Pediatric MRI
Pediatrics Tuesday, 18 May 2021
Oral
347 - 356
Digital Poster

Oral Session - Pediatric MRI
Pediatrics
Tuesday, 18 May 2021 16:00 - 18:00
  • Rapid fetal HASTE imaging using variable flip angles and simultaneous multislice wave-LORAKS
    Yamin Arefeen1, Tae Hyung Kim2, Justin Haldar3, Ellen Grant4,5, Borjan Gagoski6,7, Berkin Bilgic2,7, and Elfar Adalsteinsson1,8,9
    1Massachusetts Institute of Technology, Cambridge, MA, United States, 2Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States, 3Department of Electrical Engineering, University of Southern California, Los Angeles, CA, United States, 4Boston Children’s Hospital, Boston, MA, United States, 5Harvard Medical School, Boston, MA, United States, 6Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA, United States, 7Department of Radiology, Harvard Medical School, Cambridge, MA, United States, 8Harvard-MIT Health Sciences and Technology, Cambridge, MA, United States, 9Institute for Medical Engineering and Science, Cambridge, MA, United States
    Variable refocusing flip angles and rapid external reference scans could improve efficiency in fetal T2-weighted MRI with reduced specific-absorption rates, enabling simultaneous multi-slice with wave encoding and constrained reconstruction.
    Figure 4: Prospectively acquired in-vivo data comparing (a) GRAPPA reconstructions of standard HASTE and the proposed VFA scheme. VFA reduces blurring and retains 83% SNR in comparison to standard HASTE. (b) HASTE reconstructed with GRAPPA and POCS partial Fourier, and the proposed VFA reconstructed with SENSE-LORAKS using the external calibration scan. The reference scan allows prospective calibration of SENSE-LORAKS, and the proposed VFA regime acquired the entire stack of slices 2.3x faster than the standard HASTE.
    Figure 5: Comparison between slice-by-slice GRAPPA, retrospective GRAPPA SMS, wave-encoded SMS and wave-LORAKS SMS. While slice-GRAPPA incurs some noise amplification, wave-LORAKS SMS produces cleaner images. Accounting for SAR associated with multi-band pulses in a prospective implementation, combining the proposed VFA technique with SMS could yield between 3-5x reduction in total scan time.
  • Motion Compensated Free-Running 3D Fetal Magnetic Resonance Imaging: Initial Feasibility
    Christopher W Roy1, Leonor Alamo1, Estelle Tenisch1, John Heerfordt1,2, Milan Prsa3, Meritxell Bach Cuadra1,4,5, Davide Piccini1,2, Jérôme Yerly1,4, and Matthias Stuber1,4
    1Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, 2Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland, 3Division of Pediatric Cardiology, Department Woman-Mother-Child, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, 4Center for Biomedical Imaging (CIBM), Lausanne, Switzerland, 5Signal Processing Laboratory 5 (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
    A novel framework for 3D MRI of the fetus with retrospective motion compensation is developed enabling high isotropic resolution imaging of the entire fetus including the brain and heart.
    Representative reconstructions from the proposed motion correction strategy for 3D MRI of the fetus with isotropic millimetric spatial resolution. The top row shows the originally acquired (motion-blurred) data in approximate axial, sagittal, and coronal reformats while the bottom row shows substantial improvement in image quality and delineation of fetal brain structures after applying retrospective motion correction to the same data.
    Animated figure depicting motion-resolved reconstructions of free-running 3D fetal MRI data. A-C) A low spatial resolution real-time image series with 500 ms temporal resolution demonstrates maternal respiration and gross fetal movement in three perpendicular planes. D-F) High spatial resolution images created from unique motion states identified in A) shown in the same views centered on the brain, allowing for co-registration to “stabilize” anatomical features of interest (G-I).
  • Clinical fetal cardiovascular MRI based on Doppler ultrasound gating at 3T and 1.5T: On a technical aspect of imaging pulse sequence optimization
    Shuo Zhang1, Janine Knapp2, Roland Cronenberg3, Björn Schönnagel2, Manuela Tavares de Sousa4, Barbara Ulm5, Daniela Prayer3, Vanessa Berger-Kulemann3, and Fabian Kording2,6
    1Philips, Hamburg, Germany, 2Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany, 3Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria, 4Department of Obstetrics and Fetal Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany, 5Department of Gynecology and Obstetrics, Division of Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria, 6northh medical GmbH, Hamburg, Germany
    Fetal cardiovascular MRI was possible with direct fetal cardiac gating by the DUS device. Benefits were shown with promise in high-quality morphological and functional studies of the fetal heart using routinely available imaging techniques, including cine, 4D flow and myocardial mapping.

    Figure 3. 4D flow exam of the fetal heart based on DUS fetal cardiac gating. Image examples with streamline visualization were selected from a case at 35 gestational weeks on 3.0T. Details see text.

    DA = ductus arteriosus; PA = pulmonary artery; AoD = descending aorta; AoA = ascending aorta; RH = right heart; LH = left heart

    Figure 2. Functional cine exams of the fetal heart based on DUS fetal cardiac gating on 3.0T. (A) Selected images in 4-chamber view (4CH) at end systole (ES) and end diastole (ED). (B) Selected images from three adjacent short-axis slices (SAX) from ES to ED. Arrows indicated the fetal heart at ES and ED.
  • Early Non-Contrast Biomarkers of Left Ventricular Cardiomyopathy in Children with Duchenne Muscular Dystrophy
    ZHAN-QIU LIU1, Nyasha Maforo2, Seraina Dual3, Ashley Prosper4, Pierangelo Renella4, Nancy Halnon5, Holden Wu4, and Daniel Ennis3
    1Cardiovascular Institute, Stanford University, Stanford, CA, United States, 2Physics and Biology in Medicine Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, United States, 3Department of Radiology, Stanford University, Stanford, CA, United States, 4Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA, United States, 5Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, United States
    Septal Ecc was significantly lower against lateral Ecc in controls and LGE- DMD. Septal Ecc in LGE- DMD was significantly impaired against controls, correlated to changes in LVEDV and RVEDV. Septal Ecc outperformed lateral LV pre-contrast T1 and LVEF in distinguishing LGE- DMD from controls.

    Figure 1: Global and Regional Ecc in Healthy Boys and LGE(-) boys with DMD. Septal Ecc was significantly lower than anterior, lateral, and inferior Ecc and the lateral Ecc was significantly higher than septal, anterior, and inferior Ecc for both the controls or LGE(-) DMD patients. Furthermore, the LGE(-) DMD patients had significantly reduced septal Ecc compared to healthy volunteers. * p-value ≤ 0.05 is significant for a comparison within either controls or LGE(-) boys with DMD. # p-value ≤ 0.05 is significant for a comparison between controls and LGE(-) patients with DMD.

    Figure 2: Receiver Operator Characteristic (ROC) curves for septal Ecc, lateral LV pre-contrast T1, and LVEF from a binomial logistic regression classifier for distinguishing between LGE(-) boys with DMD from healthy boys. Larger area under the curve (AUC) values indicate better classifier performance. Regarding differentiating LGE(-) boys with DMD from healthy boys, septal Ecc outperforms each individual biomarker and the combinaiton of septal Ecc, lateral LV pre-contrast T1, and LVEF outperforms the other biomarker combinations.

  • Evaluating the Risk of Pediatric Neuroblastoma in the Abdomen with Amide Proton Transfer Imaging
    Wenqi Wang1, Xuan Jia2, Jiawei Liang2, Xiaohui Ma2, Weibo Chen3, Dan Wu1, Can Lai2, and Yi Zhang1
    1Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China, 2Department of Radiology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China, 3Philips Healthcare, Shanghai, China
    Amide proton transfer (APT) imaging was applied to evaluate the risk of pediatric neuroblastoma in the abdomen. APT MRI was able to distinguish between low- and high-risk abdominal NBs with an AUC of 0.917, which was substantially higher than that of quantitative T1 and T2.
    Figure 2. Conventional anatomical images and APT-weighted images within initial ROI (third column) and ROI after shrinkage with a cutoff value of 30% (fourth column), which were fused with an image without saturation. Columns 5 and 6 show quantitative T1 and T2 maps calculated from MIX images within ROI after shrinkage, respectively. Images were from a patient with low-risk neuroblastoma (a) and a patient with high-risk neuroblastoma (b).
    Table 2. The ROC analysis for differentiation between low- and high-risk NBs
  • Liver Stiffness in a Single Breath-hold Using Wave Polarity-Inversion Motion Encoding and Compressed SENSE: Coverage Equivalent to 5 Slices
    Amol Pednekar1, Deep B. Gandhi2, Hui Wang3, Jean A. Tkach1, Andrew T. Trout1, and Jonathan R. Dillman1
    1Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 2Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 3MR Clinical Science, Philips, Cincinnati, OH, United States
    In 19 volunteers, mean liver shear stiffness values measured with SC_2D_4BH and 3D_5sl_SBH correlated very strongly (ICC=0.96) with mean bias of 0.13 kPa (<5%). 3D_5sl_SBH MRE provides similar stiffness estimates as SC_2D_4BH with increased coverage in a single breath.
    Figure 1: Schematic pulse sequence diagrams. (A) SC_2D_4BH: The polarity of MEGs is reversed (blue and yellow) every RF excitation. The mechanical wave polarity (green) stays the same across RF excitations. Each RF excitation triggers 3 motion cycles. (B) 3D_5sl_SBH : The polarity of MEGs remains the same (blue) across RF excitations. The mechanical wave polarity inverts (green and red) every RF excitation. Every 4th RF excitation triggers 7 motion cycles. Each sequence starts with dummy excitation of 1 s that ensures both acoustic and magnetization steady-state.
    Figure 3: Comparison of liver shear stiffness values in individual slices for SC_2D_4BH and 3D_5sl_SBH techniques by Linear Regression and Bland-Altman Analysis. Values are based on manual analysis informed by a 95% confidence mask with matching ROIs on images from both techniques and maximal possible ROI in each. SC_2D_4BH: standard of care two-dimensional 4 slices through mid-liver with 13 second breath-hold per slice; 3D_5sl_SBH: 3D wave polarity-inversion motion encoding plus compressed SENSE acquisition in single breath-hold of <16s.
  • Maternal Obesity during Pregnancy is Associated with Lower Cortical Thickness in the Newborn Brain
    Xiaoxu Na1, Natalie E. Phelan1, Marinna R. Tadros1, Aline Andres2,3, Thomas M. Badger2,3, Charles M. Glasier1, Raghu H. Ramakrishnaiah1, Amy C. Rowell1, Li Wang4, Gang Li4, Zhengwang Wu4, David K. Williams5, and Xiawei Ou1,3,6
    1Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States, 2Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States, 3Arkansas Children's Nutrition Center, Little Rock, AR, United States, 4Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States, 5Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, United States, 6Arkansas Children's Research Institute, Little Rock, AR, United States
    Significant differences in cortical thickness between infants born to normal weight vs. obese mothers were found, and the cortical thickness was negatively correlated with maternal body fat mass percentage, suggesting impact of maternal obesity on offspring brain cortical development.  
    Figure 1: The anatomical locations for the 3 brain cortical regions that showed significant differences (FDR corrected P < 0.05) in mean cortical thickness between infants born to normal weight vs. obese pregnant women: a) the left pars opercularis (LPO) gyrus; b) the left pars triangularis (LPT) gyrus; and c) the left rostral middle frontal (LRMF) gyrus. The comparison of mean cortical thickness for these 3 regions between these two groups of infants is illustrated in d).
    Figure 2: Partial correlation analysis showed significant negative correlations (P < 0.05) between maternal body fat mass percentage measured at ~12 weeks of pregnancy and infant brain mean cortical thickness measured at ~2 weeks of postnatal age in the a) left pars opercularis (LPO) gyrus; b) left pars triangularis (LPT) gyrus; and c) left rostral middle frontal (LRMF) gyrus.
  • Using Free-Breathing MRI to Characterize Heterogeneity of Pancreatic Fat in Children with Nonalcoholic Fatty Liver Disease
    Jacob Story1, Sevgi Gokce Kafali2,3, Shu-Fu Shih2,3, Kara L. Calkins4, Shahnaz Ghahremani3, and Holden H. Wu2,3
    1David Geffen School of Medicine at UCLA, Los Angeles, CA, United States, 2Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States, 3Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States, 4Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, United States
    Free-breathing MR images were used to segment the pancreas on PDFF maps. In children with NAFLD, the pancreas has a high fat content that is predominantly in the superior regions. Pancreatic fat is related to BMI, liver fat, and acanthosis nigricans.
    Table 1. Demographic Information of Study Participants. SD = Standard deviation. Body mass index (BMI), full segmentation pancreatic proton density fat fraction (PDFF) and pancreatic volume were significantly higher in children with nonalcohol fatty liver disease (NAFLD) than healthy children.
    Figure 4. Box-Whisker Plots of Pancreatic Proton Density Fat Fraction (pPDFF) from Different Methods. Full segmentation (FS) pPDFF was higher in children with nonalcoholic fatty liver disease (NAFLD) compared to healthy children (p < 0.001). The 3-ROI method underestimated pPDFF compared to FS (p < 0.001 for healthy and NAFLD). The superior slices in children with NAFLD had higher pPDFF than inferior slices (p = 0.003).
  • Regional changes in brain development and cognitive outcome in infants with Congenital Heart Disease
    Alexandra F Bonthrone1, Ralica Dimitrova1,2, Andrew Chew1, Christopher J Kelly1, Lucilio Cordero-Grande1,3, Olivia Carney1, Alexia Egloff1, Emer Hughes1, Katy Vecchiato1,2, John Simpson4, Joseph V Hajnal1,5, Kuberan Pushparajah4, Suresh Victor1, Chiara Nosarti1,6, Mary A Rutherford1, A. David Edwards1, Jonathan O’Muircheartaigh1,2, and Serena J Counsell1
    1Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, 2Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom, 3Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid and CIBER-BBN, Madrid, Spain, 4Paediatric Cardiology Department, Evelina London Children's Healthcare, London, United Kingdom, 5Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, 6Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
    In toddlers with Congenital Heart Disease, reduced neonatal cerebral oxygen delivery was indirectly associated with lower cognitive scores through the mediating effect of impaired bilateral caudate and thalamus development before surgery.
    Figure 2. Path diagrams showing the indirect relationship between Cerebral Oxygen Delivery and Cognitive Composite Score mediated by (A) left thalamus (B) right thalamus (C) left caudate nucleus (D) right caudate nucleus. Standardised regression coefficients are reported; numbers in brackets show p-value *p<0.05 **p<0.01. ACME, Average Causal Mediation Effect; IMD, Index of Multiple Deprivation (a measure of socioeconomic status).
    Figure 1. Volumetric brain development in neonates with CHD. Shaded areas represent ±1,2 and 3 standard deviations from the normative model mean, separately for female and male infants. Total Tissue Volume, TTV; Grey Matter, GM; White Matter, WM; Right, R; Left, L.
  • Transcriptomic decoding of the human brain structural connectome through the 3rd trimester and early childhood
    Chenying Zhao1,2, Gabriel Santpere3, Minhui Ouyang1, David Andrijevic4, Nenad Sestan4, and Hao Huang1,5
    1Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States, 2Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States, 3Neurogenomics group, Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), DCEXS, Universitat Pompeu Fabra, Barcelona, Spain, 4Department of Neuroscience and Kavli Institute for Neuroscience, Yale School of Medicine, New Haven, CT, United States, 5Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
    Dynamic transcriptomic basis of structural connectome was studied by associating spatiotemporal transcriptome map from over 10,000 genes and diffusion-MRI-derived structural network through the 3rd trimester and early childhood.
    Figure 1. The schematic pipeline of construction of connectome trajectory (in pink) and its association (in green) with gene expression (in blue) from the 3rd trimester to 8 years of age. Abbreviations: PLS = partial least squares; MFC = medial prefrontal cortex; V1C = primary visual cortex.
    Figure 4. Gene enrichment analysis in top 10% genes associated with degree centrality demonstrated dynamic enrichment in (A) different cell types and (B) gene ontology terms for biological process through the 3rd trimester and early childhood. Significance is labeled by color (red dot: p<0.05; gray dot: p≥0.05, FDR corrected). Abbreviations: Ex=excitatory; In=inhibitory neuron; Other=other types of cells in brain. Ex2b and Astro1 are subtypes of excitatory neuron and astrocyte, respectively.
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Digital Poster Session - Pediatrics: Neuro Topics
Pediatrics
Tuesday, 18 May 2021 17:00 - 18:00
  • General factors of white matter microstructure in the newborn human brain
    Kadi Vaher1, Paola Galdi1, Manuel Blesa Cabez1, Gemma Sullivan1, Gill Black1, David Q Stoye1, Alan J Quigley2, Michael J Thrippelton3, Simon R Cox4, Mark E Bastin3, Debby Bogaert5, and James P Boardman1
    1MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom, 2Department of Paediatric Radiology, Royal Hospital for Sick Children, Edinburgh, United Kingdom, 3Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom, 4Lothian Birth Cohort Studies group, Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom, 5Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
    Applying PCA to tract-averaged diffusion MRI metrics reveals substantial shared variance within and between DTI and NODDI metrics across 16 major white matter tracts in a neonatal population. This property enables derivation of general factors, which associate with preterm birth.
    Figure 1. Visual representation of the delineated white matter tracts in the neonatal atlas space. Shown in superior (left), anterior (centre) and lateral (right) views.
    Figure 3. Multimodal general factors. (A) PCA variable contribution plot; the colours represent the contribution of the dMRI metric to the components. (B) Boxplots of the multimodal g-factors showing differences between the term and preterm group. Note that each participant is represented by 16 tracts. Reported statistics are standardised β for the PC1 or PC2 from linear mixed effect regression models and FDR-corrected p-values.
  • Learning 3D structures from 2D slices with scan-specific data for fast and high-resolution neonatal brain MRI
    Yao Sui1,2, Onur Afacan1,2, Ali Gholipour1,2, and Simon K Warfield1,2
    1Harvard Medical School, Boston, MA, United States, 2Boston Children's Hospital, Boston, MA, United States
    We developed a methodology that enables learning 3D gradient structures from 2D slices for an individual subject without the need for large, auxiliary high-resolution datasets, and achieved high-quality neonatal brain MRI at an isotropic resolution of 0.39mm with six minutes of imaging time.
    Design of our learning algorithm. The LR volumes are decomposed onto HR 2D slice stacks in the direction of slice selection, and their gradients are used as the output of the convolutional neural network (CNN) in the learning. On the other hand, all LR volumes are interpolated and combined into a blurred HR volume that is then resampled onto the LR image spaces to obtain the LR 2D slice stacks as the network input.
    Reconstructed slices from a representative subject by our approach and the baselines on the clinical dataset. (a) SRCNN. (b) GGR. (c) Our approach (deepGG). Our approach achieved the highest quality in terms of image contrast and sharpness. The fine structures delineated by our approach are highlighted by the red arrows, in particular from the hippocampus in the coronal plane.
  • Relationship between brain temperature and prognosis during hypothermia in newborns with hypoxic-ischemic encephalopathy
    Moyoko Tomiyasu1,2, Jun Shibasaki3, Yasuhiko Terada4, Katsuaki Toyoshima3, Tatsuya Higashi1, Takayuki Obata1, and Noriko Aida2
    1Department of Molecular Imaging and Theranostics, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan, 2Department of Radiology, Kanagawa Children’s Medical Center, Yokohama, Japan, 3Department of Neonatology, Kanagawa Children’s Medical Center, Yokohama, Japan, 4Institute of Applied Physics, University of Tsukuba, Tsukuba, Japan
    The brain temperature of neonates with hypoxic-ischemic encephalopathy was significantly different during and after hypothermia, but was not significantly different between favorable and adverse outcomes evaluated by neurodevelopmental testing at 18–22 months of age.
    Figure 1. Representative in vivo proton MR spectra for the deep gray matter obtained from a neonate with hypo-ischemic encephalopathy: a) without and b) with water presaturation pulse in PRESS sequence (TE/TR = 30/5000 ms). Scales of a) and b) are not proportional. c) White voxel on the images show MR spectroscopy volumes of interest. tNAA = N-acetylaspartate and N-acetylaspartylglutamate.
    Figure 2. Calibration curve obtained from NAA aqueous solution.
  • Association between multi-modal term MRI biomarkers and early cerebral palsy risk in very preterm infants
    Julia E. Kline1, Weihong Yuan1, Karen Harpster1, and Nehal A. Parikh1
    1Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
    Very preterm infants are at high risk for motor impairments, such as cerebral palsy. Graph theory metrics from term diffusion MRI connectomes and cortical surface area and subcortical volumes derived from term structural MRI are associated with the early diagnosis of cerebral palsy.
    Figure 3: Subcortical and cortical volumes (top) and cortical surface area (bottom) for regions that were negatively associated with early diagnosis of cerebral palsy are shown in blue (shade is arbitrary). Grey/white regions are not significant.
    Figure 1: Alignment (3rd column) of the 90-region Automated Anatomical Labeling atlas (2nd column) with diffusion space tractography (1st column) for an example subject. From here, we calculate the mean fractional anisotropy for all streamlines connecting each regional pair as a 90x90 symmetrical matrix.
  • Optimizing Brain Injury Biomarkers in a piglet model of Neonatal Encephalopathy: combining perfusion with proton MRS
    Hillary Idogwu1, Magdalena Sokolska2, Pang Raymand 3, Saiful Islam4, Christopher Meehan 3, Adnan Avdic-Belltheus 3, Kathryn Marinello 3, Ingran Lingam 3, Tatenda Mutshiya 3, Alan Bainbridge 2, Nikki Robertson 3, David Thomas1, and Xavier Golay1
    1Brain Repair and Rehabilitation, Institute of Neurology, UCL Queen Square Institute of Neurology, London, United Kingdom, 2Medical Physics and Biomedical Engineering, UCLH NHS Foundation Trust, London, United Kingdom, 3Neonatology, UCL EGA Institute for Women's Health, London, United Kingdom, 4UCL Queen Square Institute of Neurology, London, United Kingdom
     In this work, we hypothesised that the combination of CBF with BGT Lac/NAA would be more closely associated with quantitative cell death than either alone after HI or inflammation sensitized injury in a piglet model undergoing a variety of neuroprotective interventions.   
    Figure 1. Plots of correlation of 24h, 48h and average CBF with Cell death in BGT. (CBF = cerebral blood flow, BGT = basal ganglia thalamus)
    Figure 2. Plots of correlation of 24h, 48h and average CBF with Iba1 ramification index in the cortex. Iba1 = ionized calcium binding adaptor molecule 1 (CBF = cerebral blood flow)
  • Brain asymmetry and development of healthy preterm infants within half-year-old: a diffusion MRI study based on ROI and fixel methods
    Tingting Liu1, Weihao Zheng1, Yuqing You2, Ying Lv2, Weijun Chen2, Zhiyong Zhao1, Fusheng Gao2, Hongxi Zhang2, Chai Ji2, and Dan Wu1
    1ZheJiang University, Hangzhou, China, 2Children's Hospital, ZheJiang University School of Medicine, Hangzhou, China
    Most brain regions showed significant asymmetry and the asymmetry changed with brain development. The MD-based LI showed an center-versus-peripheral pattern, and contrast function lateralization with adult. Consistent leftward lateralization in white matter was observed.
    Figure 1. Regions with significant left/right difference after multiple comparison correction, based on MD (A) and FA (B). LIs of all 63 regions were plotted on the left (A1 and B1), with the positive values indicating leftward asymmetry and negative values indicating rightward asymmetry. *p < 0.05 by pairwise t-test. Regions with significant asymmetry were overlaid on the corresponding MD and FA maps in sagittal and axial views, with the color bar indicating the LI. Positive values (red) represented leftward asymmetry, and negative values (blue) represented rightward asymmetry.
    Figure 4. FBA revealed extensive WM regions with significant asymmetry in terms of FDC. The three rows from top to bottom show results for TEA-1month, 1-3 months, 3-6 months, respectively. The color bar indicates the LI, with positive values (red) represent leftward asymmetry, and negative values (blue) represent rightward asymmetry. A clear inside-to-outside developmental change can be identified, with the lateralization primarily localizes in the central brain and major WM at TEA, but extend to peripheral and subcortical WM at 1-3 months which further increased at 3-6 months.
  • Accounting for Measurement Noise in a Multi-Site Newborn Diffusion Weighted Imaging Study
    Jerod M Rasmussen1, Alice M Graham2, Pathik D Wadhwa1, Sonja Entringer3, Martin Styner4, Beatriz Luna5, Thomas G O'Connor6, Damien A Fair7, and Claudia Buss3
    1UC Irvine, Irvine, CA, United States, 2Oregon Health Sciences University, Portland, OR, United States, 3Charité – Universitätsmedizin Berlin, Berlin, Germany, 4University of North Carolina, Chapel Hill, NC, United States, 5University of Pittsburgh, Pittsburgh, PA, United States, 6University of Rochester, Rochester, NY, United States, 7University of Minnesota, Minneapolis, MN, United States
    Whether within or across sites, including QC measures greatly increases FAWM variance explained by PMA. Thus, adjustment results in an improved capability for identifying reproducible small-effect size relationships in large multi-site infant imaging studies.
    Figure 1. Multi-Site White Matter FA Model Without and With Consideration of Quality Control Measures. QC measures accounted for 47% of the remaining variance in FAWM after adjusting for PMA. Note the decrease in MSE and increase in the remaining variance in FAWM explained by PMA after adjusting for QC measures.
    Table 2. Single Site Association Between Whole White Matter FA and Postmenstrual Age at Scan Modeled Without and With Controlling for Quality Control Measures. All sites demonstrated marked improvement in model performance when controlling for simple QC measures (mean FD, SNR, CNR). Improved performance is indicated by increased partial R-square values, t-scores, and increased consistency in age-FA slope estimates across sites. All age-FA associations were significant at a p<10-3 threshold for all models and sites.
  • High resolution diffusion imaging in the unfixed post-mortem neonatal brain
    Wenchuan Wu1, Luke Baxter1,2, Eleri Adams2,3, Foteini Andritsou2, Matteo Bastiani1,4,5, Ria Evans Fry2, Robert Frost6,7, Sean Foxley8, Chris Gallagher1, Fiona Moultrie2, Vaneesha Monk2, David Andrew Porter9, Anthony Price10,11, Sebastian W Rieger1,12, Michael Sanders1, Anthony David Edwards11, Joseph V Hajnal10,11, Rebeccah Slater*1,2, and Karla L Miller*1
    1Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom, 2Department of Paediatrics, University of Oxford, Oxford, United Kingdom, 3Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom, 4Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom, 5NIHR Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom, 6Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States, 7Department of Radiology, Harvard Medical School, Boston, MA, United States, 8Department of Radiology, University of Chicago, Chicago, IL, United States, 9Imaging Centre of Excellence, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom, 10Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, King’s Health Partners, St. Thomas’ Hospital, London, United Kingdom, 11Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, King’s Health Partners, St. Thomas’ Hospital, London, United Kingdom, 12Department of Psychiatry, University of Oxford, Oxford, United Kingdom
    Results from our high-resolution post-mortem neonatal imaging platform demonstrate the ability to resolve features that are less prominent in low-resolution in-vivo data and potentially provide new anatomical insight into the developing brain.
    Figure 2. Diffusion kurtosis and NODDI parameters from the post-mortem infant and an age-matched in vivo infant. The mean diffusivity is expressed in μm2/ms.
    Figure 3. Left: Cortical radiality (dot product of principal diffusion direction and surface normal vector) of post mortem infant and an age-matched in vivo infant, calculated at mid-thickness. At the fundus of the central sulcus (black box), the post mortem data have high radiality but the in vivo data have low radiality. Right: principal diffusion directions for an axial plane containing central sulcus, the dashed white line indicates the grey white matter boundary. The principal diffusion directions at the fundus are radial in the post-mortem data but tangential in the in vivo data.
  • Grading of pediatric intracranial tumors: are intravoxel incoherent motion and diffusion kurtosis imaging superior to conventional DWI?
    dejun she1, dairong cao1, shan lin1, zhongshuai zhang2, and Robert Grimm3
    1The First Affiliated Hospital of Fujian Medical University, Fujian Fuzhou, China, 2SIEMENS healthcare diagnostic imaging, Shanghai, Pudong, Zhouzhu Highway 278, China, 3SIEMENS Healcare, Erlangen, Germany
    To explore the correlations between parameters derived from conventional diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) with histopathologic features of pediatric intracranial tumors.
    A 15-year-old boy with medulloblastoma in cerebellum (WHO grade Ⅳ). The lesion shows hyperintense on T2-weighted image(a), hypointense on T1-weighted image (b), and enhancement on post-contrast T1-weighted image (c). The lesion (ROI) demonstrates hypointense on the ADC map (d), D map (e), and Dk map (h), and hyperintense on the D* map (f), f map (g), and K map (i). The pathologic diagnosis was medulloblastoma with high cellularity of 4928(cell/mm2)(j), high Ki-67 index of 80% (k), and MVD of 1.4% (l) (magnification, × 200).
    A 5-year-old boy with diffuse astrocytoma in brainstem (WHO grade II). The lesion shows hyperintense on T2-weighted image(a), hypointense on T1-weighted image (b), and enhancement on post-contrast T1-weighted image (c). The lesion (ROI) demonstrates hyperintense on the ADC map (d), D map (e), and Dk map (h), and hypointense on the D* map (f), f map (g), and K map (i). The pathologic diagnosis was diffuse astrocytoma with high cellularity of 1918(cell/mm2) (j), high Ki-67 index of 1.1% (k), and MVD of 0.9% (l) (magnification, × 200).
  • Quantitative susceptibility mapping of the brain in neonates and infants
    Sayo Otani1, Yasutaka Fushimi1, Satoshi Nakajima1, Akihiko Sakata1, Takuya Hinoda1, Sonoko Oshima1, Krishna Pandu Wicaksono1, Hiroshi Tagawa1, Yang Wang1, and Yuji Nakamoto1
    1Kyoto University Graduate School of Medicine, Kyoto, Japan
    We evaluated magnetic susceptibility of a large number of pediatric subjects. Our study showed that magnetic susceptibility of the basal ganglia and thalamus increased with chronological age from birth to 2 years using volume-of-interest analysis.
    Figure 1. Averaged QSM maps for neonates and infants with chronological age (CA) of 0-150 days, 151-499 days and 500-750 days. Magnetic susceptibility of the basal ganglia and thalamus increases with age.

    Figure 2. Scattered plots of magnetic susceptibility of the basal ganglia and chronological age. Magnetic susceptibility of the CN, GP and PT correlates with chronological age (CA).

  • Mapping developmental trajectories of the cortex and its adjacent white matter for preterm neonates using DTI
    Shiyu Yuan1, Jingda Yang1, Mengting Liu1, Duan Xu2, James Barkovich2, and Hosung Kim1
    1USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States, 2Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
    The current results are best understood as increases in cyto- and myeloarchitectural complexity, characterized as DTI MD and FA changes, starting in the central region and propagating to other cortical regions with rapid elongation of dendrites and extensive expansion with maturation axons.
    Fig. 1 spatiotemporal_MD_GM
    Fig. 2 spatiotemporal_MD_sWM
  • Disentangling neurite and soma contributions to cortical microstructural development in vivo
    Sila Genc1, Maxime Chamberland1, Gareth Ball2, Erika Raven1, Isobel Ward1, Chantal Tax1, Marco Palombo3, and Derek Jones1
    1Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom, 2Developmental Imaging, Murdoch Children's Research Institute, Parkville, Australia, 3Centre for Medical Image Computing and Department of Computer Science, University College London, London, United Kingdom
    In a sample of children and adolescents aged 8-18 years, we study developmental patterns of cortical microstructure using diffusion MRI. Our findings suggest an increase in neurite signal fraction and orientation dispersion with age, and a decrease in apparent soma radius with age.
    Figure 1: Cortical microstructure processing and analysis framework. A) T1-weighted data corrected for bias field and co-registered to an upsampled b=0 s/mm2 (1x1x1mm); B) T1-weighted data processed using Freesurfer[13,24], registered to MNI space to obtain 7 functionally defined networks[12], and resampled to dMRI space to obtain network labels intersecting the cortical ribbon; C) representative maps of microstructural measures; D) high repeatability of SANDI measures at 300mT/m[9]; E) developmental patterns of macro- and microstructure averaged over the cortical ribbon
    Figure 2: Relationship between cortical microstructure and age, grouped by measure and coloured by network type. Abbreviations: CTh = cortical thickness, in mm; f = signal fraction; MD = mean diffusivity, in 10-3 mm2/s; OD = orientation dispersion; R = apparent radius, in µm. Note: MD was estimated using b=0,6000 s/mm2 to improve sensitisation to cortical microarchitecture[17]
  • Multivariate Associations Among Symptoms, Cognition, Behavior, and White Matter across ADHD and typically developing children
    Xuan Bu1,2, Yingxue Gao1, Kaili Liang1, Weijie Bao1, Lu Lu1, Ying Chen1, Lanting Guo3, Qiyong Gong1, Susumu Mori2, and Xiaoqi Huang1
    1Radiology Department, Sichuan University, Chengdu, China, 2The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States, 3Psychiatry Department, Sichuan University, Chengdu, China
    Complex ADHD phenotypes are associated with specific patterns of abnormal white matter microstructure during brain development
    Figure 1. Canonical correlations (A) and loadings (B-D) for each analysis. Colors show the loading strength of phenotype (B) and white matter (C, D) measures on their respective latent variates for each canonical correlation analysis. Warmer colors indicate stronger positive loadings (higher values on an individual measure); cooler colors indicate stronger negative loadings (lower values on an individual measure). For clarity, loadings between -0.2 and 0.2 are shown in white.
    Figure 2 A. Boxplot for differences in discriminant function between ADHD and TDC. (p<0.001) B. Table shows CCA constructs for each analysis, the effect they represent, and the standardized coefficients resulted from the linear discriminant analysis.
  • Increased glutamate + glutamine correlates with altered tactile perception and sensory responsivity in children with autism spectrum disorder
    Georg Oeltzschner1,2, Jason He3, Mark Mikkelsen1,2, Alyssa DeRonda4, Deana Crocetti4, Stewart H. Mostofsky4,5,6, Richard A.E. Edden1,2, and Nicolaas A.J. Puts3
    1Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, 2F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States, 3Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom, 4Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, United States, 5Department of Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, 6Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
    This study investigates relationships between sensory impairment in ASD, vibrotactile perceptual thresholds, and edited MRS measures of GABA and Glx. Results suggest that higher Glx levels in sensorimotor cortex may be related to abnormal touch perception.
    Figure 1: Example voxel placement in the primary sensorimotor cortex (SM1) and thalamus (THAL), along with respective data. Spectra are color-coded by acquisition phase: gray = macromolecule-suppressed MEGA-PRESS (Phase 1); blue = macromolecule-suppressed MEGA-PRESS with prospective frequency correction (Phase 2); red = HERMES (Phase 3).
    Figure 2: Group comparison of tissue-corrected metabolite levels (residuals after linear-mixed effects model accounting for age, sex, and acquisition phase) between children with ASD and typically developing children. Sensorimotor Glx levels are significantly higher in children with ASD (a), while no significant group differences were found for thalamus Glx (b), sensorimotor GABA (c), or thalamus GABA (d).
  • Prenatal maternal distress during the COVID-19 pandemic and its effects on infant brain connectivity
    Kathryn Y. Manning1,2,3, Xiangyu Long1,2,3, Lianne Tomfohr-Madsen2,4,5, Gerald Giesbrecht2,4,5,6, and Catherine Lebel1,2,3
    1Radiology, University of Calgary, Calgary, AB, Canada, 2Alberta Children's Hospital Research Institute, Calgary, AB, Canada, 3Hotchkiss Brain Institute, Calgary, AB, Canada, 4Psychology, University of Calgary, Calgary, AB, Canada, 5Pediatrics, University of Calgary, Calgary, AB, Canada, 6Community Health Sciences, Calgary, AB, Canada
    We investigated the effects of prenatal psychological distress in pregnant Canadian mothers during the COVID-19 pandemic on the developing infant brain. Relatively less mature tracts and lower amygdala-prefrontal functional connectivity were related to higher prenatal distress.
    Figure 2: The average amygdala functional connectivity across all subjects coloured by z-statistic.
    Figure 5: The relationship between the PROMIS maternal anxiety measures and infant amygdala-prefrontal functional connectivity.
  • Orientation dependence of T2 in newborn white matter shows dipole-dipole interaction effects
    Lara Bartels1,2, Jonathan Doucette1,2, Christoph Birkl2,3,4, Yuting Zhang5,6,7,8, Alexander Mark Weber2,9, and Alexander Rauscher1,2,9,10
    1Department of Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada, 2UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada, 3Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria, 4Department of Neurology, Medical University of Graz, Graz, Austria, 5Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China, 6Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Medical University, Chongqing, China, 7Key Laboratory of Pediatrics in Chongqing, Chongqing Medical University, Chongqing, China, 8Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China, 9Division of Neurology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada, 10Department of Radiology, University of British Columbia, Vancouver, BC, Canada
    We show that the tissue orientation dependency of $$$R_2$$$ relaxation in the unmyelinated newborn brain is best described by dipole-dipole interactions. In the absence of myelin, this finding suggests the alignment of water with neurofilaments or microtubuli.
    Geometric mean $$$R_2$$$ as a function of fiber angle in newborns and best fits for the dipole-dipole model, the Knight model and the diffusion model.
    Predictions for the $$$R_2$$$ orientation dependence for the dipole-dipole model, the Knight model and the diffusion model.
  • Early Sensorimotor Tract Integrity and Development of Cerebral Palsy in High Risk Infants
    Rahul Chandwani1, Julia Kline1, Karen Harpster2,3,4, Jean Tkach5,6,7, and Nehal Parikh1,2
    1Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 2Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States, 3Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 4Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati College of Allied Health Sciences, Cincinnati, OH, United States, 5Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 6Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 7Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
    Very preterm infants are at high risk of developing motor impairments such as cerebral palsy. We report macro and microstructural biomarkers of sensorimotor tract integrity, derived from diffusion MRI at term-equivalent age, that are associated with the early diagnosis of cerebral palsy.

    Figure 3. Bilaterally segmented sensorimotor tracts. (A) corticospinal tract in coronal view; (B) superior thalamic radiations (motor) in coronal view; (C) superior thalamic radiations (sensory) in coronal view; (D) posterior thalamic radiations in axial view

    *All fibers of the STRS are not visible in coronal view, as the tract continues from the thalamus to the post-central gyrus

    Figure 2. Location of regions of interest (ROIs) on the group fixel plot and the segmented right corticospinal tract. (A) Seed point ROI covering the right cerebral peduncle on an axial view; (B) Waypoint ROI covering the right posterior limb of the internal capsule on an axial view; (C) Waypoint ROI covering the right precentral gyrus on an axial view; (D-F) Right corticospinal tract on sagittal, coronal and axial views, respectively.
  • Breastmilk exposure is associated with improved MRI biomarkers of myelination in preterm infants
    Gemma Sullivan1, Manuel Cabez1, Kadi Vaher1, Paola Galdi1, Gill Black1, David Q Stoye1, Alan J Quigley2, Elizabeth N York3, Michael J Thrippleton3, Mark E Bastin3, and James P Boardman1,3
    1MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom, 2Department of Paediatric Radiology, Royal Hospital for Sick Children, Edinburgh, Edinburgh, United Kingdom, 3Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
    By combining nutritional data with myelin-weighted imaging, we show that early breast milk exposure after preterm birth is associated with improved white matter myelination at term-equivalent age.
    Figure 1. Example neonatal MTsat and MTR parametric maps.
    Table 1. Participant demographics.
  • Patterns of De Novo Myelination Identify Functionally Relevant Brain Networks
    Sean Deoni1, Lexie Volpe2, Jennifer Beauchemin2, and Viren D'Sa3
    1Bill & Melinda Gates Foundation, Seattle, WA, United States, 2Advanced Baby Imaging Lab, Rhode Island Hospital, Providence, RI, United States, 3Pediatrics, Rhode Island Hospital, Providence, RI, United States
    Infancy and childhood are important developmental periods of brain and cognitive development.  Here we use longitudinal neuroimaging and cognitive measures to delineate functionally-specific structural networks across infancy and early childhood for the first time.
    Figure 1. Representative functionally-related and specific IC maps overlaid on the study template.
    Figure 2. Overlay of the compiled core, fine and gross motor, expressive and receptive language, and visual receptive network masks.
  • Alterations in vascular injury, rsfMRI signal variability and verbal memory in young patients treated with radiation therapy for a brain tumor.
    Melanie Morrison1, Sivakami Avadappian1, Angela Jakary1, Erin Felton2, Schuyler Stoller3, Sabine Mueller3, and Janine Lupo1
    1Radiology, UCSF, San Francisco, CA, United States, 2UCSF, San Francisco, CA, United States, 3Neurology, UCSF, San Francisco, CA, United States
    Functional and vascular imaging data can be used together to provide a biomarker of cognition.
    Figure 2: Group-level large-scale brain networks derived from ICA analysis (a; orange = positive correlation, blue = negative correlation; FPN = frontoparietal network, SN= salience network, DMN = default mode network, DAN = dorsal attention network) and the methods for extracting local rsfMRI variability (b), cerebroarterial density (c) and cerebral microbleed (CMB) burden (d).
    Figure 4: Relationship between imaging parameters and verbal memory performance (dependent variable). DMN var = default mode network variability, vvol= normalized vessel volume.
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Digital Poster Session - Pediatrics: Body Topics
Pediatrics
Tuesday, 18 May 2021 17:00 - 18:00
  • A semi-supervised graph convolutional network for early prediction of motor impairments in very preterm infants using brain connectome
    Hailong Li1, Ming Chen1,2, Jinghua Wang3, Nehal A. Parikh4,5, and Lili He1,5
    1Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 2Department of Electrical Engineering and Computer Science, University of Cincinnati, Cincinnati, OH, United States, 3Deep MRI Imaging Inc., Lewes, DE, United States, 4The Perinatal Institute and Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 5Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
    Taking advantage of labeled and unlabeled data, a semi-supervised graph convolutional network model is able to identify motor impairments in very preterm infants at 2 years using brain structural connectome obtained at term-equivalent age with an accuracy of 68.1% and an AUC of 0.67.
    Figure 2. Overview of semi-supervised graph convolutional network to predict motor impairments in very preterm infants. The input is a cohort graph that describes the inter-subject similarities among training (both labeled and unlabeled) and testing (subjects-to-classify) subjects. The first graph convolutional layer contains 16 graph convolutional filters. The second graph convolutional layer contains 8 graph convolutional filters. The number of graph convolutional filters were selected from empirical values [8, 16, 32, 64] based on validation performance.
    Figure 1. (A) Cohort graph describes the inter-subject similarities among the training (both labeled and unlabeled) and testing (subjects to classify) subjects/nodes. (B) Structural connectome feature vectors are used as the node features in the cohort graph. (C) Diffuse white matter abnormality volumes and global brain abnormality scores are used to calculate the inter-subject similarity as edge weights in the cohort graph.
  • Predicting Early Neonatal Bilirubin Encephalopathy Based on Radiomics Nomogram  of T1weighted Imaging
    Jinhong Yu1, Yanwei Miao1, Yangyingqiu Liu1, Bingbing Gao1, and Yu Bing1
    1The First Affiliated Hospital of Dalian Medical University, Dalian, China
    In this study, a better early prediction model of bilirubin encephalopathy(BE) based on T1WI radiomics was obtained, which provided a new image marker for early diagnosis and monitoring of BE.
    Fig.2 Clinical-imaging radiomics nomogram
    Fig. 4 ROC curves of each model in the training set and validation set
  • Artificial neural network derived myelin water fraction map with multi-echo gradient echo signal: brain development from infants to adults.
    Hyun Gi Kim1, Jae Eun Song2, Dongyeob Han3, Jee Young Kim1, Se Won Oh1, and Dong-Hyun Kim2
    1Radiology, The Catholic University of Korea, Seoul, Korea, Republic of, 2Yonsei University, Seoul, Korea, Republic of, 3Siemens Healthcare, Seoul, Korea, Republic of
    Myelin water fraction (MWF) derived by an artificial neural network (ANN-MWF) and complex model fitting (CF-MWF) from 3D multi-echo gradient-echo (mGRE) signal showed high agreement. ANN-MWF map showed developmental growth curve pattern according to age. 
    ANN and CF derived MWF maps in children.
    Linear regression between the ANN-MWF and CF-MWF values.
  • Evaluation of compressed sensing in pediatric neuro-oncological MR imaging: Impact on image quality and scan duration
    Rieke Lisa Meister1, Shuo Zhang2, Michael Groth1, Julian Jürgens1, Christoph Katemann2, Jan-Hendrik Buhk3, and Jochen Herrmann1
    1Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 2Philips, Hamburg, Germany, 3Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
    Pediatric neuro-oncological MRI benefited from compressed sensing in reduced scan duration and better spatial resolution. Advantage for clinical practice has been demonstrated with promise in shortened procedural time with comparable or even improved image quality.
    Figure 1. Selected examples of the pediatric neuro-onco MRI exams in the current study comparing C-SENSE and conventional scans.

    Table 2. Spatial resolution improvement and scan duration reduction by C-SENSE in the pediatric neuro-onco MRI pulse sequences in comparison to the conventional scans. Details see text.

    ACQ = Acquired; SENSE = SENSitivity Encoding; C-SENSE = Compressed SENSE; TFE = Turbo field echo; FLAIR = fluid attenuated inversion recovery; TSE = Turbo spin echo.

  • A Densely Connected Neural Network with Frequency Balancing Loss for Adipose Tissue Segmentation in Children using Free-Breathing Abdominal MRI
    Sevgi Gokce Kafali1,2, Shu-Fu Shih1,2, Xinzhou Li1,2, Tess Armstrong1, Kelsey Kuwahara3, Sparsha Govardhan4, Karrie V Ly4, Shahnaz Ghahremani1, Kara L Calkins4, and Holden H Wu1,2
    1Radiological Sciences, University of California, Los Angeles, Los Angeles, CA, United States, 2Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States, 3Cognitive Science, University of California, Los Angeles, Los Angeles, CA, United States, 4Pediatrics, University of California, Los Angeles, Los Angeles, CA, United States
    This work used a densely connected neural network with a class frequency balancing, boundary emphasizing loss to segment adipose tissue using free breathing MRI in children. The network achieved high Dice scores and similar volume and content quantification with reference annotations.
    Figure 2. Representative images shown for (A) a healthy child (H1) and (B) a child with liver disease (L4). The coronal reformats show the chosen slices. The 2-D TE1 image and PDFF maps were inputs to the network. SAT (white) and VAT (gray) manual annotations are displayed. Both networks yielded comparable Dice-SAT. The proposed network yielded higher Dice-VAT than U-Net for H1 and L4, with differences shown in zoomed insets. The U-Net misclassified VAT as seen in violet boxes for H1 on chosen slice 2, and for L4 on chosen slices 1 and 2. Underlined Dice scores represent the higher score.
    Figure 1. The structure of the proposed network. (A) ResPath Dense U-Net takes 2-D TE1 images and PDFF maps as inputs, and outputs segmentation masks of 3 classes: SAT, VAT, and the others. (B) Dense connections, shown inside a dense block, improve the generalizability of the features and overcomes the vanishing gradient problem. (C) ResPath skip connections mitigate the semantic gaps during the concatenation of encoder and decoder features.
  • Survey of Acoustic Output in Neonatal Brain Protocols
    Hannah Kurdila1, Tayeb Zaidi1, Ting Zhang1, Subha Maruvada1, and Sunder Rajan1
    1Food and Drug Administration, Silver Spring, MD, United States
    Neonatal protocol sound levels exceeded sound levels known to cause non-auditory stress responses in neonates but did not exceed the IEC MRI hearing safety limit. These results indicate that these sound levels could be risky for the neonate, but further work is required to clarify this.
    LAEQ of Scans Organized by Scanner. The LAEQ ranges on each scanner vary between 8.49 - 11.9 dBA, indicating that choices in scan type can make a difference. Scanner D, the neonatal scanner, is significantly quieter than other machines. Regardless of scan type, every scan on Scanner G is louder than most other scans.

    LAEQ of neonatal protocols by scanner relative to the IEC MRI hearing safety threshold. Compared to the IEC MRI hearing safety limit (red dots), every neonatal protocol LAEQ (blue stars) with hearing protection (blue spotted area) is below the limit. The maximum hearing protection limit was calculated using an OSHA standard 14.

  • Prospectively motion-corrected multi-echo MPRAGE and wave-controlled aliasing in parallel imaging MPRAGE for pediatrics motion suppression
    Emi Niisato1, Yung-Chieh Chen2, Bhat Himanshu3, Wei Liu4, Daniel Nicolas Splitthoff5, and Cheng-Yu Chen2
    1Siemens Healthcare Limited, Taiwan, Taipei, Taiwan, 2Taipei Medical University Hospital, Taipei, Taiwan, 3Siemens Medical Solutions, Malvern, PA, USA, Malvern, PA, United States, 4Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China, Shenzhen, China, 5Siemens Healthcare GmbH, Erlangen, Germany, Erlangen, Germany
    Prospective motion correction with EPI volumetric navigators multi-echo MPRAGE suppressed the pediatrics’ head motion artifacts compared with using fast scan and the conventional MPRAGE. CNR of the cerebral brain showed no significant difference among all three different MPRAGE images.
    Figure 1. Parameters for the three different MPRAGE sequences used in this study.
    Figure 2. (A) Representative images from MPRPAGE, wave-CAIPI MPRAGE, and vNav Moco MEMPRAGE sequences from the same patient. The patient was injected with contrast enhancement for the scan. (B) Contrast-to-noise ratio (CNR) for five different cortical areas. The left figure is from the cohort that did not receive any contract enhancement, and the right figure is from the cohort that did. The analysis was performed using the three different sequences.
  • Free-breathing T2-weighted multi-shot TSE BLADE for pediatric abdominal imaging
    Fedel Machado-Rivas1,2, Daniel J Park3, John Conklin1,2, John E Kirsch2,3, and Michael S Gee1,2
    1Radiology, Massachusetts General Hospital, Boston, MA, United States, 2Radiology, Harvard Medical School, Boston, MA, United States, 3MGH Martinos Center for Biomedical Imaging, Boston, MA, United States
    Widening of the refocusing pulse of T2-weighted multi-shot TSE can mitigate signal loss associated with through-plane respiratory motion. 2x refocusing pulse modified free breathing sequence provides comparable image quality and contrast to a triggered acquisition.
    Schematic representation of through plane motion and refocusing pulse modifications. (A) shows a coronal acquisition during expiration and inspiration, where abdominal contents are displaced by the diaphragm. (B) illustrates the proposed refocusing pulse modification by doubling its thickness to mitigate long T2 signal loss.
    Comparison of respiratory triggered, free-breathing, and modified 2x refocusing pulse free breathing T2-weighted fat suppressed multi-shot TSE (BLADE). Arrow shows severe signal loss for the standard free breathing sequence that is mitigated in the modified 2x refocusing pulse sequence. Acquisition times (AT) for each sequence are displayed in mm:ss.
  • Design of a neonatal head and cardiac imaging system and parallel-transmit volume/receive phased array for 7T MRI during early infancy
    Jérémie Clément1, Kathleen Colford2, Emer Hughes2, Tomoki Arichi2,3,4, David Edwards2,3,5, Joseph Hajnal1,2, and Ozlem Ipek1
    1Biomedical Engineering, Kings College London, London, United Kingdom, 2Centre for the developing brain, Kings College London, London, United Kingdom, 3Bioengineering, Imperial College London, London, United Kingdom, 4Paediatric neurosciences, Evelina London children's hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, 5MRC Centre for Neurodevelopmental Disorders, Kings College London, London, United Kingdom
    In this work, we describe the first mechanical frame for infants for brain and cardiac imaging at 7T. The different parts incorporate important design aspects including mechanical sturdiness/safety, toxicity, sanitization and ease of use.
    Figure 4 – A) and B) 3D render of the structural elements from Fig. 1A-D. A infant model11 was added for better visualization of the positioning. The Tx-array coil holder was slightly moved out of the final position. C) 3D render of the structural elements from Fig. 1A-C. The fitting of the baby model can be clearly evaluated. The main support structure (Fig. 1E) is not shown to simplify the view.
    Figure 1 - 3D render of the main parts of the mechanical frame for infants at 7T, with A) the Tx-array coil holder showing the position of the dipole elements, B) the bed structure, C) the posterior Rx-array frame, D) the anterior Rx-array frame and E) the main support structure. The parts displayed in light blue (in C and E) correspond to the Teflon pads used for displacement between the brain-isocentred and heart-isocentred positions.
  • Damping of acoustic noise for neonatal MRI at 7 Tesla
    Erik Huijing1, Evita Wiegers1, Dennis Klomp1, Fredy Visser1,2, Edwin Versteeg1, Koenraad Rhebergen3, Kim Annink4, Niek van der Aa4, Floris Groenendaal4, Jeroen Dudink4, Thomas Alderliesten4, Maarten Lequin1, Manon Benders4, and Jannie Wijnen1
    1Radiology, University Medical Center Utrecht, Utrecht, Netherlands, 2Philips HealthCare, Best, Netherlands, 3Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands, 4Neonatology, University Medical Center Utrecht, Utrecht, Netherlands
    We present a new acoustic hood for neonatal MRI exams at 7 Tesla. The new design is lightweight and allows easy access to the neonate during the MRI examination. We were able to optimize the new acoustic hood to a noise reduction of 10.6dB.
    Fig 1. The hoods. 1a: Prototype that has been used this past year. 1b: Mechanical design of the new hood. 1c: Design of easy access point to the neonate. 1d: the finished product.
    Fig 3. Test results. a: Results of calibrated tests in the acoustic room. b: Results of tests inside the MRI during various scan protocols.
  • 3D Liver T1 Quantification using Interleaved Look-Locker Acquisition with T2 Preparation Pulse Sequence (3D-QALAS): Comparison with 2D-MOLLI
    Deep B. Gandhi1, Amol Pednekar1, Hui Wang2, Jean A. Tkach1, Andrew T. Trout1, and Jonathan R. Dillman1
    1Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 2MR Clinical Science, Philips, Cincinnati, OH, United States
    Whole liver T1 quantification in a single breath-hold using 3D-QALAS correlates very strongly (r=0.95) with 2D-MOLLI, but underestimates T1 significantly (p<0.0001) with a bias of 92.5 ms (14.2%). 
    Figure 1. Correlation plots of T1 hepatic values using 2D-MOLLI versus 3D-QALAS (A) mean T1 and (B) T1 of individual slices
    Figure 2. Bland-Altman plots of T1 hepatic values using 2D-MOLLI v/s 3D-QALAS (A) mean T1 and (B) T1 of individual slices.
  • DWI and 3D SWAN improve the knowledge of pathophysiological mechanism of neonatal bilirubin encephalopathy
    Jinhong Yu1, Yanwei Miao1, Yangyingqiu Liu1, Bingbing Gao1, and Yu Bing1
    1The First Affiliated Hospital of Dalian Medical University, Dalian, China
     In this study, we used DWI and 3D SWAN to explore the pathophysiological mechanism of brain injury in children with hyperbilirubinemia (HB), and found that the limited diffusion of water molecules is present in globus pallid and cerebral microbleeds more likely occur in children with HB.
    Fig.1 Setting ROI and FWM on DWI and ADC
    Fig.2 Box plot of rADC values in HC, HBn and HBh groups
  • Liver Stiffness Measurement in Less Than Half the Conventional Breath-hold Time: Wave Polarity-Inversion Motion Encoding and Compressed SENSE
    Amol Pednekar1, Deep B. Gandhi2, Hui Wang3, Jean A. Tkach1, Andrew T. Trout1, and Jonathan R. Dillman1
    1Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 2Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 3MR Clinical Science, Philips, Cincinnati, OH, United States
    In 19 participants, mean liver shear stiffness values measured with SC_2D_4BH and 2D_CS_HBH with or without flow saturation correlated very strongly (ICC>0.96) with mean bias of <0.15 kPa (<6 %). 2D_CS_HBH MRE has potential benefit in participants with compromised breath-holding capacity.
    Figure 1: Schematic pulse sequence diagrams. (A) SC_2D_4BH: The polarity of MEGs is reversed (blue and yellow) every RF excitation. The mechanical wave polarity (green) stays the same across each RF excitation. Each RF excitation triggers 3 motion cycles. (B) 2D_CS_HBH with inflow saturation: The polarity of MEGs remains the same (blue) across RF excitations. The mechanical wave polarity inverts (green and red) every RF excitation. (C) 2D_CS_HBH no inflow saturation. Every other RF excitation triggers 4/3 motion cycles.
    Figure 3: Comparison of liver shear stiffness values in individual slices for SC_2D_4BH and 2D_CS_HBH techniques by Linear Regression and Bland-Altman Analysis. Values are based on manual analysis informed by a 95% confidence mask with matching ROIs on images from both techniques and maximal possible ROI in each. SC_2D_4BH: standard of care two-dimensional 4 slices through mid-liver with 13 second breath-hold per slice; 2D_CS_HBH: two-dimensional polarity-inversion motion encoding plus compressed SENSE acquisition in half the SC breath-hold.
  • MRI T2* liver iron concentration measurement in children comparison using Wood or Garbowski (T2*-LIC) conversions and Ferriscan (R2-LIC)
    Dianna ME Bardo1, Nicholas Rubert1, Mittun Patel1, Shiza Shahid1, and Robyn Augustyn1
    1Radiology, Phoenix Children's Hospital, Phoenix, AZ, United States
    LIC analysis may be performed with accurate and reproducible results in children using an ROI or a whole liver segmentation technique using locally available software and the FerriScan® technique.

    FIG 1 LIC ROIs

    FIG 2 Graph comparison of LIC - all results

    FIG 3 Bland-Altman plots

    FIG 4 Sample individual results

    FIG 5 ROC curves

  • Comparison of Respiratory-Gating Weighting Algorithms in Neonatal Pulmonary UTE-MRI
    Deep B. Gandhi1, Nara S. Higano2, Andrew D. Hahn3, Luis Torres3, Sean B. Fain3, Jason C. Woods2, and Alister J. Bates2
    1Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 2Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 3Department of Medical Physics, University of Wisconsin, Madison, WI, United States
    Soft-gating weighted lung UTE-MRI reconstruction provides higher aSNR compared to hard-gating. Exponential and linearly weighted soft-gating functions provide improved trade-off in terms of aSNR and motion blurring at  lung-diaphragm boundary compared to inverse weighting functions.
    Figure 2. Images reconstructed using hard-gating and 3 soft-gating weighting functions (exponential, inverse and linear). aSNR for each reconstructed image using the different weighting function is based on the optimized parameter for each weighting function. Area in the red rectangle encompasses the superior-inferior lines used to generate linearly scaled mean signal intensity profiles at the lung-diaphragm boundary in figure 3.
    Figure 1. (A) A smoothed waveform fit through initial phase of free induction decay (FID) with data binned into 8 different bins from 0 to 7. (B) Bin assignment of the data based on the median wave in (A), where bin 8 represents bulk-motion and is discarded. (C) Hard-gating and three soft-gating weighting functions (exponential, inverse and linear) shown here with respect to Bin 0.
  • Dffusion tensor imaging of the physis and metaphisys as predictor of child growth
    Diego M Jaramillo1, Phuong M Duong1, Jie C Nguyen2, Sogol Mostoufi-Moab2, Michael K Nguyen2, Andrew Moreau2, Christian A Barrera3, Shijie Hong2, and Jose M Raya4
    1Columbia University Medical Center, New York, NY, United States, 2Children’s Hospital of Philadelphia, Philadelphia, PA, United States, 3Massachusetts General Hospital, Boston, MA, United States, 4New York University, New York, NY, United States
    DTI of the physis and metaphysis (DTI-P/M) has potential to become a biomarker of skeletal growth. Compared to clinical standards DTI-P/M reduced prediction errors over 40% and has not bias in their predictions.
    Figure 1. Example of tractography. Example of tractography of two children, ages 12 (boy) and 15 (girl).
    Figure 1. Bland-Altman plots of predicted and measured VH and THG. Bland-Altman plots showed reduced error in DTI-P/M predictions (top) compared to bone-age predictions (bottom). Also, DTI-P/M predictions did not have bias (zero difference within the 95%-confidence interval), while bone-age predictions had a significant bias. The dashed line represents the mean difference between predicted and measured; the dot-dash line the two-sigma range. The light gray area indicates the 95%-confidence interval of the mean difference. Purple circles are boys and dark pink girls.
  • Estimation of Glomerular Filtration Rate in a Pediatric Population using Renal Phase Contrast MRI
    Alex J Barker1, Lorna P Browne1, Michal Schafer2, Erin K Englund2, Takashi Fujiwara2, Kristen J Nadeau2, and Petter Bjornstad2
    1Radiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States, 2University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
    The correlation between gold-standard GFR by 125I iothalamate clearance and renal blood flow measurements from a noninvasive 20-minute PC-MRI are superior to that of the commonly used endogenous filtration markers, serum creatinine or cystatin C.
    Figure 1: Study protocol, MRI planning, and quantitative flow measurements obtained with PC-MRI (note: renal veins not shown).
    Figure 2: Scatter plots of: (a) total left and right arterial renal blood flow, and (b) the average left and right peak renal blood flow.
  • Quantitative bone marrow MRI in children with leukaemia
    Nataliia Kriventsova1, Petr Menshchikov2, Dmitry Kupriyanov2, Dmitry Litvinov1, Galina Novichkova1, and Galina Tereshchenko1
    1Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation, 2Philips Healthcare, Moscow, Russian Federation
    Fat fraction measured by MRI in bone marrow in children with acute leukemia is significantly lower than FF in bone marrow in children without hematological diseases
    Box plots diagram of fat fraction values of healthy children and patients with leukemia
    Pearson correlation analysis results for fat fraction (FF) quantification by mDixon-Quant and MR-spectroscopy
  • Diagnosis, Characterization of Fetal Sacrococcygeal Teratomas (Type IV) with Prenatal MRI and Its Outcome
    Xianyun Cai1, Jinxia Zhu2, and Guangbin Wang1
    1Shandong Medical Imaging Research Institute, Shandong University, Jinan, China, China, 2MR Collaboration, Siemens Healthcare Ltd., Beijing, China, China
    This study investigated the prenatal diagnosis and prognosis of fetal sacrococcygeal teratomas (SCTs) (Type IV) with Prenatal MRI. This suggests correct diagnosis of teratoma on prenatal MRI and early operation after birth are important for prognosis.
    Fig 1. 25-weeks’ gestation fetus with sacrococcygeal type IV teratoma (a) (b) Sagittal and coronal T2-weighted image shows cystic mass (arrow) arising from coccyx, with septa (small arrow) is seen (b). (c) Sagittal Susceptibility-weighted imaging (SWI) shows fetal sacrococcygeal vertebra were nicely demonstrated
    Fig 4. 28-weeks’ gestation fetus with sacrococcygeal type IV teratoma(a) (b) Coronal and sagittal T2-weighted image shows solid mass (arrow) arising from sacrococcygeal region with unilateral hydronephrosis (white arrow)(c,d) Diffusion Weighted Imaging (DWI) and corresponding apparent diffusion coefficient (ADC) showed the mass diffusion limited
  • Quantifying Fetal and Maternal Body Composition Using 3-D Stack-Of-Radial Free-Breathing MRI
    Katie M Strobel1, Sevgi Gokce Kafali2, Shu-Fu Shih2, Rinat Masamed2, Kara Calkins1, and Holden Wu2
    1Pediatrics, University of California Los Angeles, Los Angeles, CA, United States, 2Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States
    This study measured fetal and maternal body composition in the third trimester by calculating volume and proton density fat fraction (PDFF). Fetal liver PDFF was associated with maternal pre-pregnancy BMI and maternal SAT PDFF. Pregnancies with gestational diabetes had higher liver PDFF.
    Figure 1. A. T2-HASTE axial images of the fetal liver in a mother with fetal growth restriction to provide an anatomical reference. B. Axial 3-D stack-of-radial FB-MRI PDFF map (range: 0-100%) of the fetal liver. Circular ROIs with 1-cm2 area were used to measure the fetal liver PDFF. C. Axial 3-D stack-of-radial FB-MRI PDFF maps of the fetal abdomen. The red ROI was used to measure fetal abdominal subcutaneous adipose tissue (SAT) volume and PDFF. D. Coronal reformatted PDFF map of fetus. The green dashed and solid lines indicate the axial slices in panels B and C, respectively.
    Figure 2. A. Axial 3-D stack-of-radial FB-MRI PDFF maps (range: 0-100%) of the maternal liver in a mother with gestational diabetes. Cyan outline measured liver PDFF. Purple ROI measured subcutaneous adipose tissue (SAT) PDFF and volume. B. Axial 3-D stack-of-radial FB-MRI PDFF maps (range: 0-100%) of the maternal abdomen. Red ROI measured visceral adipose tissue (VAT) PDFF and volume. C. Coronal reformatted PDFF map of the maternal liver and abdomen. The green dashed and solid lines indicate the axial slices in panels A and B, respectively.