Preliminary results: comparison of two different radiological exams (thoracic MRI versus CT-scan) to characterize congenital lung malformations in infants

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Congenital lung anomalies (CLA) detected prenatally represent a group of rare malformations (8 /10000 births) , including adenomatoid malformation, sequestration, bronchial atresia or congenital hyperinflation. Postnatal clinical management of lung malformations generally implies the surgical removal of the affected lung lobe. However, some medical centres use a conservative approach without applying systematic surgery; the pro and contra arguments being pondered between the prevention of malignant transformation of the malformations and an increased risk of cystic infection.

After birth, CLA are investigated during the first months of life by radiological exams to obtain a more acurate characterization  (localisation, aspect: size of the lesion, presence of cysts, abnormal pulmonary parenchyma, abnormal vascularization). Usually a thoracic CT-scan (computerized tomography) is performed. This exam, used by Geneva's team, allows a good description of the lesions, but with the disadvantages of radiation. Since a few years, Zurich investigated these patients using a thoracic MRI (Magnetic Resonance Imaging). These radiological exams have the advantage to be non-radiating, but are currently not clearly recognised to have the same precision as CT-scan.

After the radiological exams, the majority of these patients are treated by a surgical removal of the affected lung. Histological analysis of the resected lung will precise the real subtype of the malformation and evaluate potential malignant transformation risk.

The goal of our retrospective study is to analyse thoracic CT-scan performed in Geneva and  thoracic MRI performed in Zurich, comparing to the histological informations obtained on the resected lung malformation. Each radiological exam and each histological samples would be blindly interpreted with a standardized form, with similar items for CT-scan, MRI and histological analysis.

The preliminary results would allow a better management of these patients by helping clinicians to choose the more adapted radiological exam to follow up these patients with prenatal diagnosis of CLA.