Portable MRI Technology for Neonatal Care

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Project Summary/Abstract Magnetic Resonance Imaging (MRI), especially with diffusion contrast, has been the undisputed standard of care for the detection and diagnosis of neonatal brain disorders and injuries such as Hypoxic-ischemic encephalopathy (HIE). However, the nature of these large, expensive, potentially dangerous instruments limits accessibility and requires that patients be transported to a radiology suite. In the neonatal intensive care unit (NICU) setting, patient transfer introduces safety concerns, since it requires a full hand-off of patient care responsibilities and exposes the neonate to stress from transport and acoustic noise. In particular, HIE patients are often not stable enough to transfer to the scanner for several days after birth. Instead bed-side cranial imaging is performed with ultrasound, which has a low sensitivity for early abnormalities associated with HIE. We design a bed-side scanner specifically for the needs of neonatal brain imaging in an NICU. The proposed scanner will be transported to the bedside in the NICU, prioritizing minimal handling and manipulation of the infant and enabling true POC diagnostics and monitoring. We significantly reduce the size, cost, and complexity of conventional MRI hardware by designing for the smaller FOV needed for neonatal brain imaging and significantly depart from the canonical scanner design. The magnet, field gradients, and RF coils will be optimized for the smaller imaging volume to maximize image quality. To allow operation outside an RF shielded room, we propose an EMI mitigation method that retrospectively removes artifacts using external detectors. As DWI imaging is highly valuable in the HIE patient population, we will develop a RARE DWI sequence for the unconventional scanner architecture. The new scanner will first be validated with an anthropomorphic neonatal phantom with realistic tissue properties and then at the MGH Neonatal ICU as an addition to the standard care of HIE patients. We will determine if the POC MRI offers valuable early information about the brain condition, which is corroborated in later high-field MRI images obtained when the baby is stable enough to be transferred to the conventional scanner.