April 5th, 2020

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A Novel Approach to Prenatal Measurement of the Fetal Frontal Lobe Using Three-Dimensional Sonography
Authors:  Steffen A. Brown, M.D., Rebecca Hall, Ph.D., Lauren Hund, Ph.D., Hilda L. Gutierrez, B.S., Timothy Hurley, M.D., Bradley D. Holbrook, M.D., and Ludmila N. Bakhireva, M.D., Ph.D., M.P.H.
  OBJECTIVE: To assess the feasibility of a standardized approach to biometric measurement of the fetal frontal lobe and to construct frontal lobe growth trajectories throughout gestation.

STUDY DESIGN: A sonographic 3-dimensional (3D) volume set was obtained and measured in 101 patients between 16.1 and 33.7 gestational weeks. Measurements were obtained by 2 independent raters. To model the relationship between gestational age and each frontal lobe measurement, flexible linear regression models were fit using penalized regression splines.

RESULTS: The sample contained an ethnically diverse population (7.9% Native Americans, 45.5% Hispanics/Latinas). There was high interrater reliability (correlation coefficients 0.95, 1.0, and 0.87 for frontal lobe length, width, and height; p values <0.001). Graphs of the growth trajectories and corresponding percentiles were estimated as a function of gestational age. The estimated rates of frontal lobe growth were 0.096 cm/week, 0.247 cm/week, and 0.111 cm/week for length, width, and height, respectively.

CONCLUSION: To our knowledge, this is the first study to examine fetal frontal lobe growth trajectories through 3D prenatal ultrasound examination. Such normative data will allow for future prenatal evaluation of a particular disease state by 3D ultrasound imaging.
Keywords:  3D ultrasound, diagnostic ultrasound, fetal development, fetal growth, frontal lobe, obstetrics, percentiles, ultrasonography
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