{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T14:58:50Z","timestamp":1765378730484,"version":"3.46.0"},"reference-count":41,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T00:00:00Z","timestamp":1762560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the efficacy of high intensity focused ultrasound (HIFU) to target and ablate the fetal intra\u2010umbilical vessels and terminate fetal perfusion in a pregnant rabbit model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Pregnant New Zealand white rabbits (gestational age: E25\u201027,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a06 rabbits,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a018 treated fetuses,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a06 controls) underwent high\u2010resolution MRI for fetal localization, orientation assessment, beam guidance, and treatment monitoring. Ultrafast ultrasound with power Doppler quantified cardiac output and placental perfusion pre\u2010 and post\u2010treatment. HIFU (100\u2013120Wac, 16\u201320s) induced thermal ablation; MR\u2010thermometry monitored intraoperative temperature; histology confirmed ablation. Ultrafast ultrasound imaging and gross examination confirmed termination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Target fetal livers (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a018) reached a maximum temperature of . Ultrafast ultrasound imaging confirmed the termination of target fetuses, verifying the treatment success in 11 fetuses. Successfully treated fetuses showed a 95%\u00a0\u00b1\u00a07.4% decrease in cardiac output compared with 11%\u00a0\u00b1\u00a04.6% decrease in controls,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.022. Placental perfusion dropped 83%\u00a0\u00b1\u00a010.0% in successfully treated fetuses compared with 16%\u00a0\u00b1\u00a05.5% in control fetuses,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002. Overall, 83% (15\/18) of targeted fetuses were terminated, with adjacent controls surviving. Thermal necrosis was present in all targeted livers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MR\u2010guided HIFU can effectively ablate fetal rabbit umbilical vessels to cause selective termination, modeling a non\u2010invasive treatment for twin reversed arterial perfusion sequence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70010","type":"journal-article","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T15:36:53Z","timestamp":1762616213000},"page":"1827-1836","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Intensity Focused Ultrasound\u2010Induced Ablation of the Intra\u2010Abdominal Umbilical Vessels in a Rabbit Fetus: A Model Treatment of Twin\u2010Reversed Arterial Perfusion Sequence"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4499-660X","authenticated-orcid":false,"given":"Ava","family":"Danialy","sequence":"first","affiliation":[{"name":"The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikan","family":"Fakhari","sequence":"additional","affiliation":[{"name":"University of Toronto  Toronto Ontario Canada"},{"name":"Division of Cardiology Department of Pediatrics The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Medical Biophysics University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8519-9105","authenticated-orcid":false,"given":"Karolina","family":"Piorkowska","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9017-2700","authenticated-orcid":false,"given":"Tao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine Kingston Health Sciences Centre Queen's University  Kingston Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerome","family":"Baranger","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Physics for Medicine Paris Inserm, ESPCI PSL Paris CNRS  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sydney","family":"Nowak","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Villemain","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"},{"name":"Department of Pediatric and Adult Congenital Cardiology Institut Hospital\u2010Universitaire Liryc  Pessac France"},{"name":"Bordeaux University Hospital (CHU)  Pessac France"},{"name":"Fondation Bordeaux Universit\u00e9  Pessac France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"Drake","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"University of Toronto  Toronto Ontario Canada"},{"name":"Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam C.","family":"Waspe","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11122"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2020.63.2.108"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000343223"},{"volume-title":"Twining\u2019s Textbook of Fetal Abnormalities","year":"2015","author":"Coady A. 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