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，儿科患者更容易受到辐射照射。每年220万 在美国进行利用电离辐射的小儿头部计算机断层摄影（CT）扫描。 头部创伤和颅缝早闭是两种最常见的儿科疾病，需要进行头部CT扫描。 在临床随访期间经常进行多次CT扫描，加剧了辐射的累积风险 exposure.头部创伤在儿童中很常见，经常导致颅骨骨折。颅缝早闭是一种 一种先天性残疾，定义为颅缝过早融合。儿科患者的标准临床护理 头部外伤或颅缝早闭患者使用3D高分辨率颅骨CT图像来识别颅骨骨折 或颅缝通畅国家癌症研究所报告说， 由于儿童的辐射敏感性，儿童的扫描有可能使白血病和脑癌的风险增加两倍。 骨髓和脑组织磁共振成像（MRI）是一种无电离辐射的安全替代方法。 现有的“黑骨”MRI方法依赖于标准梯度回波扫描中的减弱的骨信号来成像 头骨虽然这些方法已经显示出令人鼓舞的结果，但它们尚未转化为临床实践 这是由于以下几个挑战：运动伪影、长采集时间和主观手动图像处理。以来 儿科患者的运动是非常常见的，镇静已经被常规地用于最小化运动伪影， 磁共振扫描。不幸的是，镇静与发育迟缓和心肺功能障碍等风险有关。 并发症采集高分辨率的MR图像需要几分钟的时间，这对于 儿科受试者依从性并限制临床采用。由于骨与其周围组织之间的信号对比度差， 对于MR图像中的周围组织，现有的基于手动信号强度的方法是具有挑战性的， 适合临床翻译。我们的主要目标是开发新的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）发展运动校正，以解决 未镇静的儿科患者的头部运动; 2）开发一种由 在将MR采集时间减少到1分钟或更短之前进行深度学习; 3）开发3D贝叶斯神经网络 从MRI中估计伪CT（pCT）和不确定性图，以进行稳健和自动化的图像后处理; （4）确定pCT在识别颅骨骨折和颅缝开放中的临床应用。本研究 将通过消除与辐射和镇静相关的风险对儿科健康产生深远的影响。