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: 10391989
• 负责人: Hongyu An
• 金额: $ 65.09万
• 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/10391989
• 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; Gold; Head; Health; Image; Ionizing radiation; Joint structure of suture of skull; 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; Sampling; 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; base; 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，小儿患者更容易受到辐射暴露。每年，220万 在美国，使用电离辐射进行了电离辐射的小儿头计算机断层扫描（CT）扫描。 头部外伤和颅骨突变病是需要头部CT扫描的两种最常见的儿科疾病。 在临床随访期间通常进行多次CT扫描，加剧了辐射的累积风险 接触。头部创伤在儿童中很常见，经常导致头骨骨折。颅突式症是 先天性残疾由过早融合的颅缝线定义。小儿患者的标准临床护理 用头部外伤或颅骨症的员工3D高分辨率颅骨CT图像识别颅骨骨折 或颅骨缝合通畅。国家癌症研究所报告说，来自多个头部CT的辐射暴露 由于其放射敏感性，对儿童进行扫描有可能使白血病和脑癌风险增加三倍。 骨髓和脑组织。磁共振成像（MRI）是一个安全的替代方案，而无需电离辐射。 现有的“黑骨” MRI方法依赖于标准梯度回声扫描中的骨信号降低来图像 头骨。尽管这些方法表现出令人鼓舞的结果，但它们尚未转化为临床实践 由于几个挑战：运动伪影，较长的习得时间和主观的手动图像处理。自从 儿科患者运动非常普遍，镇静剂通常被用来最大程度地减少运动伪像 扫描先生。不幸的是，镇静与包括发育延迟和心肺在内的风险有关 并发症。获得高分辨率的MR图像需要几分钟，这可能会挑战 小儿对象的依从性和限制临床采用。由于骨头及其之间的信号对比不良 在MR图像中周围的组织，现有的基于手动信号强度的方法是挑战，而不是 适用于临床翻译。我们的主要目标是开发新颖的MR技术以提供CT等效的3D 高分辨率颅骨成像。提出了四个具体目标：1）开发运动校正以解决 未修剪过的小儿患者的头部运动； 2）开发由A正常的MR图像重建方法 在将MR采集时间减少到1分钟之前，深入学习； 3）开发一个3D贝叶斯神经网络 估计MRI的伪CT（PCT）和不确定性图，以进行健壮和自动化图像后处理； 4）确定PCT在识别颅骨骨折和颅骨缝合通畅方面的临床实用性。这项研究 通过消除与辐射和镇静相关的风险，将对小儿健康产生深远的影响。