Current Projects

Institution: Johns Hopkins (Dr. Kunisaki)

Antenatal steroid administration has been associated with regression of large CPAMs and reduction of hydrops, yet indications, dosing, and  response predictors remain poorly defined. This study aims to  characterize outcomes across institutions and identify which lesion characteristics are most likely to respond.

Institution: Johns Hopkins (Dr. Kunisaki)

Significant variability exists in how fetal lung lesions are evaluated  prenatally, including use of ultrasound, MRI, and lesion characterization indices. We are working to define a consensus evaluation pathway that supports consistent counseling and cross-institutional comparison.

Institution: Boston Children's Hospital (Dr. Buchmiller)

Fetal MRI offers anatomic detail beyond ultrasound, particularly in distinguishing lesion type, defining vascular supply, and quantifying lung volumes. This project examines how MRI findings alter clinical  management and whether routine MRI improves diagnostic accuracy and surgical planning.

Institution: Boston Children's Hospital (Dr. Buchmiller)

Extralobar sequestrations are anatomically distinct lesions with an  independent pleural investment and variable presentation — from  incidental postnatal finding to fetal hydrops. Optimal management,  including observation versus early resection, remains debated. This  study evaluates outcomes across operative and non-operative approaches.

Institution: Johns Hopkins (Dr. Kunisaki)

Considerable practice variability exists regarding when to resect asymptomatic CPAMs — with approaches ranging from early resection in infancy to observation into childhood. This multicenter study compares complications, respiratory outcomes, and long term outcomes across operative timing strategies.

Institution: Children's Mercy Hospital, Kansas City (Dr. Lobeck)

Fetal procedures including thoracoamniotic shunting and thoracoscopic resection have been used in lesions complicated by hydrops or mediastinal shift. This project evaluates current indications,  complication rates, and neonatal outcomes to better define appropriate patient selection.

Institution: New York- Presbyterian Kids, Morgan Stanley Children's Hopsital (Dr. Duron)

Bronchial atresia is an underrecognized cause of focal pulmonary overinflation that may mimic CPAM on prenatal imaging. This study  examines the diagnostic accuracy of prenatal and postnatal imaging,  natural history, and management outcomes in a multi-institutional cohort.

Institution: Children's Mercy Hospital, Kansas City (Dr. Lobeck)

The EXIT procedure secures the fetal airway on placental support prior  to delivery in cases with anticipated neonatal airway compromise. We are examining institutional experience with EXIT for thoracic lesions — including indications, procedural outcomes, and survival — to refine  selection criteria and technique.