PhD defence C.M. (Casper) Kersten

Brief summary on the aim of the doctoral thesis:

The studies presented in this thesis focus on congenital lung abnormalities (CLA) and were conducted with the aim to improve clinical care for children with CLA. If a child with CLA develops symptoms after birth, there is general agreement amongst caregivers that surgical resection is indicated. However, the majority of children remain asymptomatic after birth, the preferred management of which case is under persistent discussion.

In chapter 4, the study protocol is presented of the international randomised controlled CONNECT trial, which compares in children with asymptomatic CPAM the outcomes of elective surgical resection with those of conservative management and hereby aims to identify the superiority of either management.

In chapter 6 it was demonstrated that a novel artificial intelligence algorithm – designed for semi-automated segmentation of bronchovascular structures and lesions based on conventional CT images – was suitable for virtual reality (VR) visualisation of congenital lung abnormalities.

Chapter 7 reports a systematic review that investigated current outcomes, practices and terminology regarding segment level, i.e., sublobar pulmonary resection in children with CLA. The outcomes proved similar to those of conventional lobectomy, and especially the rate of post-operative residual disease appeared to be lower than reported earlier.

Chapter 8 presents the development of an MRI-protocol for the follow-up of CLA lesions, and reports on the implementation of this protocol among school-aged children with CLA.

Children that underwent resection of a symptomatic CLA lesion were studied in chapter 9, to evaluate if these children are at an increased risk of neurodevelopmental impairment during childhood.