3D imaging detects foetal abnormalities before birth

Author: Mark Gould
3D imaging detects foetal abnormalities before birth

Scientists from King’s College London and the Evelina London Children’s Hospital at Guy’s and St Thomas’ hospital have developed a new method using MRI for producing detailed 3D images of the foetal heart, to improve the diagnosis of congenital heart disease before birth.

Pregnant women were scanned in an MRI machine and powerful computers built 3D models of the tiny beating hearts inside their unborn children.

The team writing in the Lancet* says the new imaging system will improve the care of babies with congenital heart disease and could easily be adopted by other hospitals.

A series of 2D pictures of the heart are taken from different angles using an MRI machine. But the foetal heart is tiny, beats incredibly quickly, and the baby moves around inside the womb so the images of the heart look like a fuzzy blur.

Sophisticated computer software pieces the images together, adjusts for the beating of the heart and then builds an unprecedented 3D image of the heart. It gives doctors a clear view of the abnormality.

Professor Reza Razavi, a consultant paediatric cardiologist, wanted to improve the diagnosis of the birth defects after his daughter was born with one: "We thought we were going to lose her, that was a strong motivator... we should be able to pick up the problem in the womb," he told the BBC.

He describes the 3D images as "beautiful" and says they let doctors clearly see the problem and improve care.

"We can have complete certainty and plan ahead what treatment is needed, what's the operation we need to do.

"It really helps the parents to have the right support to know what's going to happen.

"But it also really helps the babies because they get the right operation at the right time and have the best outcomes."

Dr David Lloyd, a clinical research fellow at King's College London, said: "Our hope is this approach will now become standard practice for the Evelina foetal cardiology team, who make a prenatal diagnosis in 400 babies each year.

"This will also improve the care of over 150 babies each year who deliver at St Thomas's Hospital with known congenital heart disease."

He says the technology would be easy to adopt if a hospital already has an MRI machine, because the only new equipment needed would be a computer with a decent graphics card.

*Lloyd DFA, Pushparajah K, Simpson JM, et al. Three-dimensional visualisation of the fetal heart using prenatal MRI with motion-corrected slice-volume registration: a prospective, single-centre cohort study. The Lancet. 22 March 2019, DOI: 10.1016/S0140-6736(18)32490-5