Simcock, Ian Craig;
(2021)
Development of micro-computed tomography for human fetal post-mortem imaging.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Perinatal autopsy is an essential way of assessing the cause of fetal loss during pregnancy. However, parents are reluctant to consent to an invasive autopsy. Modern imaging techniques can offer a non-invasive solution, but most current clinical techniques are unable to offer adequate image resolution for early gestation miscarriages, typically below 20weeks gestation or 300g body weight. This thesis describes evaluating micro-CT imaging for this purpose, culminating in developing a pragmatic clinical protocol. Within this thesis, five aspects are evaluated: 1. Scan preparation. The optimal concentration and immersion time for I2KI was established, with a formula to predict the immersion time required for full iodination. 2. Imaging parameters. Optimal micro-CT imaging parameters were investigated, comparing the signal-to-noise (SNR) and relative contrast-to-noise ratio (rCNR) across different settings. 3. Patient factors. The effect of demographics/external factors on image quality was evaluated. Maceration was identified as having the greatest detriment to image quality, yet high image quality was attained in the majority of scans. Fetal weight and number of projections were also noted to be positive predictors. 4. Image SNR / rCNR. Assessments were tested across whole fetus organ volumes with imaging parameters defined as 110kV, 200µA, 250ms, 2frames-per-projection, enabling a single anatomical area to be optimally imaged within a clinically relevant timeframe, <30minutes. 5. Parental experience. A pilot study consisting of parents who have experienced a miscarriage was also undertaken. Response to the technique was overwhelmingly positive, with key potential benefits being increased choice and uptake of autopsy investigations with multiple mental health benefits. Finally, the future direction of this work within the clinical setting is presented. The clinical impact of the research is to be able to offer parents a more acceptable non-invasive imaging investigation following miscarriage.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Development of micro-computed tomography for human fetal post-mortem imaging |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. - Some third party copyright material has been removed from this e-thesis. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10139665 |
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