Keywords: Fetal, Fetus

Motivation: Maternal supine sleeping position in the third trimester has been linked to decreased uterine blood flow and increases in stillbirth.

Goal(s): To investigate the impact of maternal position on fetal and placental T2* values by taking advantage of the increased dynamic T2* range at low field strengths

Approach: We acquired dynamic whole uterus multi-echo gradient echo sequences at 0.55T with the subject in both left lateral and supine positions and compare the T2* placental and fetal body organ values organs in 91 subjects.

Results: Significant differences in mean T2* values were observed between both positions in the placenta and 7 fetal body organs.

Impact: Maternal position significantly impacts mean placental and fetal body T2* values. In addition, future quantitative fetal T2* studies should consider maternal position in their study design.

Keywords: Cancer, Spectroscopy, DIPG, Pediatrics, NMR

Motivation: There is a need for developing next generation of clinical trials by targeting selective pathways in diffuse intrinsic pontine glioma (DIPG).

Goal(s): We explore the impact of Vehicle (DMSO), Paxalisib, BAY-876, and their combination in patient-derived SJ-DIPGX7 cell line to evaluate their potential as a therapeutic strategy for patients with DIPG.

Approach: 2H-NMR spectra were longitudinally obtained in a cell suspension. We calculated the lactate flux turnover, which was validated using 100-run Monte-Carlo simulation. This outcome was further confirmed by conducting a glycolysis stress test. 

Results: The combined therapy (Paxalisib + BAY-876) holds potential for enhancing its therapeutic effectiveness against DIPGs.

Impact: This study paves the way for future in-vitro and in-vivo studies to be conducted for monitoring efficacy of targeted therapeutic combination for DIPG.

Keywords: Neuro, Diffusion Tensor Imaging

Motivation: Diffusion MRI (dMRI) is promising for predicting disabilities due to neonatal hypoxic-ischemic encephalopathy (HIE), yet current automated image quantification methods are slow and unvalidated for HIE lesions.

Goal(s): Develop a rapid deep-learning model, OpenMAP-Di, to quantify dMRI with and without HIE injury to predict the short-term outcome (STO) score.

Approach: We utilized nnU-Net to develop OpenMAP-Di, enabling dMRI parcellation and quantification, and applied an elastic regression model to predict the STO score.

Results: OpenMAP-Di accurately parcellated and quantified infant brains across varying scanners, acquisition parameters, and HIE severity levels in three minutes, and can also predict STO.

Impact: The increased processing speed and robustness to technological and pathological variations offered by OpenMAP-Di promises timely and reliable future neurodevelopmental outcome assessments for individuals surviving HIE, while also offering researchers opportunities for extensive medical image analysis.

Keywords: Neuro, Velocity & Flow, Brain Arteriovenous Malformation

Motivation: Approximately 10-20% of pediatric patients with brain arteriovenous malformation (bAVM) present with reoccurring formation or growth even after initial successful treatment.

Goal(s): Evaluate the feasibility and efficacy of 4D Flow MRI to quantitatively assess the hemodynamic changes in pediatric bAVMs following treatment and establish its use for early detection of high-risk changes.

Approach: Prospective 4D Flow MRI study of pediatric bAVM patient cohort pre and post treatment

Results: Decreased flow rate and maximum velocity in main bAVM feeding arteries post treatment, resulting in reduced flow laterality mismatch between hemispheres.

Impact: 4D Flow MRI provides a quantitative tool to assess pediatric bAVM flow characteristics and the hemodynamic impact of intervention, which may help to identify patients at risk of bAVM reoccurrence.

Keywords: Neuro, White Matter, autism spectrum disorder

Motivation: Autism spectrum disorder (ASD) lacks sensitive and effective imaging biomarkers.

Goal(s): Using diffusion tensor imaging to detect white matter tracts damage and changes in local directional fields in children with ASD and combining machine learning to construct a diagnostic model for preschool-aged children with ASD.

Approach: Introducing the novel mathematical framework of director field analysis, we investigate the local geometric structure of white matter tracts using tract-based spatial statistics and automated fiber quantification techniques.

Results: Children with ASD have reduced fractional anisotropy and increased twist and distortion values. The machine learning model showed an area under the curve of 0.85 for diagnosing ASD.

Impact: The director field analysis parameters fill the gap in previous studies and provide a new perspective for exploring the neuropathological mechanisms of ASD. By combining machine learning, the diagnostic efficiency of ASD is improved.

Keywords: Neuro, Brain, Brain, quantitative imaging, relaxometry, pediatric, synthetic MR

Motivation: Rapid multi-contrast MRI acquisitions are crucial to minimize motion artifacts in awake pediatric subjects.

Goal(s): To evaluate a newly developed EPI-based multi-contrast MRI sequence for generating multi-parametric quantitative brain maps in awake pediatric participants.

Approach: T₁, T_2, and T₂^* measurements were obtained using the rapid imaging sequence in 17 children (age 3-10 years). The parametric values were compared to those acquired using conventional mapping sequences, and repeatability and reproducibility were assessed.

Results: The brain relaxation parametric values obtained with the rapid sequence were comparable to those obtained through conventional acquisitions. Furthermore, these values exhibited good repeatability and reproducibility.

Impact: Rapid (1 minute and 15 seconds) measurements of T₁, T₂, and T₂^* in the brains of awake children (aged 3-10 years) were comparable to those obtained using conventional quantitative mapping methods.

Keywords: Neuro, Motion Correction, Quiet

Motivation: Improve imaging for pediatric subjects by reducing loud acoustic noise and accommodating subject motion. 

Goal(s): Develop a ZTE-based silent and motion-corrected neuroimaging protocol in pediatric subjects.

Approach: Nine pediatric volunteers were imaged with a protocol consisting of silent ZTE based T1w and T2w acquisitions and conventional Cartesian 3D gradient echo T1 MPRAGE and T2 FSE-CUBE.  Images were reviewed and scored by a board-certified radiologist to assess overall image quality.

Results: Radiologist review indicates relatively comparable image quality for the ZTE acquisitions versus the conventional acquisitions. Motion induced blurring of some brain structures during motion was reduced using ZTE with motion correction.

Impact: This approach shows promise for studies in sensitive populations such as pediatrics with ear disorders and autism spectrum disorder.

Keywords: Neuro, Brain, Spectroscopy, Autism, Neurological, Analysis

Motivation: ¹H-Magnetic Resonance Spectroscopy (MRS) studies have revealed alterations in neuro-metabolite concentrations in autism, but results have been inconsistent.

Goal(s): Perform a comprehensive meta-analysis of previous MRS studies in autism.

Approach: Data was included from 59 relevant studies. After assessment of data quality, data was grouped by metabolite, brain region and other demographic and methodological factors.

Results: We find significantly lower concentrations of GABA and NAA in autism. These alterations were most pronounced in children and in limbic brain regions involved in processes relevant to autism phenotypes. We also investigate factors that contribute to effect size variation between studies, including MRS quantification method.

Impact: Our meta-analysis comprehensively summarises previous MRS studies to provide evidence of regional disruptions to brain metabolite concentrations in autism. We also examine how MRS study outcome varies due to methodological and demographic factors.  

Keywords: Neonatal, Brain

Motivation: Clinical diagnosis of neonatal acute bilirubin encephalopathy (ABE) based on the conventional MRI sequence has been limited by its difficulty in differentiating confounding image contrast changes associated with normal myelination. 

Goal(s): This study aims to assess the value of quantitative susceptibility mapping (QSM) in detecting ABE and understanding its pathogenesis.

Approach: All MRI scans were carried out on 3.0T MR scanner (Omega, United Imaging Health Care, Shanghai, China) with multi-parametric MR imaging with flexible design (MULTIPLEX) transverse axis sequence.

Results: ABE caused significant magnetic susceptibility value changes in several brain regions which showed correlation with peak total serum bilirubin value.

Impact: Our study demonstrated that the brain regions with altered magnetic susceptibility values might be related with ABE pathology, which might be valuable for further studies. And QSM might have the potential efficacy in the auxiliary diagnosis of ABE.

Keywords: Neuro, Diffusion/other diffusion imaging techniques, OGSE; IMPULSED; Glioblastoma; cellularity；cell diameter

Motivation: Gliomas are the most common type of central nervous system tumors in children, and the histological classification plays a crucial role in determining the prognosis and the treatment. A non-invasive approach is needed for pre-surgery characterization of the histopathology of the tumor.

Goal(s): The aim of this study was to explore the feasibility of applying time-dependent diffusion magnetic resonance imaging (t_d-dMRI) parameters in discriminating between high-grade gliomas (HGG) and low-grade gliomas (LGG).

Approach: Nine pediatric glioma patients were involved and underwent t_d-dMRI scan.

Results: The t_d-dMRI parameters may serve as potential markers for the differentiation between high-grade gliomas (HGG) and low-grade gliomas (LGG).

Impact: Time-dependent diffusion MRI parameters can distinguish pediatric high-grade and low-grade gliomas noninvasively, aiding personalized treatment and enhancing prognosis, among other potential applications.

Keywords: Neuro, Pulse Sequence Design, T1 Mapping

Motivation: T1 mapping is essential for demyelination disease diagnosis and brain development assessment, but conventional sequences suffer from considerable acoustic noise or long scanning time. 

Goal(s): This study aims to develop a silent, accurate and fast 3D T1 mapping method.

Approach: It uses inversion recovery-prepared rotating radial trajectories to avoid significant gradient switching, forming a series of images collected at different TIs. 

Results: Its accuracy is compared with IRSE method, acquiring 0.9994 R², and its feasibility is tested on the human brain with gray and white matter T1 values close to literatures. The SPL is measured only 1.5 dBA higher than the background noise.

Impact: The high acoustic noise of sequences like MPRAGE has disadvantages for pediatric imaging due to its risks of neonatal hearing loss and decreased scanning comfort. Our study might provide a solution with nearly silent sound and highly accurate measurements.

Keywords: Neuro, Quantitative Imaging

Motivation: Children with congenital heart disease (CHD) may exhibit brain development abnormalities, making it crucial to understand the risk and improve neurological function in these patients. 

Goal(s): In this study, we aimed to quantitative assessment of preoperative brain development in CHD children using Synthetic Magnetic Resonance Imaging (SyMRI).

Approach: Through the quantitative evaluation and correlation analysis of T1, T2 and and PD values of SyMRI in the preoperative brain development of children with CHD.

Results: The results indicate that the presence of neurological development abnormalities existed in children with CHD before surgery. SyMRI can provid a basis for early clinical evaluation and timely intervention.

Impact: SyMRI quantitative assessment can serve as a reference indicator for brain development abnormalities in CHD children, aiding in guiding early clinical evaluation and timely intervention.

Keywords: Neuro, Motion Correction, Segmentation

Motivation: Head motion is a common cause of image degradation in pediatric neuroimaging. Multiple strategies are available for correcting intrascan motion, including DISORDER - a retrospective motion correction approach.

Goal(s): We aimed to validate the use of DISORDER for brain morphometric analyses in a pediatric population.

Approach: We compared a wide range of morphometry measures obtained from high quality linear phase-encoding MPRAGE and DISORDER MPRAGE acquisitions in 21 children aged 7-8 years.

Results: DISORDER reduced data loss due to motion and brain morphometric analyses obtained using both MPRAGE acquisitions were highly consistent for most brain regions.

Impact: DISORDER, a retrospective motion correction technique, reduces data loss due to head motion in pediatric populations and produces quantitative brain morphometric measures that are largely consistent with measures derived from a standard acquisition.

Keywords: Neonatal, Brain Connectivity, congenital heart defects

Motivation: Structural connectivity in the thalamus, essential for cortical-subcortical communication, is known to be disrupted in congenital heart defect (CHD) patients. Yet, assessing thalamic nuclei via local diffusion characteristics in vivo remains challenging. 

Goal(s): We aimed to validate a diffusion-based clustering method to map the developing thalamus and explore topological differences between CHD infants and healthy controls

Approach: By refining a segmentation method and employing k-means and GMM clustering, we characterized thalamic nuclei

Results: Notable volume reductions in six thalamic clusters were identified in CHD infants, with significant mediodorsal nucleus group alterations, pertinent to prefrontal connectivity

Impact: Our validated segmentation technique enables robust delineation of thalamic nuclei in vivo, unveiling developmental alterations in CHD infants. This advancement paves the way for targeted clinical interventions and improves neurodevelopmental outcomes prediction

Keywords: Neuro, Adolescents, Congenital Heart Disease Neurodevelopment Brain Dysmaturation Evaluation Method

Motivation: Develop and validate point-of-care MRI-based evaluation method for scoring brain dysplasia/abnormality (BDS) in congenital heart disease (CHD) that incorporates morphological alterations and subcortical structures.

Goal(s): Further develop our BDS system, previously validated in infants with CHD, in the older pediatric and young adult CHD population.

Approach: Evaluate brain dysplasia from T1 and T2 structural MRI of CHD and control participants and compare differences. Correlate BDS with executive function outcomes and genetic ciliary motion (CM) abnormalities.

Results: CHD group had higher total and subcortical dysplasia, especially single ventricle CHD group. Higher BDS (greater dysplasia) correlated with poorer executive function outcomes and greater CM abnormality.

Impact: Our BDS method is sensitive to dysmaturational features in CHD and correlated with executive function outcomes and CM - genetic-basis of CHD pathogenesis. Since it employs common point-of-care MRI techniques, it could be adapted for wider application in CHD brain evaluation.