Fetal Cardiac Tumor: HDlive Flow Silhouette with Spatiotemporal Image Correlation and HDlive Features

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Multiple fetal cardiac tumors (suspected cardiac rhabdomyoma) and tortuous ductus arteriosus (n=1). Intervention: HDlive flow silhouette with spatiotemporal image correlation (STIC) and postnatal everolimus. Primary outcome: Prenatal visualization of fetal cardiac tumors and postnatal tumor resolution.

Takahito Miyake; Tomomi Kawahara; Toshiyuki Hata; Kei Hayata

doi:10.5005/jp-journals-10009-1969

June 30, 2023Donald School Journal of Ultrasound in Obstetrics & GynecologyOpen Access

Fetal Cardiac Tumor: HDlive Flow Silhouette with Spatiotemporal Image Correlation and HDlive Features

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Key result

HDlive flow silhouette with STIC details fetal cardiac tumors that fully resolve postnatally with everolimus.

n=1

Why the study?

Three-dimensional and four-dimensional ultrasound provide detailed information and better visualization of the continuity, curvature, and localization of fetal cardiac tumors.

Key Points

To describe the sonographic features and vascular blood flow dynamics of multiple fetal cardiac tumors using HDlive flow silhouette with spatiotemporal image correlation (STIC).
Evaluation of a 35-year-old pregnant woman at 28 weeks and 2 days of gestation during a routine early third-trimester fetal screening.
Application of HDlive, HDlive flow, and HDlive flow silhouette with STIC to visualize intracardiac tumor movements, chamber anatomy, and vascular structures up to 34 weeks of gestation.
HDlive flow silhouette with STIC and HDlive demonstrated intraventricular tumors in all four chambers, real-time tumor movement, a small ventricular septal defect, and a tortuous ductus arteriosus.
Tumor dimensions increased from 5.8 × 5.7 mm to 7.9 × 6.1 mm in the left ventricle and from 5.4 × 2.5 mm to 6.4 × 3.1 mm in the right ventricle between 28 weeks 2 days and 34 weeks, without causing fetal cardiac failure.
Following delivery at 37 weeks and 6 days (birth weight 2794 gm), treatment with the mTOR inhibitor everolimus led to complete resolution of the cardiac tumors within 2 months.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

1 pregnant 35-year-old Japanese woman carrying a male fetus diagnosed at 28 weeks and 2 days of gestation with multiple four-chamber cardiac tumors and tortuous ductus arteriosus, followed through delivery and 2 months postpartum.

I

Intervention

Prenatal 3D/4D ultrasound assessment using HDlive, HDlive flow, and HDlive flow silhouette with spatiotemporal image correlation (STIC), followed by postnatal administration of everolimus 0.1 mg/day for 2 months.

O

Outcome

Anatomical and hemodynamic visualization of fetal cardiac tumors and great vessels prenatally, and complete resolution of cardiac tumors at 2 months after delivery.surrogate

HDlive flow silhouette with STIC serves as a useful adjunct to conventional fetal echocardiography for visualizing real-time intraventricular tumor movements and spatial blood flow dynamics in fetal cardiac rhabdomyoma.

Limitations

Genetic testing for tuberous sclerosis complex (TSC) was not conducted for either the neonate or family members
Definitive diagnosis of tuberous sclerosis complex was not made
The reason for the combination of tortuous ductus arteriosus and cardiac tumors is currently unknown
A definitive diagnosis of tuberous sclerosis complex was not made

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Implication

Supports adjunctive fetal cardiac imaging in rhabdomyoma; leaves open efficacy of postnatal everolimus and broader adoption.

Abstract

The incidence of primary cardiac tumors was reported to be 0.0017-0.02% at autopsy in all age-groups 1 and 0.25% in infants and young children. 2 Among fetal primary cardiac tumors, rhabdomyoma is the most common (60%), followed by teratomas, fibromas, hemangiomas, and myxomas. bout 40% of suspected fetal cardiac rhabdomyoma cases had a tuberous sclerosis complex (TSC). In other words, fetal cardiac rhabdomyoma may be the initial sign of TSC. Threedimensional (3D)/four-dimensional (4D) ultrasound has the advantage of providing more detailed information on fetal cardiac tumors. 8 Visualization of the continuity, curvature, and localization of cardiac tumors is better with 3D/4D ultrasound. In the present case, we describe HDlive flow, HDlive flow silhouette with STIC, and HDlive features of multiple fetal cardiac tumors at 28 weeks and 2 days of gestation.

Discussion

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Cite This Study

Miyake et al. (2023) conducted a case report in Multiple fetal cardiac tumors (suspected cardiac rhabdomyoma) and tortuous ductus arteriosus (n=1). HDlive flow silhouette with spatiotemporal image correlation (STIC) and postnatal everolimus was evaluated on Prenatal visualization of fetal cardiac tumors and postnatal tumor resolution. HDlive flow silhouette with STIC clearly visualized multiple fetal intraventricular tumors and tortuous ductus arteriosus at 28 weeks gestation, which resolved 2 months post-delivery with everolimus (0.1 mg/day).

synapsesocial.com/papers/6a75b49a587a7ee38dd37894 https://doi.org/10.5005/jp-journals-10009-1969

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Fetal Cardiac Tumor: HDlive Flow Silhouette with Spatiotemporal Image Correlation and HDlive Features

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Fetal Cardiac Tumor: HDlive Flow Silhouette with Spatiotemporal Image Correlation and HDlive Features

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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