Hailong Li¹, Ming Chen^1,2, Jinghua Wang³, Nehal A. Parikh^4,5, and Lili He^1,5
1Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ²Department of Electrical Engineering and Computer Science, University of Cincinnati, Cincinnati, OH, United States, ³Deep MRI Imaging Inc., Lewes, DE, United States, ⁴The Perinatal Institute and Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ⁵Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States

About 32−42% of very preterm infants develop minor motor impairments around the world.  Unfortunately, large MRI datasets with clinical outcome annotations/labels are typically unavailable, especially in neonates. To address this challenge of limited training data, we developed a semi-supervised graph convolutional network model to utilize both labeled and unlabeled data during model training to predict motor impairments at 2 years corrected age using brain structural connectome derived from diffusion MRI obtained at term-equivalent age in very preterm infants. The proposed model was able to identify infants with motor impairments with an accuracy of 68.1% and an AUC of 0.67.   

Jinhong Yu¹, Yanwei Miao¹, Yangyingqiu Liu¹, Bingbing Gao¹, and Yu Bing^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China

The T1WI hyperintensity of bilateral globus pallidus（GP）is considered to be a typical imaging manifestation of bilirubin encephalopathy(BE), but the diagnosis ability is insufficient for the early stage of the disease (hyperbilirubinemia and T1WI negative). In this study, a better early prediction model of BE based on T1WI radiomics was obtained, which provided a new image marker for early diagnosis and monitoring of BE.

Hyun Gi Kim¹, Jae Eun Song², Dongyeob Han³, Jee Young Kim¹, Se Won Oh¹, and Dong-Hyun Kim^2
1Radiology, The Catholic University of Korea, Seoul, Korea, Republic of, ²Yonsei University, Seoul, Korea, Republic of, ³Siemens Healthcare, Seoul, Korea, Republic of

Myelin water fraction (MWF) values were obtained by an artificial neural network (ANN-MWF) and complex model fitting (CF-MWF) with 3D multi-echo gradient-echo (mGRE) signal. Linear regression test showed high correlation between ANN-MWF and CF-MWF values (R² = 0.802, p < .001). Bland-Altman plot showed higher ANN-MWF values compared to CF-MWF values in the areas with high MWF values. The ANN-MWF values in the white matter showed a high association with age (R² = 0.821, p =.005). 

Rieke Lisa Meister¹, Shuo Zhang², Michael Groth¹, Julian Jürgens¹, Christoph Katemann², Jan-Hendrik Buhk³, and Jochen Herrmann^1
1Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, ²Philips, Hamburg, Germany, ³Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

High-resolution MRI plays an important role in neuro-oncological exams in children. However, high-quality imaging remains challenging due to long scan times. In this study, we evaluate the compressed SENSE technique that employs compressed sensing with coil sensitivity information in a dedicated pediatric neuro-oncological scan protocol in children with brain tumor. The resulted image quality and scan duration are compared with the conventional techniques, showing promise for a wide adaption in the clinical routine practice.

Sevgi Gokce Kafali^1,2, Shu-Fu Shih^1,2, Xinzhou Li^1,2, Tess Armstrong¹, Kelsey Kuwahara³, Sparsha Govardhan⁴, Karrie V Ly⁴, Shahnaz Ghahremani¹, Kara L Calkins⁴, and Holden H Wu^1,2
1Radiological Sciences, University of California, Los Angeles, Los Angeles, CA, United States, ²Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States, ³Cognitive Science, University of California, Los Angeles, Los Angeles, CA, United States, ⁴Pediatrics, University of California, Los Angeles, Los Angeles, CA, United States

Obese children have larger amounts of subcutaneous and visceral adipose tissue (SAT, VAT) and are at high risk for cardiometabolic disease. The reference standard to analyze SAT/VAT uses breath-held (BH) abdominal MRI for manual annotation of SAT/VAT. In children, the BH requirement and spatially varying VAT distribution are major challenges for body composition analysis. This work proposed a densely connected neural network with a class frequency balancing, boundary emphasizing loss to segment SAT/VAT using free breathing abdominal MRI in children.

Hannah Kurdila¹, Tayeb Zaidi¹, Ting Zhang¹, Subha Maruvada¹, and Sunder Rajan^1
1Food and Drug Administration, Silver Spring, MD, United States

The purpose of this study was to determine the expected sound exposure to the neonate during neonatal brain protocols. To accomplish this, 7 neonatal brain protocols were recorded on 7 different MRI machines across 4 vendors. Neonatal protocol sound levels straddled existing notions of risk, exceeding sound levels known to cause non-auditory stress responses in neonates but not exceeding the IEC MRI hearing safety limit. These results indicate that these sound levels could be risky for the neonate, but that further work is required to clarify this.

Emi Niisato¹, Yung-Chieh Chen², Bhat Himanshu³, Wei Liu⁴, Daniel Nicolas Splitthoff⁵, and Cheng-Yu Chen^2
1Siemens Healthcare Limited, Taiwan, Taipei, Taiwan, ²Taipei Medical University Hospital, Taipei, Taiwan, ³Siemens Medical Solutions, Malvern, PA, USA, Malvern, PA, United States, ⁴Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China, Shenzhen, China, ⁵Siemens Healthcare GmbH, Erlangen, Germany, Erlangen, Germany

Pediatric patients are preferred to be scanned with protocols which are resistant to motion artifact or which complete in a short scan time. We investigated the extent of motion artifact suppression in pediatric patients using modified multi-echo Magnetization Prepared Rapid Acquisition Gradient Echo (MEMPRAGE) with prospective motion correction using 3D EPI volumetric navigators (vNav Moco) by comparing with wave-controlled aliasing in parallel imaging (wave-CAIPI) MPRAGE. Visual assessment revealed vNav Moco MEMPRAGE significantly suppressed head motion artifacts compared with wave-CAIPI MPRAGE and conventional MRPAGE.

Fedel Machado-Rivas^1,2, Daniel J Park³, John Conklin^1,2, John E Kirsch^2,3, and Michael S Gee^1,2
1Radiology, Massachusetts General Hospital, Boston, MA, United States, ²Radiology, Harvard Medical School, Boston, MA, United States, ³MGH Martinos Center for Biomedical Imaging, Boston, MA, United States

Abdominal MRI respiratory triggered acquisitions in pediatric populations often fail due to shallow or irregular breathing patterns, degrading image quality and increasing acquisition time. A free-breathing T2-weighted multi-shot TSE BLADE acquisition could overcome these limitations, but through plane motion of respiration causes substantial signal loss from long T2 (such as biliary ducts). We hypothesized that by modifying the refocusing pulse width of the sequence we could mitigate signal loss. Our results show that a 2x refocusing pulse modified free breathing sequence provides comparable image quality and contrast. Furthermore, it offers a fixed acquisition time independent of respiratory patterns.   

Jérémie Clément¹, Kathleen Colford², Emer Hughes², Tomoki Arichi^2,3,4, David Edwards^2,3,5, Joseph Hajnal^1,2, and Ozlem Ipek^1
1Biomedical Engineering, Kings College London, London, United Kingdom, ²Centre for the developing brain, Kings College London, London, United Kingdom, ³Bioengineering, Imperial College London, London, United Kingdom, ⁴Paediatric neurosciences, Evelina London children's hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, ⁵MRC Centre for Neurodevelopmental Disorders, Kings College London, London, United Kingdom

Magnetic resonance imaging (MRI) of the developing brain and heart could greatly benefit from the higher signal levels and improved tissue contrast at 7T. However, there are currently no dedicated RF coils and associated patient handling for young infants (<3-months). We describe design criteria and solutions to build the first mechanical frame and coil formers for imaging the brain and heart in infants up to 3-months of age in an integrated manner at 7T. The different parts incorporate important design aspects including mechanical sturdiness/safety, toxicity, sanitization and ease of use.

Erik Huijing¹, Evita Wiegers¹, Dennis Klomp¹, Fredy Visser^1,2, Edwin Versteeg¹, Koenraad Rhebergen³, Kim Annink⁴, Niek van der Aa⁴, Floris Groenendaal⁴, Jeroen Dudink⁴, Thomas Alderliesten⁴, Maarten Lequin¹, Manon Benders⁴, and Jannie Wijnen^1
1Radiology, University Medical Center Utrecht, Utrecht, Netherlands, ²Philips HealthCare, Best, Netherlands, ³Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands, ⁴Neonatology, University Medical Center Utrecht, Utrecht, Netherlands

We designed a new acoustic hood for neonatal MRI exams at 7 Tesla. The new design is lightweight and allows easy access to the neonate during the MRI examination. We were able to optimize the new acoustic hood to a noise reduction of 10.6dB, exceeding the damping of a prototype with damping of 3.1dB. The new hood was designed to fit a head coil and allows the use of a ventilation tube.

Deep B. Gandhi¹, Amol Pednekar¹, Hui Wang², Jean A. Tkach¹, Andrew T. Trout¹, and Jonathan R. Dillman^1
1Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ²MR Clinical Science, Philips, Cincinnati, OH, United States

Hepatic T1 relaxation values have been shown to correlate with hepatic fibrosis. The established 2D T1 mapping techniques require multiple breath-holds to quantify whole liver T1. 3D whole liver T1 quantification in a single breath-hold using an interleaved Look-Locker acquisition sequence with T2 preparation pulse (3D-QALAS) correlates very strongly (r=0.95) with T1 values obtained with a 2D Modified Look-Locker Acquisition (2D-MOLLI). However, 3D-QALAS underestimated T1 significantly (p<0.0001) compared to 2D-MOLLI with a mean bias of 92.5 ms (14.2%). 3D-QALAS has potential to measure T1 of the whole liver in a single breath hold, while simultaneously providing T2 relaxation values.

Jinhong Yu¹, Yanwei Miao¹, Yangyingqiu Liu¹, Bingbing Gao¹, and Yu Bing^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China

Exposure to high levels of bilirubin can cause serious severe motor symptoms and cerebral palsy,but the pathophysiological mechanism of brain injury is still unclear.The aim of this study was to explore the possible pathophysiological mechanism of brain tissue injury using diffusion weighted imaging (DWI) and three dimensions T2* weighted angiography( 3D SWAN). 

Amol Pednekar¹, Deep B. Gandhi², Hui Wang³, Jean A. Tkach¹, Andrew T. Trout¹, and Jonathan R. Dillman^1
1Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ²Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ³MR Clinical Science, Philips, Cincinnati, OH, United States

2D GRE MRE liver images acquired at 4 transverse levels in breath-hold times >13s per slice is currently standard of care (SC_2D_4BH). Inadequate breath-holds lead to inaccurate stiffness estimation and/or failed studies. The combination of wave polarity-inversion motion encoding and compressed-SENSE enables MRE images to be acquired in less than half the breath-hold time (2D_CS_HBH) e.g. <7s, with identical spatial resolution and field of view. In 19 participants, mean liver shear stiffness values estimated with SC_2D_4BH and 2D_CS_HBH correlated very strongly (ICC>0.96) with a bias of <0.15 kPa (<6%). 2D_CS_HBH MRE is beneficial in participants with compromised breath-holding capacity.

Dianna ME Bardo¹, Nicholas Rubert¹, Mittun Patel¹, Shiza Shahid¹, and Robyn Augustyn^1
1Radiology, Phoenix Children's Hospital, Phoenix, AZ, United States

LIC analysis may be performed with accurate and reproducible results in children using an ROI or a whole liver segmentation technique using locally available software and the FerriScan® technique. 

Deep B. Gandhi¹, Nara S. Higano², Andrew D. Hahn³, Luis Torres³, Sean B. Fain³, Jason C. Woods², and Alister J. Bates^2
1Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ²Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ³Department of Medical Physics, University of Wisconsin, Madison, WI, United States

Pulmonary ¹H ultrashort echo-time (UTE)-MRI provides clinically relevant structural information in neonates with lung disease of prematurity (bronchopulmonary dysplasia, BPD) and has strong, unexplored potential to evaluate regional pulmonary function. Retrospective respiratory-gated UTE-MRI allows reconstructed images from different phases of the breathing cycle. Here, we compared four retrospective gating approaches in 3 BPD subjects with different weighted time intervals: 1 hard-gating and 3 soft-gating (exponential, inverse and linear weighting functions). Overall, linearly weighted soft-gating provided better compromise between apparent SNR (aSNR) and motion-blurring. This optimized respiratory-gating approach opens the door for improved understanding of regional pulmonary function deficits in neonates.

Diego M Jaramillo¹, Phuong M Duong¹, Jie C Nguyen², Sogol Mostoufi-Moab², Michael K Nguyen², Andrew Moreau², Christian A Barrera³, Shijie Hong², and Jose M Raya^4
1Columbia University Medical Center, New York, NY, United States, ²Children’s Hospital of Philadelphia, Philadelphia, PA, United States, ³Massachusetts General Hospital, Boston, MA, United States, ⁴New York University, New York, NY, United States

Prediction of growth potential in the pediatric population is critical to trace therapies targeting growth deficiencies and to inform surgical planning. Clinical models to predict growth potential are very inaccurate. We aim to validate DTI of the physis and metaphysis (DTI-P/M) as a prediction biomarker of growth potential in children. We compared in a cohort of 90 children the prediction accuracy of DTI-P/M and clinical models. Our data showed that DTI-P/M predicted growth potential more accurately than clinical models (over 40% reduction in error). Even more importantly, compared to clinical models DTI-MP predictions did not show any prediction bias. 

Alex J Barker¹, Lorna P Browne¹, Michal Schafer², Erin K Englund², Takashi Fujiwara², Kristen J Nadeau², and Petter Bjornstad^2
1Radiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States, ²University of Colorado, Anschutz Medical Campus, Aurora, CO, United States

Pediatric patients may experience inaccurate estimates of glomerular filtration rate (GFR) by serum creatinine or cystatin C. Renal blood flow (RBF) is a key physiological determinant of GFR, thus, phase-contrast MRI (PC-MRI) is a promising non-invasive technique to investigate relationships to GFR. An interim prospective analysis (n=18) is presented, which investigates RBF as measured by PC-MRI in pediatric bone-marrow transplant candidates who also underwent gold standard measurement of GFR by ¹²⁵I iothalamate clearance (GFR-iothalamate). The correlation between GFR-iothalamate and RBF by PC-MRI was markedly superior to that of the commonly used endogenous filtration markers serum creatinine or cystatin C.

Nataliia Kriventsova¹, Petr Menshchikov², Dmitry Kupriyanov², Dmitry Litvinov¹, Galina Novichkova¹, and Galina Tereshchenko^1
1Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation, ²Philips Healthcare, Moscow, Russian Federation

In our study, we quantified the bone marrow fat fraction (FF) using mDixon-Quant MRI and MR Spectroscopy. The FF values in the bone marrow in children with acute leukemia compared with children of the same age without hematological diseases were  significantly different. The value of the fat fraction may become an MR-biomarker of bone marrow in children with acute leukemia.

Xianyun Cai¹, Jinxia Zhu², and Guangbin Wang^1
1Shandong Medical Imaging Research Institute, Shandong University, Jinan, China, China, ²MR Collaboration, Siemens Healthcare Ltd., Beijing, China, China

This study investigated the prenatal diagnosis and prognosis of fetal sacrococcygeal teratomas (SCTs) (Type IV) with Prenatal MRI. Sixteen fetuses with suspected Type IV teratomas were included and followed up in this study. The results showed that prenatal MRI could effectly diagnosed fetal Type IV SCTs, which have a bright outcomes postnatally after surgery resection. This suggests correct diagnosis of teratoma on prenatal MRI and early operation after birth are important for prognosis.

Katie M Strobel¹, Sevgi Gokce Kafali², Shu-Fu Shih², Rinat Masamed², Kara Calkins¹, and Holden Wu^2
1Pediatrics, University of California Los Angeles, Los Angeles, CA, United States, ²Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States

This pilot prospective cohort study investigated fetal and maternal body composition in the third trimester of pregnancy using 3D stack-of-radial free-breathing MRI. Nine women with healthy pregnancies, gestational diabetes, or fetal growth restriction were included. Fetal subcutaneous fat and liver fat, as well as maternal liver fat, subcutaneous fat, and visceral fat were successfully measured. Maternal body composition was associated with fetal body composition. Pregnancies complicated by gestational diabetes appear to alter fetal body composition.