ISSN# 1545-4428 | Published date: 19 April, 2024
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At-A-Glance Session Detail
   
Pediatric Body & Lung Imaging
Oral
Pediatrics
Monday, 06 May 2024
Room 331-332
16:00 -  18:00
Moderators: Jonathan Dyke & Mary-Louise Greer
Session Number: O-47
CME Credit

16:000289.
Trajectories of abdominal subcutaneous and visceral adipose tissue accumulation and cardiometabolic health in children: The GUSTO study
Suresh Anand Sadananthan1, Varsha Gupta1,2, Yeshe Manuel Kway1,3, Kashthuri Thirumurugan1, Mya Thway Tint1, Navin Michael1, Fabian Kok Peng Yap4,5,6, Kok Hian Tan5,7, Keith M Godfrey8, Peter D Gluckman1,9, Yap Seng Chong1,10, Dennis Wang1,11,12,13, Yung Seng Lee1,14,15, Marielle V Fortier1,16, Johan G Eriksson1,10,17,18,19, and S. Sendhil Velan1,3,17,20
1Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore, 2Bioinformatics Institute, A*STAR, Singapore, Singapore, 3Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, 4Department of Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore, Singapore, 5Duke-National University of Singapore Graduate Medical School, Singapore, Singapore, 6Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore, 7Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore, 8MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom, 9Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand, 10Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, 11Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, United Kingdom, 12Department of Computer Science, University of Sheffield, Sheffield, United Kingdom, 13National Heart and Lung Institute, Imperial College London, London, United Kingdom, 14Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, Singapore, 15Department of Paediatrics, Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore, 16Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore, Singapore, 17Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, 18Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland, 19Folkhälsan Research Center, Helsinki, Finland, 20Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Keywords: Body, Body, Pediatrics, abdominal adipose tissue, subcutaneous and visceral fat, insulin resistance

Motivation: Unravel the links between childhood abdominal fat distribution patterns and subsequent cardiometabolic risks aiming to provide effective strategies for preventing childhood obesity.

Goal(s): To investigate the presence of distinct abdominal fat accumulation patterns during infancy and childhood in a multi-ethnic cohort, and their associations with cardiometabolic risk.

Approach: Latent class growth mixture modeling was used to identify three trajectories (stable, slow acceleration, rapid acceleration) for deep subcutaneous (DSAT), superficial subcutaneous (SSAT), and visceral adipose tissues (VAT).

Results: Compared to Chinese children, Indian children had higher odds of being in the rapid acceleration trajectory. All accelerated trajectories were associated with inflammatory marker, hsCRP.

Impact: This research has the potential to impact public health by providing evidence-based insights into the relationships between abdominal fat distribution patterns and cardiometabolic health. Our findings may aid development of targeted interventions and strategies to mitigate long-term adverse cardiometabolic consequences.

16:120290.
Accelerated Free-Breathing Liver Fat/R2* Quantification in Pediatrics Using XD-GRASP Multi-Echo Stack-of-Radial MRI: A Retrospective Study
Xiaodong Zhong1, Aaryani Tipirneni-Sajja2, Marcel Nickel3, Cara Morin4, Zachary Abramson5, Fei Han6, Vibhas Deshpande7, and Stephan Kannengiesser3
1Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States, 2Biomedical Engineering, University of Memphis, Memphis, TN, United States, 3MR Application Predevelopment, Siemens Healthineers AG, Erlangen, Germany, 4Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 5Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN, United States, 6MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Los Angeles, CA, United States, 7MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Austin, TX, United States

Keywords: Body, Liver, Fat and iron quantification

Motivation: Free-breathing liver fat and iron quantification is of growing interest in pediatric patients. However, motion compensation is necessary for quantification accuracy, resulting in prolonged acquisition times.

Goal(s): This study was to retrospectively evaluate a newly developed technique with XD-GRASP reconstruction in pediatric patients.

Approach: Data with oversampled k-space radial views were undersampled to fewer radial views. All data were reconstructed and compared between a self-gating method and the proposed XD-GRASP method.

Results: When applied to data with undersampled radial views, the proposed XD-GRASP method reduced image artifacts and improved PDFF and R2* results compared to the self-gating method.

Impact: The proposed multi-echo stack-of-radial MRI method using motion-resolved reconstruction and multi-dimensional regularization may allow accelerated free-breathing liver PDFF and R2* mapping in pediatric patients.

16:240291.
Multiorgan quantitative abdominal MRI in paediatric patients with Cystic Fibrosis
Chris R Bradley1,2, Alex Yule2,3, Nayan Dey2,3, Christabella Ng2,3, Naaventhan Palaniyappan2,4, Zachary Peggs1,2, Jonathan Brooke2,4, Neele Dellschaft1,2, Luca Marciani1,2, Robin Spiller2,4, Guruprasad Aithal2,3, Caroline Hoad1,2, Penny A Gowland1,2, Ian Hall2,3, Alan Smyth2,3, Susan T Francis1,2, and Andrew Prayle2,3
1Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, 2NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom, 3Population and Lifespan Sciences, University of Nottingham, Nottingham, United Kingdom, 4Translational Medical Sciences, University of Nottingham, Nottingham, United Kingdom

Keywords: Body, Pediatric, liver, pancreas, spleen

Motivation: Cystic fibrosis (CF) is a multi-system, life-limiting genetic disorder. There is a need for multiorgan assessment in children with CF and the response to modulator therapies.

Goal(s): To perform multiorgan MRI in children to quantify lung, liver, pancreas, spleen, and gut function.

Approach: 8 children with CF and 3 healthy volunteers (HV) performed the protocol including quantitative assessment (T1, T2, T2*, fat fraction (FF), stiffness) of liver, pancreas and spleen.

Results: Increased pancreas FF, T1 and T2, spleen T1 and hepatic arterial velocity in CF compared to HVs. Increased liver T1, T2 and stiffness in a CF child independently diagnosed with liver disease.

Impact: This protocol will be used to study the effect of the Cystic Fibrosis Transmembrane Regulator Modulator therapy in children on liver toxicity, pancreas and gut function, and lung health, by performing MRI before and 12 months after commencement of Kaftrio.

16:360292.
Abbreviated Whole-Body MRI as a Novel Imaging Modality for Pediatric Lymphoma Follow-Up: A Multicenter study
Dongqiu Shan1, Bingjie Zheng1, and Yue Wu1
1The Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Keywords: Adolescents, Whole Body

Motivation: Our study is motivated by the need to assess abbreviated whole-body MR for evaluating treatment response in pediatric patients with lymphoma.

Goal(s): To evaluate the diagnostic efficacy and reproducibility of a novel abbreviated whole-body MRI (WB-MRI) for response assessment in pediatric patients with lymphoma.

Approach: We conducted a multicenter prospective study included pediatric patients underwent both PET/CT and abbreviated WB-MRI at baseline and during follow-up. 

Results: The image quality of abbreviated WB-MRI was rated good or excellent, with high sensitivity and accuracy.

Impact: Abbreviated WB-MRI has the advantage of being non-invasive and without radiation exposure, making it an alternative to PET/CT for response surveillance in pediatric patients.

16:480293.
Comparison of diagnostic image quality of a 24-channel pediatric screen-printed coil to commercially available coils in clinical body MR exams
Yingzhen Zhang1, Surbhi Raichandani 1, and Ali B Syed1
1Stanford University Department of Radiology, Palo Alto, CA, United States

Keywords: Body, Pediatric

Motivation: To evaluate diagnostic image quality of novel 24-channel screen-printed flexible coil array in pediatric body MR at 3T

Goal(s): Whether the diagnostic image quality of novel 24-channel screen-printed flexible coil array in pediatric body MR at 3T is comparable to commercially available coils

Approach: Retrospective case-control study with pediatric patients who underwent clinical body MR exams using either screen-printed coils or commercial coils. A single radiologist reviewed image quality using anonymized randomized image stacks.

Results: A flexible screen-printed pediatric MRI receive coil yielded similar diagnostic image quality to commercial coils on body MRI exams performed in the clinical setting.   

Impact: Screen-printed pediatric MRI receive coil yielded comparable diagnostic image quality to commercial coils on body MRI exams performed in the clinical setting on 3T scanners while offering the advantages of comfort, flexibility, and ease of use.

17:000294.
Investigating Phase-Cycled bSSFP Imaging for Functional Lung Imaging in 2-Year-Olds After Congenital Diaphragmatic Hernia Repair
Efe Ilıcak1,2, Safa Özdemir1,2, and Frank Gerrit Zöllner1,2
1Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, 2Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

Keywords: Lung, Lung, Functional, Pulmonary, non-contrast-enhanced

Motivation: bSSFP-based non-contrast-enhanced imaging is a promising alternative for functional lung imaging in pediatric patients. However, bSSFP acquisitions suffer from magnetic field inhomogeneities. 

Goal(s): Our goal is to investigate phase-cycled bSSFP acquisitions as a robust alternative in pediatric functional lung imaging. 

Approach: We acquired dynamic images using conventional and phase-cycled bSSFP acquisitions at 1.5T, from five 2-year-old patients after congenital diaphragmatic hernia repair. The images were non-rigid registered to a reference frame and functional maps were obtained using dynamic mode decomposition technique. 

Results: We have successfully obtained functional maps in all patients and observed a trend toward improved ventilation map homogeneity using phase-cycled acquisitions.

Impact: Pulmonary functional maps obtained via non-contrast-enhanced bSSFP acquisitions may suffer from field inhomogeneity artifacts. Here, we investigate phase-cycled bSSFP imaging in 2-year-old congenital diaphragmatic hernia patients, and show improved robustness, which may be beneficial for lung function assessments.

17:120295.
Ventilation and Gas Exchange Delay maps in Pre-clinical Thoracic Insufficiency Syndrome Models using Dynamic Hyperpolarized-Xenon MRI
Mostafa K. Ismail1, Hooman Hamedani1, Faraz Amzajerdian1, Luis Loza1, Madeleine Boyes2, Klaus Hopster2, Benjamin Sinder2, Patrick Cahill2, Brian Snyder3, Thomas P. Schaer2, Stephen Kadlecek1, Kai Ruppert1, and Rahim Rizi1
1University of Pennsylvania, Philadelphia, PA, United States, 2Children’s Hospital of Philadelphia, Philadelphia, PA, United States, 3Boston Children’s Hospital, Boston, MA, United States

Keywords: Hyperpolarized MR (Gas), MSK, Hyperpolarized MR (Gas), Dynamic Imaging, Pediatric, Signal Modeling, Skeletal, Preclinical, Lung, Flow, Analysis/Processing

Motivation: The pressing need to develop and evaluate novel treatments of thoracic insufficiency syndrome (TIS), a condition with significant implications for compromised pulmonary growth and function.

Goal(s): To gain deeper insights into the altered lung function associated with TIS, ultimately improving patient care and outcomes.

Approach: Dynamic hyperpolarized-xenon-129 MRI was used to assess ventilation and gas exchange dynamics in pre-clinical models of TIS.

Results: Significant ventilation and gas exchange delays were found in the TIS animals compared to the healthy ones.

Impact: Our findings hold the promise to improve TIS assessment and treatment monitoring by providing crucial insights into altered lung function. This study offers a valuable tool for clinicians/researchers, fostering improved patient care and stimulating further TIS management and intervention research.

17:240296.
Comparison of MR-Signal-based and Deformation-based Ventilation Measurement in Pediatric Patients with non-CF Bronchiectasis
Andreas Voskrebenzev1,2, Marcel Gutberlet1,2, Filip Klimeš1,2, Robin Müller1,2, Marius Wernz1,2, Martha Dohna1, Diane Renz1, Frank Wacker1,2, and Jens Vogel-Claussen1,2
1Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany, 2Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany

Keywords: Lung, Lung, Registration, Ventilation, Free-Breathing

Motivation: A previous study showed that MR-signal-based (RVent) and deformation-based approaches (JVent) for ventilation are theoretically equivalent, but result in different defects in a digital lung model. A verification of this finding using real data is pending. 

Goal(s): Test if both ventilation parameters result in significant differences on a global and regional level.

Approach: A retrospective analysis of 32 patients with non-CF Bronchiectasis was performed, calculating RVent, JVent and corresponding ventilation defects for three registration variants.

Results: There were significant differences and patterns on a global and regional level, which are consistent with the findings in the lung model study.

Impact: Inferior-superior gradient in deformation-based ventilation measurements might lead to a biased defect detection. Therefore, use of such parameters might require further correction and/or diligent registration optimization. Thus, signal-based ventilation with more stable performance across different registration variants might be benefical. 

17:360297.
Feasibility of MRI-based lung tissue mechanics computational models of the paediatric lung
Megan Soo1, Haribalan Kumar1,2,3, Daniel Cornfeld3, Paul Condron3,4, Taylor Emsden3,4, Leigh Potter3,5, Samantha Holdsworth3,4, Merryn H. Tawhai1, and Ho-Fung Chan1,3
1Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand, 2GE Healthcare Australia and New Zealand, Auckland, New Zealand, 3Mātai Medical Research Institute, Gisborne, New Zealand, 4Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, 5Ngāti Porou, Ngāti Kahungungu, Rongomaiwahine, Rongowhakaata; Tūranganui-a-Kiwa, Tairāwhiti, New Zealand

Keywords: Lung, Lung

Motivation: There is a scarcity of personalised computational physiology models of the paediatric lung because most models have previously been derived for the adult lung from CT images.

Goal(s): We aim to derive personalised computational models of the paediatric lung from novel structure-function lung MRI techniques.

Approach: In this feasibility study, lung ZTE MR images from healthy children were used to create finite element soft tissue deformation mechanics models. 

Results: Simulations of regional supine lung tissue densities were shown to be similar to lung ZTE MRI densities, demonstrating the strong potential for developing computational paediatric lung models from MR images.

Impact: A computational physiology model of soft tissue deformation was created from lung ZTE MR images of healthy children, demonstrating the potential of using novel regional lung structure-function information for personalised paediatric computational models.

17:480298.
Real-Time Imaging of Lower Airway Collapse at 0.55T
Sarina Kapai1, Prakash Kumar1, Ecrin Yagiz1, Ye Tian1, Roberta Kato2, Marcus Chen3, Marcela Ferrada3, Adrienne Campbell-Washburn3, and Krishna S Nayak1
1Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, United States, 2Children's Hospital Los Angeles, Los Angeles, CA, United States, 3National Institutes of Health, Bethesda, MD, United States

Keywords: Rare Disease, Low-Field MRI, Acquisition Methods, Data Acquisition, Pulse Sequence Design, Lower Airway, Tracheomalacia, Lung

Motivation: Tracheomalacia involves intermittent collapse of the lower airway and is difficult to diagnose. Currently, this condition is evaluated with invasive procedures like bronchoscopy or dynamic computer tomography (CT) which utilizes ionizing radiation.

Goal(s): To develop and optimize a high spatial and temporal resolution pulse sequence for evaluating tracheomalacia at 0.55T.

Approach: We optimize contrast (sequence, flip angle) for dynamic imaging in the lower airway for both 2D and SMS real-time imaging.

Results: Spiral acquisition achieves sufficient temporal resolution and the TrueFISP sequence (flip angle=32°) offers optimal contrast for imaging lower airway collapse.

Impact: We demonstrate the feasibility of capturing lower airway collapse with 2D and SMS real-time imaging (at 0.55T) in a way that is informative to the diagnosis and longitudinal monitoring of tracheomalacia.