Development of an MRI Template & Neuroimaging Biomarkers of the Pediatric Spinal Cord

儿童脊髓损伤（SCI）的神经学后果尚未完全了解。无法 准确评估儿科人群的运动、感觉和损伤程度， 诊断、恢复潜力和治疗效果。这项拟议的研究建立在该小组的基础上， 以前的工作，以建立定量成像生物标志物使用先进的成像方法， 张量成像（DTI）、弥散峰度成像（DKI）和通过脊髓交叉评估的萎缩 脊髓横截面积（SCCSA）-在小儿SCI患者中。近年来，磁共振成像（MRI） DTI、DKI、SCCSA测量和神经突取向密度弥散成像等方法 （NODDI）作为评价脊髓功能的强有力的非侵入性生物标志物， (SC)小儿据我们所知，我们的研究团队是迄今为止唯一一个应用这些技术的团队。 影像学技术应用于儿科人群。尽管所有这些技术都证明了 为提供有关SC的微观结构信息，客观扩散- 基于生物标志物来识别受损脊髓的精确位置一直具有挑战性， 儿科SC的标准解剖模板，也没有生物学年龄和性别匹配的标准值， available.因此，本研究的第一个目的是创建一个标准化的SC成像模板， 6-17岁儿童SC的SCCSA测量。本研究的第二个目的是 建立颈胸段连续节段的标准多壳层扩散成像值 6-17岁的儿童SC。这项工作将导致标准化和一致的解释 这些神经成像指标，并将减少用户的可变性。这项工作的一个子目标是证明 这些成像生物标志物在一组患有慢性运动完全性的儿童中的可行性（American Spinal 损伤相关损害量表（AIS）A和B）SCI。这项工作将解决一个重大的知识差距， 为临床医生和研究人员提供功能性成像生物标志物，以便他们能够客观地确定 严重程度和损伤程度，并开发儿童SCI的预测模型。这项工作也将有助于 临床医生评估神经恢复，并在临床试验中评估治疗效果。此外，本发明还提供了一种方法， 这些成像生物标志物和标准模板可以扩展到其他儿科SC疾病， 未来

The neurological consequence of spinal cord injury (SCI) in children is not fully understood. The inability to accurately assess motor, sensation and extent of injury in the pediatric population raises speculation about diagnoses, recovery potential, and treatment effectiveness. This proposed study builds upon the team's previous work to establish quantitative imaging biomarkers using advanced imaging methods such as diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI) and atrophy estimated through a spinal cord cross sectional area (SCCSA) – in pediatric SCI patients. In the recent years magnetic resonance imaging (MRI) methods such as DTI, DKI, SCCSA measurements, and Neurite Orientation Density Dispersion Imaging (NODDI) have shown promising results as powerful and non-invasive biomarkers to evaluate the spinal cord (SC) in children. To the best of our knowledge, our research team is the only one thus far to apply these imaging techniques to the pediatric population. Although all of these techniques have demonstrated potential for providing microstructural information about the SC, the development and application of objective diffusion- based biomarkers for identifying the precise location of the injured cord has been challenging because neither a standard anatomical template of the pediatric SC nor biological age and sex matched normative values are available. Hence, the first aim of this study is to create a standardized SC imaging template and establish SCCSA measurements of the entire pediatric SC between 6-17 years of age. The second aim of this study will establish normative multishell diffusion imaging values for continuous segments of the cervical-thoracic pediatric SC between 6-17 years of age. This work will result in standardization and consistent interpretation of these neuroimaging metrics and will reduce user variability. A sub aim of this work is to demonstrate the feasibility of these imaging biomarkers in a group of children with chronic motor complete (American Spinal Injury Association Impairment Scale (AIS) A and B) SCI. This work will address a significant knowledge gap by providing functional imaging biomarkers to clinicians and researchers so they can objectively determine the extent of severity and level of injury and develop prediction models in pediatric SCI. This work would also aid clinicians in assessing neurological recovery, and evaluate treatment effectiveness in clinical trials. In addition, these imaging biomarkers and normative templates can be extended to other pediatric SC diseases in the future.