title: Fetal lung volume measurements: determination with MR imaging--effect of various factors.
abstract: OBJECTIVE
  To retrospectively determine the effect of gestational age (GA), imaging plane, section thickness, and inter- and intraobserver variability on fetal lung volume (FLV) measurements obtained with magnetic resonance (MR) imaging in a cohort of fetuses without thoracic abnormalities.
  
  
  METHODS
  Institutional review board approval was obtained. Informed consent for this retrospective cohort study was waived, and the conduct of this study was HIPAA compliant. FLV was measured in 30 fetuses (GA, 17-36 weeks) referred for MR imaging for indications other than pulmonary abnormalities. Measurements were made on single-shot fast spin-echo images by tracing free-form regions of interest on individual consecutive sections in the transverse, sagittal, and coronal planes. Measurements were performed twice by two observers independently. Correlations between FLV and GA, imaging plane, and section thickness were assessed, as were intra- and interobserver variability. Time to perform FLV was assessed in a subset of fetuses.
  
  
  RESULTS
  Total FLV ranged from 2 to 110 mL. Mixed-effects regression model showed significant quadratic trend in FLV with increasing GA, with comparable strength of correlation (r = 0.89-0.91) in the three imaging planes of measurement. Intraobserver agreement was good in all three planes (r = 0.65-0.83) and was highest in the transverse plane. Interobserver agreement was good in all three planes (r = 0.68-0.76). FLV showed no significant dependence on section thickness (P = .23) or imaging plane (P = .82). Mean time to obtain FLV measurements ranged from 48 seconds at GA of 21 weeks to 77 seconds at GA of 29-30 weeks.
  
  
  CONCLUSIONS
  GA-based FLV measurements obtained with MR images are independent of section thickness and imaging plane and can be performed with good inter- and intraobserver agreement in less than 2 minutes.
authors.affiliation: Department of Radiology, Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA. valerie.ward@childrens.harvard.edu
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Ward
authors.forename: Mizuki
authors.initials: M
authors.lastname: Nishino
authors.forename: Hiroto
authors.initials: H
authors.lastname: Hatabu
authors.forename: Judy A
authors.initials: JA
authors.lastname: Estroff
authors.forename: Carol E
authors.initials: CE
authors.lastname: Barnewolt
authors.forename: Henry A
authors.initials: HA
authors.lastname: Feldman
authors.forename: Deborah
authors.initials: D
authors.lastname: Levine
mesh_terms: D005260:Female; D005325:Fetal Organ Maturity; D005333:Fetus / Q000033:anatomy & histology*; D005865:Gestational Age; D006801:Humans; D008168:Lung / Q000196:embryology*; D008176:Lung Volume Measurements / Q000379:methods*; D008279:Magnetic Resonance Imaging; D015588:Observer Variation; D011247:Pregnancy; D012044:Regression Analysis