Mp55-14 Role of Fetal Imaging in Diagnosing Congenital Anomalies of the Kidney and Urinary Tract

You have accessJournal of UrologyPediatrics IV (MP55)1 May 2024MP55-14 ROLE OF FETAL IMAGING IN DIAGNOSING CONGENITAL ANOMALIES OF THE KIDNEY AND URINARY TRACT Grace Thompson, Mariana Meyers, Eniola Ogundipe, Emily Cooper, Daniel Han, and Vijaya M. Vemulakonda Grace ThompsonGrace Thompson , Mariana MeyersMariana Meyers , Eniola OgundipeEniola Ogundipe , Emily CooperEmily Cooper , Daniel HanDaniel Han , and Vijaya M. VemulakondaVijaya M. Vemulakonda View All Author Informationhttps://doi.org/10.1097/01.JU.0001008616.01808.0f.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prenatal diagnosis of congenital anomalies of the kidney and urinary tract (CAKUT) is critical for adequate counseling about potential postnatal outcomes. While ultrasound (US) is the gold standard for prenatal diagnosis of CAKUT, MRI has been increasingly used for complex congenital anomalies. However, the diagnostic accuracy of fetal MRI for CAKUT is unknown. The purpose of this study is to compare prenatal US and MRI for the diagnosis of CAKUT. METHODS: We retrospectively reviewed gravid mothers evaluated with US and MRI at a tertiary fetal care center for potential CAKUT between 2012-2020. Data collection included maternal demographics, prenatal US, prenatal MRI, postnatal US, and postnatal diagnosis. Prenatal imaging and postnatal diagnoses were categorized into kidney, ureteral, and/or bladder anomalies. Anatomic categories were then stratified based on the relative concordance between the prenatal imaging findings and the subsequent postnatal diagnosis (concordant, incomplete, or discordant). Diagnostic accuracy of prenatal MRI and US for identifying postnatal anomalies was evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Sensitivity and specificity were compared using McNemar's test. PPV and NPV were compared using relative predictive values. Rates of incomplete results were compared using Fisher's exact test. RESULTS: 33 fetuses meeting inclusion criteria were identified. Prenatal MRI had significantly lower rates of incomplete results compared to US (6.7% vs. 12.1%, p-value<0.001). Across all anatomical categories, fetal MRI had greater sensitivity and NPV compared to US (0.96 vs. 0.87 and 0.98 vs. 0.93, respectively), but lower specificity and PPV (0.91 vs. 0.95 and 0.85 vs. 0.91, respectively). This relationship held true for ureteral anomalies. In the kidney, MRI had higher sensitivity (1 vs. 0.93), PPV (0.94 vs. 0.93), and NPV (1 vs. 0.75) but equivalent specificity (0.75). In the bladder, MRI and US were equivalent in terms of diagnostic accuracy (PPV=0.75, NPV=1, sensitivity=1, specificity=0.95). None of the comparisons between diagnostic accuracy measures were statistically significant (p>0.05). CONCLUSIONS: Fetal MRI has greater sensitivity and NPV for kidney and ureteral anomalies; while these data trended to significance, they did not reach statistical significance. However, our study suggests that fetal MRI should be considered complementary to fetal US, particularly for kidney and ureteral anomalies. Further work is ongoing to validate these findings in a larger cohort. Source of Funding: No source of funding © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e921 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Grace Thompson More articles by this author Mariana Meyers More articles by this author Eniola Ogundipe More articles by this author Emily Cooper More articles by this author Daniel Han More articles by this author Vijaya M. Vemulakonda More articles by this author Expand All Advertisement PDF downloadLoading ...