{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T23:56:54Z","timestamp":1790553414458,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the reliability of qualitative foetal lung size assessments on ultrasound (US) and MRI in left congenital diaphragmatic hernia (CDH) and their correlation with quantitative metrics and neonatal mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single tertiary center, 2008\u20132020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>A total of 103 cases of prenatally diagnosed isolated left CDH underwent postnatal active care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two independent reviewers performed qualitative foetal lung size assessments on US and MRI. Interrater agreement was assessed, and correlations were determined between qualitative assessments, quantitative metrics (observed\u2010to\u2010expected lung\u2010to\u2010head ratio [o\/e LHR] and observed\u2010to\u2010expected total Foetal lung volume [o\/e TFLV]), and neonatal mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Interrater agreement and correlation between qualitative and quantitative assessments of lung size and neonatal mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 74 cases with both US and MRI imaging were included. Interrater agreement for qualitative lung size assessment was strong for US (weighted kappa: 0.80, 95% CI 0.68\u20130.93) and moderate for MRI (Cohen's kappa: 0.48, 95% CI 0.30\u20130.66). Both modalities showed a strong correlation between qualitative and quantitative lung size assessments. On US, qualitative and quantitative assessments had similar associations with neonatal mortality (Spearman's correlation: 0.44 for each reviewer vs. 0.49). On MRI, quantitative metrics correlated more strongly with neonatal mortality than qualitative assessment (Cram\u00e9r's V: 0.44 vs. 0.34\u20130.35).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Qualitative foetal lung size assessment, by US more so than MRI, is a reliable and reproducible tool that correlates with established quantitative metrics and neonatal mortality. These findings support its role as a complementary method for prenatal risk stratification in left CDH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70120","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:55:31Z","timestamp":1766393731000},"page":"833-841","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative Assessment of Foetal Lung Size in Left Congenital Diaphragmatic Hernia Using Ultrasound and MRI: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-4846","authenticated-orcid":false,"given":"Shiri","family":"Shinar","sequence":"first","affiliation":[{"name":"Ontario Fetal Centre, Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilkash","family":"Kajal","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, Women's College Hospital and Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Johnson","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, Women's College Hospital and Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Otvodenko","sequence":"additional","affiliation":[{"name":"Ontario Fetal Centre, Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7449-5985","authenticated-orcid":false,"given":"Seungwoo","family":"Lee","sequence":"additional","affiliation":[{"name":"Maternal\u2010Infant Care Research Centre Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla P. L.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of General and Thoracic Surgery, the Hospital for Sick Children, Department of Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Keunen","sequence":"additional","affiliation":[{"name":"Ontario Fetal Centre, Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Ontario Fetal Centre, Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Ryan","sequence":"additional","affiliation":[{"name":"Ontario Fetal Centre, 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