Development of Advanced Techniques for MR of the Newborn Brain

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DESCRIPTION (provided by applicant): Recent studies at 1.5 Tesla using MR compatible incubators have clearly demonstrated clinical and research value for the detection and characterization of neonatal brain injury. With the extraordinarily high premature birth rate of over 540,000 per year in the US and its extremely high human and economic costs, neonatal MRI is a critically important advance in radiological care. A major obstacle facing neonatal MR research is that MR hardware and software have been developed and validated primarily for adult brain applications and are typically suboptimal for neonatal studies. Through the proposed bioengineering partnership, we aim to develop and translate new specialized 3T MR imaging tools for the non-invasive characterization of brain maturation and injury in premature and term newborns. Our partners at Harvard Medical School, Dr. Lawrence Wald and colleagues, are the world leaders in high channel count phased array coils and are well-equipped to design and build dedicated MR coils for neonatal imaging. Dr. John Pauly's group at Stanford University's Electrical Engineering Department is world renowned in RF design, MR sequence development and image reconstruction techniques. The UCSF investigators comprise a multidisciplinary team highly experienced in performing neonatal MR imaging including pediatric neuroradiologists, pediatric neurologists, neonatal nurses, and imaging bioengineers with expertise in translating basic MR techniques into reliable clinical research tools. Through this Bioengineering partnership, we aim to design, implement, and test the proposed techniques and tools to improve MR imaging of newborn patients. This will be the first neonatal MR project to our knowledge to: 1) develop 3T multi-channel MR coils specifically for premature and term infants, 2) develop fast phased-array 3T MR spectroscopic imaging techniques with novel lactate and glutamine & glutamate detection techniques for quantitating cellular metabolite levels that are known to be altered in brain injury, 3) develop and apply multichannel high resolution and high-angular diffusion techniques to characterize white matter microstructural development, 4) apply these advanced MR techniques in a cohort of premature newborns to quantify metabolic, diffusion, and morphological parameters to define normative values (in those with normal outcome) and the deviations in cases of brain injury. PUBLIC HEALTH RELEVANCE: Recent studies at 1.5 Tesla using MR compatible incubators have clearly demonstrated clinical and research value for the detection and characterization of neonatal brain injury. With the extraordinarily high premature birth rate of over 540,000 per year in the US and its extremely high human and economic costs, neonatal MRI is a critically important advance in radiological care. Through the proposed bioengineering partnership, we aim to advance this technology to create and validate new specialized 3T MR imaging tools for the non-invasive characterization of brain maturation and injury in premature and term newborns.