transfusion conditions. RESULTS The whole placenta can easily be visualized on MRI, with a clear boundary against the amniotic fluid, and a less clear placental-uterine boundary. Contrasts such as diffusion weighted imaging, relaxometry, blood oxygenation level dependent MRI and flow and metabolite measurement by dynamic contrast enhanced MRI, arterial spin labeling, or spectroscopic techniques are contributing to our wider understanding of placental function. CONCLUSION The future of placental MRI is exciting, with the increasing availability of multiple contrasts and new models that will boost the capability of MRI to measure oxygen saturation and placental exchange, enabling examination of placental function in complicated pregnancies.
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Affiliation(s)
| | - Emma Ingram
- Division of Developmental Biology & MedicineUniversity of ManchesterManchesterUK
| | - Edward D. Johnstone
- Division of Developmental Biology & MedicineUniversity of ManchesterManchesterUK
| | - Laurent J. Salomon
- Hôpital Necker‐Enfants Malades, AP‐HP, EHU PACT and LUMIERE PlatformUniversité Paris DescartesParisFrance
| | - Anna L. David
- Institute for Women's HealthUniversity College LondonLondonUK
- National Institute for Health ResearchUniversity College London Hospitals Biomedical Research CentreLondonUK
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
- Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
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10
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Flouri D, Owen D, Aughwane R, Mufti N, Maksym K, Sokolska M, Kendall G, Bainbridge A, Atkinson D, Vercauteren T, Ourselin S, David AL, Melbourne A. Improved fetal blood oxygenation and placental estimated measurements of diffusion-weighted MRI using data-driven Bayesian modeling. Magn Reson Med 2019; 83:2160-2172. [PMID: 31742785 PMCID: PMC7064949 DOI: 10.1002/mrm.28075] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE Motion correction in placental DW-MRI is challenging due to maternal breathing motion, maternal movements, and rapid intensity changes. Parameter estimates are usually obtained using least-squares methods for voxel-wise fitting; however, they typically give noisy estimates due to low signal-to-noise ratio. We introduce a model-driven registration (MDR) technique which incorporates a placenta-specific signal model into the registration process, and we present a Bayesian approach for Diffusion-rElaxation Combined Imaging for Detailed placental Evaluation model to obtain individual and population trends in estimated parameters. METHODS MDR exploits the fact that a placenta signal model is available and thus we incorporate it into the registration to generate a series of target images. The proposed registration method is compared to a pre-existing method used for DCE-MRI data making use of principal components analysis. The Bayesian shrinkage prior (BSP) method has no user-defined parameters and therefore measures of parameter variation in a region of interest are determined by the data alone. The MDR method and the Bayesian approach were evaluated on 10 control 4D DW-MRI singleton placental data. RESULTS MDR method improves the alignment of placenta data compared to the pre-existing method. It also shows a further reduction of the residual error between the data and the fit. BSP approach showed higher precision leading to more clearly apparent spatial features in the parameter maps. Placental fetal oxygen saturation (FO2 ) showed a negative linear correlation with gestational age. CONCLUSIONS The proposed pipeline provides a robust framework for registering DW-MRI data and analyzing longitudinal changes of placental function.
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Affiliation(s)
- Dimitra Flouri
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - David Owen
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Rosalind Aughwane
- Institute for Women's Health, University College Hospital, London, United Kingdom
| | - Nada Mufti
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Institute for Women's Health, University College Hospital, London, United Kingdom
| | - Kasia Maksym
- Institute for Women's Health, University College Hospital, London, United Kingdom
| | | | - Giles Kendall
- Institute for Women's Health, University College Hospital, London, United Kingdom
| | - Alan Bainbridge
- Medical Physics, University College Hospital, London, United Kingdom
| | - David Atkinson
- Centre for Medical Imaging, University College London, London, United Kingdom
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Anna L David
- Institute for Women's Health, University College Hospital, London, United Kingdom.,University Hospital KU Leuven, Leuven, Belgium.,NIHR Biomedical Research Centre, University College London Hospitals, London, United Kingdom
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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11
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Byrne M, Aughwane R, James J, Hutchinson C, Arthurs O, Sebire N, Ourselin S, David A, Melbourne A, Clark A. Structure-function relationships in the feto-placental circulation from in silico interpretation of micro-CT vascular structures. Placenta 2019. [DOI: 10.1016/j.placenta.2019.06.267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Couper S, Clark A, Mirjalili A, Flouri D, Aughwane R, David A, Melbourne A, Stone P. Magnetic resonance assessment of the effect of maternal position on fetoplacental blood flow and oxygenation. Placenta 2019. [DOI: 10.1016/j.placenta.2019.06.268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Slator P, Aughwane R, Cade G, Taylor D, David AL, Lewis R, Jauniaux E, Desjardins A, Salomon LJ, Millischer AE, Tsatsaris V, Rutherford M, Johnstone ED, Melbourne A. Placenta Imaging Workshop 2018 report: Multiscale and multimodal approaches. Placenta 2018; 79:78-82. [PMID: 30396518 DOI: 10.1016/j.placenta.2018.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 11/19/2022]
Abstract
The Centre for Medical Image Computing (CMIC) at University College London (UCL) hosted a two-day workshop on placenta imaging on April 12th and 13th 2018. The workshop consisted of 10 invited talks, 3 contributed talks, a poster session, a public interaction session and a panel discussion about the future direction of placental imaging. With approximately 50 placental researchers in attendance, the workshop was a platform for engineers, clinicians and medical experts in the field to network and exchange ideas. Attendees had the chance to explore over 20 posters with subjects ranging from the movement of blood within the placenta to the efficient segmentation of fetal MRI using deep learning tools. UCL public engagement specialists also presented a poster, encouraging attendees to learn more about how to engage patients and the public with their research, creating spaces for mutual learning and dialogue.
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Affiliation(s)
- Paddy Slator
- Centre for Medical Image Computing and Department of Computer Science, University College London, UK.
| | - Rosalind Aughwane
- Dept. of Medical Physics and Biomedical Engineering, University College London, UK; Institute for Women's Health, University College London, UK
| | - Georgina Cade
- Dept. of Medical Physics and Biomedical Engineering, University College London, UK
| | - Daniel Taylor
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
| | - Anna L David
- Institute for Women's Health, University College London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | | | - Eric Jauniaux
- Institute for Women's Health, University College London, UK
| | - Adrien Desjardins
- Dept. of Medical Physics and Biomedical Engineering, University College London, UK
| | - Laurent J Salomon
- Hôpital Necker & Paris Descartes University, France, LUMIERE Platform, EHU Fetus Affiliated to the IMAGINE Institute, France
| | - Anne-Elodie Millischer
- Hôpital Necker & Paris Descartes University, France, LUMIERE Platform, EHU Fetus Affiliated to the IMAGINE Institute, France
| | | | | | - Edward D Johnstone
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Andrew Melbourne
- Dept. of Medical Physics and Biomedical Engineering, University College London, UK; King's College London, UK
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14
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Melbourne A, Aughwane R, Sokolska M, Owen D, Kendall G, Flouri D, Bainbridge A, Atkinson D, Deprest J, Vercauteren T, David A, Ourselin S. Separating fetal and maternal placenta circulations using multiparametric MRI. Magn Reson Med 2018; 81:350-361. [PMID: 30239036 PMCID: PMC6282748 DOI: 10.1002/mrm.27406] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/21/2018] [Accepted: 05/24/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE The placenta is a vital organ for the exchange of oxygen, nutrients, and waste products between fetus and mother. The placenta may suffer from several pathologies, which affect this fetal-maternal exchange, thus the flow properties of the placenta are of interest in determining the course of pregnancy. In this work, we propose a new multiparametric model for placental tissue signal in MRI. METHODS We describe a method that separates fetal and maternal flow characteristics of the placenta using a 3-compartment model comprising fast and slowly circulating fluid pools, and a tissue pool is fitted to overlapping multiecho T2 relaxometry and diffusion MRI with low b-values. We implemented the combined model and acquisition on a standard 1.5 Tesla clinical system with acquisition taking less than 20 minutes. RESULTS We apply this combined acquisition in 6 control singleton placentas. Mean myometrial T2 relaxation time was 123.63 (±6.71) ms. Mean T2 relaxation time of maternal blood was 202.17 (±92.98) ms. In the placenta, mean T2 relaxation time of the fetal blood component was 144.89 (±54.42) ms. Mean ratio of maternal to fetal blood volume was 1.16 (±0.6), and mean fetal blood saturation was 72.93 (±20.11)% across all 6 cases. CONCLUSION The novel acquisition in this work allows the measurement of histologically relevant physical parameters, such as the relative proportions of vascular spaces. In the placenta, this may help us to better understand the physiological properties of the tissue in disease.
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Affiliation(s)
- Andrew Melbourne
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.,School of Biomedical Engineering and Imaging, Kings College London, London, United Kingdom
| | - Rosalind Aughwane
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.,Institute for Women's Health, University College Hospital,London, London, United Kingdom
| | | | - David Owen
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.,School of Biomedical Engineering and Imaging, Kings College London, London, United Kingdom
| | - Giles Kendall
- Institute for Women's Health, University College Hospital,London, London, United Kingdom
| | - Dimitra Flouri
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.,School of Biomedical Engineering and Imaging, Kings College London, London, United Kingdom
| | - Alan Bainbridge
- Medical Physics, University College Hospital, London, United Kingdom
| | - David Atkinson
- Centre for Medical Imaging, University College London, London, United Kingdom
| | - Jan Deprest
- Institute for Women's Health, University College Hospital,London, London, United Kingdom.,University Hospital KU Leuven, Leuven, Belgium
| | - Tom Vercauteren
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.,School of Biomedical Engineering and Imaging, Kings College London, London, United Kingdom
| | - Anna David
- Institute for Women's Health, University College Hospital,London, London, United Kingdom.,University Hospital KU Leuven, Leuven, Belgium.,NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Sebastien Ourselin
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.,School of Biomedical Engineering and Imaging, Kings College London, London, United Kingdom
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15
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Shelmerdine SC, Simcock IC, Hutchinson JC, Aughwane R, Melbourne A, Nikitichev DI, Ong JL, Borghi A, Cole G, Kingham E, Calder AD, Capelli C, Akhtar A, Cook AC, Schievano S, David A, Ourselin S, Sebire NJ, Arthurs OJ. 3D printing from microfocus computed tomography (micro-CT) in human specimens: education and future implications. Br J Radiol 2018; 91:20180306. [PMID: 29698059 DOI: 10.1259/bjr.20180306] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Microfocus CT (micro-CT) is an imaging method that provides three-dimensional digital data sets with comparable resolution to light microscopy. Although it has traditionally been used for non-destructive testing in engineering, aerospace industries and in preclinical animal studies, new applications are rapidly becoming available in the clinical setting including post-mortem fetal imaging and pathological specimen analysis. Printing three-dimensional models from imaging data sets for educational purposes is well established in the medical literature, but typically using low resolution (0.7 mm voxel size) data acquired from CT or MR examinations. With higher resolution imaging (voxel sizes below 1 micron, <0.001 mm) at micro-CT, smaller structures can be better characterised, and data sets post-processed to create accurate anatomical models for review and handling. In this review, we provide examples of how three-dimensional printing of micro-CT imaged specimens can provide insight into craniofacial surgical applications, developmental cardiac anatomy, placental imaging, archaeological remains and high-resolution bone imaging. We conclude with other potential future usages of this emerging technique.
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Affiliation(s)
- Susan C Shelmerdine
- 1 UCL Great Ormond Street Institute of Child Health , London , UK.,2 Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust , London , UK
| | - Ian C Simcock
- 1 UCL Great Ormond Street Institute of Child Health , London , UK.,2 Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust , London , UK
| | - John Ciaran Hutchinson
- 1 UCL Great Ormond Street Institute of Child Health , London , UK.,3 Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust , London , UK
| | - Rosalind Aughwane
- 4 Department of Medical Physics and Biomedical Engineering, Translational Imaging Group, University College London , London , UK
| | - Andrew Melbourne
- 4 Department of Medical Physics and Biomedical Engineering, Translational Imaging Group, University College London , London , UK
| | - Daniil I Nikitichev
- 4 Department of Medical Physics and Biomedical Engineering, Translational Imaging Group, University College London , London , UK.,5 Department of Medical Physics and Biomedical Engineering, University College London , London , UK
| | - Ju-Ling Ong
- 6 Craniofacial Unit, Great Ormond Street Hospital for Children NHS Foundation Trust , London , UK
| | | | | | - Emilia Kingham
- 8 UCL Culture, Bidborough House, 38-50 Bidborough Street, London UK
| | - Alistair D Calder
- 2 Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust , London , UK
| | - Claudio Capelli
- 9 Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London UK.,10 Institute of Cardiovascular Science, University College London , London , UK
| | - Aadam Akhtar
- 10 Institute of Cardiovascular Science, University College London , London , UK
| | - Andrew C Cook
- 10 Institute of Cardiovascular Science, University College London , London , UK
| | - Silvia Schievano
- 1 UCL Great Ormond Street Institute of Child Health , London , UK.,9 Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London UK.,10 Institute of Cardiovascular Science, University College London , London , UK
| | - Anna David
- 11 Institute for Women's Health, University College London , London , UK
| | - Sebastian Ourselin
- 4 Department of Medical Physics and Biomedical Engineering, Translational Imaging Group, University College London , London , UK
| | - Neil J Sebire
- 1 UCL Great Ormond Street Institute of Child Health , London , UK.,3 Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust , London , UK
| | - Owen J Arthurs
- 1 UCL Great Ormond Street Institute of Child Health , London , UK.,2 Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust , London , UK
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16
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Ebner M, Wang G, Li W, Aertsen M, Patel PA, Aughwane R, Melbourne A, Doel T, David AL, Deprest J, Ourselin S, Vercauteren T. An Automated Localization, Segmentation and Reconstruction Framework for Fetal Brain MRI. Medical Image Computing and Computer Assisted Intervention – MICCAI 2018 2018. [DOI: 10.1007/978-3-030-00928-1_36] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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