title: Assessment of MRI-Based Automated Fetal Cerebral Cortical Folding Measures in Prediction of Gestational Age in the Third Trimester.
abstract: OBJECTIVE
  Traditional methods of dating a pregnancy based on history or sonographic assessment have a large variation in the third trimester. We aimed to assess the ability of various quantitative measures of brain cortical folding on MR imaging in determining fetal gestational age in the third trimester.
  
  
  METHODS
  We evaluated 8 different quantitative cortical folding measures to predict gestational age in 33 healthy fetuses by using T2-weighted fetal MR imaging. We compared the accuracy of the prediction of gestational age by these cortical folding measures with the accuracy of prediction by brain volume measurement and by a previously reported semiquantitative visual scale of brain maturity. Regression models were constructed, and measurement biases and variances were determined via a cross-validation procedure.
  
  
  RESULTS
  The cortical folding measures are accurate in the estimation and prediction of gestational age (mean of the absolute error, 0.43 ± 0.45 weeks) and perform better than (P = .024) brain volume (mean of the absolute error, 0.72 ± 0.61 weeks) or sonography measures (SDs approximately 1.5 weeks, as reported in literature). Prediction accuracy is comparable with that of the semiquantitative visual assessment score (mean, 0.57 ± 0.41 weeks).
  
  
  CONCLUSIONS
  Quantitative cortical folding measures such as global average curvedness can be an accurate and reliable estimator of gestational age and brain maturity for healthy fetuses in the third trimester and have the potential to be an indicator of brain-growth delays for at-risk fetuses and preterm neonates.
authors.affiliation: From the Department of Radiology (J.W., B.B.A., A.V., J.C.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania woojohn911@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Computer Science and Engineering (S.P.A.), Indian Institute of Technology Bombay, Mumbai, India.
authors.forename: S P
authors.initials: SP
authors.lastname: Awate
authors.affiliation: Neurovascular Imaging Lab (D.J.L.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: D J
authors.initials: DJ
authors.lastname: Licht
authors.affiliation: Advanced Pediatric Brain Imaging Research Laboratory (C.C., C.L.), Children's National Medical Center, Washington, DC Departments of Neurology, Radiology, and Pediatrics (C.C., A.J.d.P., C.L.), George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: C
authors.initials: C
authors.lastname: Clouchoux
authors.affiliation: Departments of Neurology, Radiology, and Pediatrics (C.C., A.J.d.P., C.L.), George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: A J
authors.initials: AJ
authors.lastname: du Plessis
authors.affiliation: From the Department of Radiology (J.W., B.B.A., A.V., J.C.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: B B
authors.initials: BB
authors.lastname: Avants
authors.affiliation: From the Department of Radiology (J.W., B.B.A., A.V., J.C.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: A
authors.initials: A
authors.lastname: Vossough
authors.affiliation: From the Department of Radiology (J.W., B.B.A., A.V., J.C.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: J C
authors.initials: JC
authors.lastname: Gee
authors.affiliation: Advanced Pediatric Brain Imaging Research Laboratory (C.C., C.L.), Children's National Medical Center, Washington, DC Departments of Neurology, Radiology, and Pediatrics (C.C., A.J.d.P., C.L.), George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: C
authors.initials: C
authors.lastname: Limperopoulos
mesh_terms: D002540:Cerebral Cortex / Q000033:anatomy & histology*; D005260:Female; D005333:Fetus / Q000033:anatomy & histology*; D005865:Gestational Age; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D011247:Pregnancy; D011263:Pregnancy Trimester, Third