Seeking an alternative to invasive amniocentesis via MR spectroscopy

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Researchers are working on a way to use MR spectroscopy as a new non-invasive way to assess fetal lung maturity in patients who must delivery early due to various conditions, RSNA News reports. Currently amniocentesis is the standard method used to detect fetal lung maturity. However, it is invasive and can lead to bleeding and premature labor.

2006 RSNA Research Scholar Bonnie Joe, MD, PhD, is leading a research project called Non-invasive Evaluation of Fetal Lung Maturity Using MR Spectroscopy: Development and Assessment of Ex Vivo and In Vivo Techniques. The research is based out of the University of California San Francisco (UCSF) where Joe is assistant professor of radiology. At her side is 2006 RSNA Medical Student Research Assistant Kiarash (Kia) Vahidi, B.S. 

 “If we are successful, patients will be spared the risk associated with amniocentesis and the decision to administer maternal corticosteroids to reduce the risk of RDS will be based on this noninvasive rest,” said Vahidi, in comments to RSNA. “This project has already added to our understanding of third-trimester amniotic fluid composition and has the potential to advance the state of the art in neonatal diagnostic imaging and fetal MR imaging.”

The researchers are utilizing spectroscopy to analyze the different levels of choline in a patients’ amniotic fluid. Choline, Dr. Joe believes, can be used as a marker for lung maturity because surfactant compounds that make the lungs mature contain choline.

During the ex vivo portion of the study, the researchers are evaluating discarded amniotic fluid with a spectrometer at high resolution and field strength.

“We have analyzed about 40 ex vivo samples and things are looking very promising,” Joe said, in comments to RSNA. “Our data show a positive correlation of increasing choline and increasing surfactant: albumin ratios, the current biochemical test UCSF runs to indicate lung maturity.

The researchers are hopeful for additional funding to drive the research into different areas. If the funding comes through “we can really branch off and start looking more closely at other potential markers for fetal lung maturity in addition to choline. MR spectroscopy of amniotic fluid may have potential applications for evaluating other fetal conditions,” Joe said. “Ultimately, the goal is to understand the metabolic profile of what normal amniotic fluid looks like, so that we can start looking at abnormal fetuses. That’s definitely on the horizon.”

The hope is now for the research to evolve into the in vivo phase.

“We have successfully detected choline in a couple of in vivo patients and I think that’s a big breakthrough considering how complicated this system is,” Joe said. “Over the next year we are going to improve our in vivo MR imaging technique and to fine tune our imaging parameters.”