Robust and Rapid 3D High-Resolution Cranial bone imaging for pediatric patients using MRI

使用 MRI 为儿科患者提供稳健、快速的 3D 高分辨率颅骨成像

• 批准号: 10532253
• 负责人: Hongyu An
• 金额: $ 62.79万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-01 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10532253
• 关键词: 3-Dimensional; Accident and Emergency department; Address; Adoption; Adult; American College of Radiology; Bayesian neural network; Black race; Bone Marrow; Cardiopulmonary; Cephalic; Child; Childhood; Clinical; Consensus; Craniocerebral Trauma; Craniosynostosis; Data; Development; Developmental Delay Disorders; Diagnosis; Enrollment; Evaluation; Fracture; Goals; Head; Health; Image; Ionizing radiation; Joint structure of suture of skull; Legal patent; Magnetic Resonance Imaging; Malignant neoplasm of brain; Manuals; Maps; Medical center; Methods; Modeling; Morphologic artifacts; Motion; Movement; National Cancer Institute; Noise; Patient risk; Patients; Pilot Projects; Postoperative Care; Postoperative Period; Public Health; Radiation; Radiation Tolerance; Radiation exposure; Rapid diagnostics; Reporting; Research; Resolution; Risk; Safety; Scanning; Sedation procedure; Signal Transduction; Skull Fractures; Surgical sutures; Techniques; Time; Tissues; Translating; Trauma; Uncertainty; United States; United States Food and Drug Administration; Work; X-Ray Computed Tomography; age related; bone; bone imaging; brain tissue; clinical care; clinical diagnosis; clinical practice; clinical translation; cranium; deep learning; diagnostic tool; disability; follow-up; image processing; image reconstruction; imaging modality; indexing; leukemia; novel; patient subsets; pediatric patients; premature; radiation risk; reconstruction; skull base; success; temporal measurement; transfer learning

Project Summary Pediatric patients are more vulnerable to radiation exposure when compared to adults. Each year, 2.2 million pediatric head computed tomography (CT) scans utilizing ionizing radiation are performed in the United States. Head trauma and craniosynostosis are two of the most common pediatric conditions requiring head CT scans. Multiple CT scans are often performed during clinical follow-up, exacerbating the cumulative risk of radiation exposure. Head trauma is common in children, frequently resulting in a skull fracture. Craniosynostosis is a congenital disability defined by a prematurely fused cranial suture. Standard clinical care for pediatric patients with head trauma or craniosynostosis employs 3D high-resolution cranial CT images to identify cranial fractures or cranial suture patency. The National Cancer Institute reported that radiation exposure from multiple head CT scans in children has the potential to triple the risk of leukemia and brain cancer due to radiosensitivity of their bone marrow and brain tissue. Magnetic resonance imaging (MRI) is a safe alternative without ionizing radiation. Existing “black bone” MRI methods rely on a diminished bone signal in a standard gradient echo scan to image the skull. Though these methods have shown encouraging results, they have not translated into clinical practice due to several challenges: motion artifacts, long acquisition time, and subjective manual image processing. Since pediatric patient movement is very common, sedation has been routinely used to minimize motion artifacts in an MR scan. Unfortunately, sedation is associated with risks including developmental delay and cardiopulmonary complications. It takes several minutes to acquire high-resolution MR images, which can be challenging for pediatric subject compliance and limits clinical adoption. Due to poor signal contrast between bone and its surrounding tissues in MR images, existing manual signal intensity-based approaches are challenging and not suitable for clinical translation. Our primary goal is to develop novel MR techniques to provide CT-equivalent 3D high-resolution cranial bone imaging. Four specific aims are proposed: 1) develop motion correction to address head motion in unsedated pediatric patients; 2) develop an MR image reconstruction method regularized by a deep-learning prior to reduce MR acquisition time to 1 minute or below; 3) develop a 3D Bayesian neural network to estimate pseudo-CT (pCT) and uncertainty maps from MRI for robust and automated image post-processing; and 4) determine the clinical utility of pCT in identifying cranial fractures and cranial suture patency. This study will have a profound impact on pediatric health by removing the risks associated with radiation and sedation.

项目摘要 与成人相比，儿童患者更容易受到辐射的影响。每年，220万 在美国，利用电离辐射进行儿童头部计算机断层扫描(CT)。 头部创伤和颅缝早闭是需要头部CT扫描的两种最常见的儿科疾病。 在临床随访期间，经常进行多次CT扫描，这加剧了辐射的累积风险 曝光。头部创伤在儿童中很常见，经常导致头骨骨折。颅缝早闭是一种 先天残疾定义为过早融合的颅缝。儿科患者的标准临床护理 有颅脑损伤或颅缝融合的患者使用3D高分辨率头颅CT图像来识别颅骨骨折 或颅缝通畅。美国国家癌症研究所报告称，多头CT的辐射暴露 儿童的扫描有可能使白血病和脑癌的风险增加两倍，这是由于儿童对辐射的敏感性 骨髓和脑组织。磁共振成像(MRI)是一种安全的替代方案，没有电离辐射。 现有的“黑骨”核磁共振成像方法依赖于标准梯度回波扫描中减弱的骨信号来成像。 头骨。尽管这些方法显示了令人鼓舞的结果，但它们并没有转化为临床实践。 由于几个挑战：运动伪影、较长的获取时间和主观的人工图像处理。自.以来 儿科患者的运动是非常常见的，镇静已经被常规使用来减少运动伪影在 扫描先生。不幸的是，镇静与发育迟缓和心肺疾病等风险有关。 并发症。获取高分辨率的MR图像需要几分钟时间，这对 儿科受试者依从性和限制临床采用。由于骨骼和其之间的信号对比度较差 在磁共振图像的周围组织中，现有的基于手动信号强度的方法具有挑战性且不 适合临床翻译。我们的主要目标是开发新的磁共振技术，以提供与CT相当的3D 高分辨率颅骨成像。提出了四个具体目标：1)发展运动矫正以解决 未服用镇静剂的儿童患者的头部运动；2)开发一种磁共振图像重建方法，该方法由 深度学习，将MR采集时间减少到1分钟或以下；3)建立三维贝叶斯神经网络 从MRI中估计伪CT(PCT)和不确定性图，以实现稳健和自动化的图像后处理； 4)确定PCT在判断颅骨骨折和颅缝通畅方面的临床价值。本研究 通过消除与辐射和镇静相关的风险，将对儿科健康产生深远影响。