title: Change in diagnostic confidence brought about by using in utero MRI for fetal structural brain pathology: analysis of the MERIDIAN cohort.
abstract: OBJECTIVE
  To measure possible change in diagnostic confidence by performing in utero magnetic resonance imaging (iuMRI) studies on fetuses with brain abnormalities recognised on ultrasonography (US).
  
  
  METHODS
  The analyses are based on the primary cohort from the prospective MERIDIAN study, which consisted of 570 fetuses with brain abnormalities detected on US, with iuMRI performed within 2 weeks of US and complete outcome reference data. The cohort was recruited between July 2011 and August 2014, and written informed consent was obtained for all participants. They all had indicators of diagnostic confidence measured on US by fetal medicine experts and iuMRI by the reporting radiologists. Three assessments were carried out using the conventional uncorrected (C2-C1%) method, the conventional (C2-C1%) with the Omary correction, and the score-based weighted average method.
  
  
  RESULTS
  All three assessments showed statistically significant (p<0·0001) positive effects indicating that iuMRI was potentially beneficial when included in the diagnostic pathway for prenatal structural brain anomalies (in terms of diagnostic confidence).
  
  
  CONCLUSIONS
  These results strongly support the routine clinical use of iuMRI as an adjunct to US when assessing fetuses with structural brain abnormalities.
authors.affiliation: Academic Unit of Radiology, University of Sheffield, Glossop Road, Sheffield, S10 2JF, UK; INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield S10 2JF, UK.
authors.forename: P D
authors.initials: PD
authors.lastname: Griffiths
authors.affiliation: Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
authors.forename: M
authors.initials: M
authors.lastname: Bradburn
authors.affiliation: Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Campbell
authors.affiliation: Department of Radiology, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK; Royal Hallamshire Hospital, Sheffield Teaching Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: D J A
authors.initials: DJA
authors.lastname: Connolly
authors.affiliation: Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
authors.forename: C L
authors.initials: CL
authors.lastname: Cooper
authors.affiliation: Academic Unit of Radiology, University of Sheffield, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: D
authors.initials: D
authors.lastname: Jarvis
authors.affiliation: Centre for Women's & Newborn Health, Institute of Metabolism & Systems Research, University of Birmingham, Birmingham B15 2TT, UK; Fetal Medicine Centre, Birmingham Women's Foundation Trust (Birmingham Health Partners), Birmingham, B15 2TG, UK.
authors.forename: M D
authors.initials: MD
authors.lastname: Kilby
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK.
authors.forename: G
authors.initials: G
authors.lastname: Mason
authors.affiliation: Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. Electronic address: c.d.mooney@sheffield.ac.uk.
authors.forename: C
authors.initials: C
authors.lastname: Mooney
authors.affiliation: Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
authors.forename: S C
authors.initials: SC
authors.lastname: Robson
authors.affiliation: Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
authors.forename: A
authors.initials: A
authors.lastname: Wailoo
mesh_terms: D001921:Brain / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D016001:Confidence Intervals; D005260:Female; D005333:Fetus / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies