Researchers from King's College London have been awarded over £191,000 for a project to detect congenital cardiac risks before birth using ultrasound images and computational models.
Coarctation of the Aorta (CoA) is a heart condition among unborn babies, where the main artery narrows soon after they are born, restricting blood flow and posing serious risks after birth.
The condition affects around 7 in every 10,000 births and, early and accurate detection is essential to ensure timely treatment and improve both short and long term outcomes for newborn babies.
Some existing routine ultrasound screening tests, however, incorrectly suggest a baby may have coarctation when they do not - resulting in false positives. These misdiagnoses can cause unnecessary clinical interventions, creating significant stress for families, and placing additional financial and logistical pressure on healthcare systems to monitor babies who are ultimately healthy.
Conversely, many cases of coarctation are not detected before birth due to limitations in current screening accuracy. These missed diagnoses can prevent babies from receiving swift treatment after delivery, increasing the risk of serious complications, including cognitive impairment or, in severe cases, death.
Now, a project led by King's researchers, Professor Pablo Lamata, Dr Adelaide de Vecchi, Dr Kuberan Pushparajah, Dr Thomas Day and Dr David Lloyd has received the grant from Action Medical Research - a UK wide charity supporting medical innovation for over 70 years - to enhance the prediction of aortic coarctation by adapting their established 3D morphological biomarker from MRI to ultrasound.
The research team has previously shown that the 3D anatomy of the aorta before birth, reconstructed from a medical scan during pregnancy, can greatly improve the accuracy of CoA diagnosis before birth. To achieve this, they worked with a unique dataset of hundreds of cases from the Evelina London Children's Hospital using an advanced imaging modality called Fetal Magnetic Resonance Imaging (Fetal MRI). Fetal MRI, however, is only available in very specialised centres.
Through this project, they want to develop the technology to allow the reconstruction of the same 3D aortic morphology from more widely available routine 2D ultrasound scans.
Using advanced imaging (MRI) and 3D computational modelling, we have learned how aortic development of babies with high risk of CoA follows a different developmental pathway. We want now to prove that we can reconstruct the same 3D aortic morphology from a more challenging but widely available imaging method and thus reach wide impact by making a solution available in routine screening."
Professor Pablo Lamata, Director of the Centre for Doctoral Training in Digital Twins for Healthcare.
Coarctation of the aorta is one of the most difficult heart conditions for fetal cardiologists to diagnose accurately before birth. This project builds on the amazing work of Professor Lamata and his team, who have used our advanced MRI techniques to show how the shape of the blood vessels is closely related to blood flow through the developing fetal heart. This exciting new project will help translate those insights directly into bedside ultrasound, potentially allowing many babies to benefit from earlier and more reliable diagnosis of this potentially life-threatening condition."
Dr David Lloyd, Consultant in Paediatric and Fetal Cardiology, Evelina London Children's Hospital
Completing the MedTech Venture Builder Programme at the School's London Institute for Health Engineering, helped the research team refine their follow up strategy and sharpen their focus on achieving real clinical impact.
While the team had previously worked extensively with MRI, the programme highlighted the importance of transitioning to echocardiography. The programme also provided valuable practical insights, from defining the target patient population to considering health economic factors and other key elements that ultimately strengthened their funding pitch.
We are delighted to be funding this innovative research, uniting a team of expert engineers and clinical academics. Dr Caroline Johnston, Senior Research Manager, Action Medical ResearchAs a charity we fund cutting-edge medical research most likely to deliver real benefit in pregnancy and to babies, children and young people. Professor Lamata and his team aim to translate novel technology to the clinic where ultrasound scans, automatic 3D shape reconstruction of the heart and the prediction of risk of CoA promise to improve outcomes for babies affected by this life-threatening condition."
Dr Caroline Johnston, Senior Research Manager, Action Medical Research
