ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Combined Educational & Scientific Session

Pediatric Neuroimaging

SKILL LEVEL: Advanced

ORGANIZERS: Jeffrey J. Neil, M.D., Ph.D.

Thursday 4 June 2015

Overview
This session will focus on the challenges associated with pediatric neruoimaging, and examine what types of information neurodevelopmental testing using MR can provide. The first portion will focus on tactics to scanning children without using sedation, and the scientific portion will include novel techniques which can be used to improve patient compliance and/or image quality for pediatric scanning. The second portion will describe how neurodevelopmental testing is performed using MRI and highlight technical challenges and potential solutions.

Target Audience
MR Scientists and Physicians who want to perform pediatric scanning without sedation, and those who would like to use MR for neuroimaging and neurodevelopmental testing and understand the current state-of-the-art

Educational Objectives
Upon completion of this course, participants should be able to:

• Implement techniques to improve patient compliance and avoid the use of sedation when scanning infants or children;
• Describe how MRI is used to evaluate brain development; and
• Apply newly proposed imaging techniques to neurodevelopmental imaging.

PROGRAM
Moderators: Petra S. Hüppi, M.D., Terrie E. Inder, M.B.Ch.B., M.D.
10:30   How to Scan an Infant or Child Without Using Sedation
Kelly N. Botteron, M.D.
10:54 0832.   Propeller techniques for pediatric exams in the presence of large motion
Stefan Skare1, Enrico Avventi1, Magnus Mårtensson2, Ola Norbeck1, Mathias Engström1, Maria Sandell1, and Chen Wang1
1Neuroradiology, Karolinska University Hospital, Stockholm, Stockholm, Sweden, 2EMEA Research & Collaboration, GE, Stockholm, Sweden

 
A multi-contrast propeller sequence with an improved retrospective 3D motion correction was developed and applied to pediatric patients, aiming for fast and robust exams without the use of general anesthesia

 
11:06 0833.   Retrospective Motion Correction of MPnRAGE Studies in Children
Andrew L. Alexander1,2, Janet E Lainhart1, Audra Sterling1, Brittany G Travers1, Abigail Freeman1, and Steven R. Kecskemeti1
1Waisman Center, University of Wisconsin, Madison, WI, United States, 2Medical Physics and Psychiatry, University of Wisconsin, Madison, WI, United States

 
Head motion is a significant challenge particularly for neuroimaging studies of young and intellectually impaired children. This study investigates the application of a retrospective motion correction algorithm for 3D T1-weighted imaging using MPnRAGE, which is an inversion recovery prepared method with 3D radial k-space sampling. This correction significantly improved the quality of MPnRAGE images obtained on four children that moved during their studies. The correction did not cause any deleterious effects on image quality.

 
11:18   What MR Scientists Should Know About Neurodevelopmental Testing
Peter J. Anderson, Ph.D.
11:42 0834.   Multifunctional Liposome for Non-small Cell Lung Cancer Targeting and Theranostic MRI
Ren Lili1, Shizhen Chen1, Haidong Li1, Zhiying Zhang1, Jianping Zhong1, and Xin Zhou1
1National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Wuhan, Hubei, China

 
A multifunctional liposome, which contained Gd-DOTA (MRI probe), paclitexal (PTX) and c(RGDyk) (targeting peptide), was prepared. This nanoparticle could utilize the insolubility of PTX, reduce the side effect of FDA-approved formulation of PTX-Cre (Taxol®), and improve the drug delivery efficiency to tumor.

 
11:54 0835.   Neural Correlates of Phonological Processing in 4-6 year olds - permission withheld
Andrea S. Miele1, Holly Dirks2, Dannielle John Whiley2, Terry Harrison-Goldman1, Viren D'Sa3, and Sean Deoni2,4
1Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, United States, 2Advanced Baby Imaging Laboratory, Brown University, Providence, Rhode Island, United States, 3Pediatrics, Neurodevelopmental Center, MHRI, Pawtucket, Rhode Island, United States, 4Pediatric Radiology, Children's Hospital Colorado, Colorado, United States

 
Phonological processing development is considered essential for reading acquisition. Deficient phonological awareness is considered a core feature of the specific learning disability, dyslexia. Despite being neurobiological in origin, the underlying mechanisms that lead to deficits in phonological processing and dyslexia remain elusive. Results support a positive relationship between myelin content and performance on a measure of phonological awareness in very young children. Underlying aspects of phonological awareness appear related to distinct WM correlates not only in the frontal subcortical system but also in the temporal lobe, suggesting involvement of auditory and visual processing systems as well.

 
12:06 0836.   Differing Contributions of Whole Brain Fractional Anisotropy, Axon Density and Axon Dispersion to Neurodevelopmental Outcomes of Children Born Very Preterm
Claire E Kelly1, Deanne K Thompson1,2, Jian Chen1,3, Alexander Leemans4, Christopher L Adamson1, Terrie E Inder5, Jeanie LY Cheong1,6, Lex W Doyle1,6, and Peter J Anderson1,7
1Murdoch Childrens Research Institute, Melbourne, VIC, Australia, 2Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia, 3Monash University, Melbourne, VIC, Australia, 4Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands, 5Brigham and Women’s Hospital, Boston, MA, United States, 6Royal Women’s Hospital, Melbourne, VIC, Australia, 7University of Melbourne, Melbourne, VIC, Australia

 
Children born very preterm (VPT; <32 weeks’ gestation) are at risk of neurodevelopmental delays. We aimed to determine whether whole brain Diffusion Tensor Imaging (DTI) and Neurite Orientation Dispersion and Density Imaging (NODDI) values are associated with neurodevelopment in 145 VPT 7-year-olds. Decreasing fractional anisotropy in widespread fiber tracts correlated with poorer cognitive, motor, academic and behavioral/emotional outcomes. In many of the same tracts, increasing axon dispersion correlated with poorer motor outcome, while decreasing axon density correlated with poorer behavioural/emotional outcome. DTI combined with NODDI enables more specific identification of the microstructural factors contributing to neurodevelopmental outcomes in VPT children.

 
12:18 0837.   White Matter Maturation Profiles Through Early Childhood Predict General Cognitive Ability
Sean Deoni1, Jonathan O'Muircheartaigh2, Holly Dirks1, and Douglas C Dean1
1Brown University, Providence, RI, United States, 2NeuroImaging, King's College London, London, United Kingdom

 
An important neurodevelopmental processes during early childhood is the maturation of the myelinated white matter. Though prior brain imaging studies in older children and adults have linked white matter development with cognitive maturation and intelligence, few studies have examined how these processes are related throughout early development. Here we show the profile of white matter myelination across the first 5 years of life is strongly related to cognitive ability, even when controlling for SES, gestation, and birth weight. Specifically, higher ability children exhibit slower but more prolonged early development, resulting in overall increased myelin by ~3 years of age.

 
12:30   Adjournment & Meet the Teachers