News | Magnetic Resonance Imaging (MRI) | October 01, 2020

Early MRIs Can Predict Motor Development Risks for Preterm Infants

With new software quantification, volume of diffuse white matter abnormality (DWMA) can serve as biomarker, according to experts at Cincinnati Children's

These MRI scans show diffuse white matter abnormality (DWMA). The top three panels display raw MRI images from very preterm infants born at 27 weeks (left), 26 weeks (center) and 31 weeks (right) gestation.

These MRI scans show diffuse white matter abnormality (DWMA). The top three panels display raw MRI images from very preterm infants born at 27 weeks (left), 26 weeks (center) and 31 weeks (right) gestation. Higher signal intensity can be seen in the central white matter, particularly for the 31-week gestation infant. The bottom panels display the corresponding slices with objectively segmented DWMA in yellow. The 27-week infant (left) was diagnosed with mild DWMA, the 26-week infant (center) was diagnosed with moderate DWMA, and the 31-week infant had severe DWMA. Image courtesy of Cincinnati Children's and Nature Scientific Reports

October 1, 2020 — As many as 70% of very premature infants (born earlier than 32 weeks gestation) show signs of white matter abnormalities at birth. But only some of those infants go on to develop cognitive, language, motor, or behavioral disorders as they grow.

Now, scientists say a new software tool can employ magnetic resonance imaging (MRI) scan data to predict which infants are most at risk of these brain developmental issues. The tool's latest milestone — predicting the risk of motor development disorders (e.g. cerebral palsy) — were detailed online Sept. 28, 2020, in Scientific Reports.

The study was led by Nehal Parikh, DO, MS, a neonatologist and researcher with the Perinatal Institute at Cincinnati Children's who has been working on this line of research for 12 years. He and his collaborators have published several papers exploring the value of measuring diffuse white matter abnormality (DWMA) as a biomarker for brain disorders.

A quantitative look at white matter diffusion

"While most researchers and doctors have concluded that DWMA is not pathologic, our novel studies are concluding otherwise," Parikh says. "Most studies have diagnosed DWMA qualitatively based on visual readings from radiologists (yes/no, mild/moderate/severe). These subjective diagnoses have been unreliable and therefore have not been significantly associated with neurodevelopmental disorders."

However, quantifying the volume of DWMA, does allow for risk stratification, Parikh says. The method also allows for earlier diagnosis. Currently, affected children are not diagnosed with these disorders until 2 to 5 years of age.

The first publications related to the software date back to 2013, with findings reported in NeuroimagePLOS ONE and Pediatric Neurology that showed an association between DWMA volume and cognitive and language development at 2 years of age.

Earlier this year, they externally validated their findings and reported in the Journal of Pediatrics that DWMA volume significantly predicts cognitive and language development at 2 years of age. Additionally, in Pediatric Neurology, the team reported DWMA volume associations with the two most common neonatal diseases, bronchopulmonary dysplasia and retinopathy of prematurity.

Now, the tool shows that DWMA volume significantly and independently predicts motor development deficits, including cerebral palsy, at 3 years of age.

What's next

Parikh says the team is close to completing a large cohort study called the Cincinnati Infant Neurodevelopment Early Prediction Study (CINEPS) to further validate the findings.

"We plan to work with MRI manufacturers to incorporate our software onto their systems in order to provide objective diagnosis of DWMA at the point of care," Parikh says. "This advance will permit accurate parental counseling and early risk stratification to enable targeted early intervention therapies."

For more information: www.cincinnatichildrens.org

Related Content

A, Initial conventional axial CT image shows no noticeable lung damage (within red box) in right upper lobe. B, Electron density spectral CT image obtained at same time as image in A shows lesions (within red box) in right upper lobe. C, Follow-up conventional axial chest CT image obtained 5 days after images in A and B confirm presence of lesions (within red box) in right upper lobe.

A, Initial conventional axial CT image shows no noticeable lung damage (within red box) in right upper lobe. B, Electron density spectral CT image obtained at same time as image in A shows lesions (within red box) in right upper lobe. C, Follow-up conventional axial chest CT image obtained 5 days after images in A and B confirm presence of lesions (within red box) in right upper lobe. Image courtesy of the American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

News | Coronavirus (COVID-19) | October 22, 2020
October 22, 2020 — According to an open-...
The fMRI hyperscanning environment.

(A) The fMRI hyperscanning environment. The clinician (1) and patient (2) were positioned in two different 3T MRI scanners. An audio-video link enabled online communication between the two scanners (3), and video images were used to extract frame-by-frame facial expression metrics. During simultaneous acquisition of blood oxygen level–dependent (BOLD)–fMRI data, the clinician used a button box (4) to apply electroacupuncture (EA) treatment (real/sham, double-blind) to the patient (5) to alleviate evoked pressure pain to the leg (6; Hokanson cuff inflation). Pain and affect related to the treatment were rated after each trial. (B) Study overview. After an initial behavioral visit, each individual participated in a Clinical-Interaction (hyperscan preceded by a clinical intake) and No-Interaction condition (hyperscan without a preceding intake), in a counterbalanced order, with two different partners. (C) Experimental protocol. Each hyperscan was composed of 12 repeated trials (four verum EA, four sham EA, and four no treatment) in a pseudo-randomized order. After a resting period (far left), both participants were shown a visual cue to indicate whether the next pain stimulus would be treated (green frame) or not treated (red frame) by the clinician. These cues prompted clinicians prepare to either apply or not apply treatment while evoking corresponding anticipation for the patient. Following the anticipation cue, moderately painful pressure pain was applied to the patient’s left leg, while the clinician applied or did not apply treatment, respectively. After another resting period, participants rated pain (patients), vicarious pain (clinicians), and affect (both) using a visual analog scale (VAS).

News | Clinical Trials | October 22, 2020
October 22, 2020 — The potential impact of the patient-clinician relationship on a patient's response to treatment is
The FDA clearance, Quantib’s 6th to date, marks the first time a comprehensive AI prostate solution will be available to radiologists in the United States
News | Prostate Cancer | October 21, 2020
October 21, 2020 — Quantib, a market leader in...
Lesion was originally reported as indeterminate enhancing mass, and outside report recommended biopsy. Classic features of benign hemangioma are shown. Error was attributed to faulty reasoning. A, Axial MR image obtained 5 minutes after contrast agent administration shows peripheral nodular discontinuous enhancement. B, Axial MR image obtained 10 minutes after contrast agent administration shows centripetal progression of enhancement (arrow). C, Axial fast imaging employing steady-state acquisition (FIESTA)

Lesion was originally reported as indeterminate enhancing mass, and outside report recommended biopsy. Classic features of benign hemangioma are shown. Error was attributed to faulty reasoning. A, Axial MR image obtained 5 minutes after contrast agent administration shows peripheral nodular discontinuous enhancement. B, Axial MR image obtained 10 minutes after contrast agent administration shows centripetal progression of enhancement (arrow). C, Axial fast imaging employing steady-state acquisition (FIESTA) MR image shows lesion is homogeneously hyperintense compared with liver parenchyma. Image courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

News | Magnetic Resonance Imaging (MRI) | October 21, 2020
October 21, 2020 — According to an artic...
According to an inquest, a man with a heart disorder and chest pain died two days after a doctor viewed the wrong scan and sent him home
News | Computed Tomography (CT) | October 21, 2020
October 21, 2020 — The BBC News
Flowchart of patient inclusion and exclusion.

Figure 1. Flowchart of patient inclusion and exclusion.

News | Coronavirus (COVID-19) | October 20, 2020
October 20, 2020 — A new multi-institutional study published in the journal ...
Rensselaer, First-Imaging, and GE Global researchers develop a deep neural network to perform nearly as well as more complex dual-energy CT imaging technology
News | Computed Tomography (CT) | October 20, 2020
October 20, 2020 — Bioimaging technologies are the eyes that allow doctors to see inside the body in order to diagnos
Ezra, a NY-based startup transforming early cancer screening using magnetic resonance imaging (MRI), announced that it has received FDA 510(k) premarket authorization for its Artificial Intelligence, designed to decrease the cost of MRI-based cancer screening, assisting radiologists in their analysis of prostate MRI scans. It is the first prostate AI to be cleared by the FDA.
News | Artificial Intelligence | October 20, 2020
October 20, 2020 — Ezra, a NY-based startup transforming early cancer screening using...
Lesion was originally reported as indeterminate enhancing mass, and outside report recommended biopsy. Classic features of benign hemangioma are shown. Error was attributed to faulty reasoning. A, Axial MR image obtained 5 minutes after contrast agent administration shows peripheral nodular discontinuous enhancement. B, Axial MR image obtained 10 minutes after contrast agent administration shows centripetal progression of enhancement (arrow). C, Axial fast imaging employing steady-state acquisition (FIESTA)

56-Year-Old Woman With Benign Hemangioma: Lesion was originally reported as indeterminate enhancing mass, and outside report recommended biopsy. Classic features of benign hemangioma are shown. Error was attributed to faulty reasoning. A, Axial MR image obtained 5 minutes after contrast agent administration shows peripheral nodular discontinuous enhancement. B, Axial MR image obtained 10 minutes after contrast agent administration shows centripetal progression of enhancement (arrow). C, Axial fast imaging employing steady-state acquisition (FIESTA) MR image shows lesion is homogeneously hyperintense compared with liver parenchyma.

News | Magnetic Resonance Imaging (MRI) | October 16, 2020
October 16, 2020 —