Yamin Arefeen¹, Tae Hyung Kim², Justin Haldar³, Ellen Grant^4,5, Borjan Gagoski^6,7, Berkin Bilgic^2,7, and Elfar Adalsteinsson^1,8,9
1Massachusetts Institute of Technology, Cambridge, MA, United States, ²Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States, ³Department of Electrical Engineering, University of Southern California, Los Angeles, CA, United States, ⁴Boston Children’s Hospital, Boston, MA, United States, ⁵Harvard Medical School, Boston, MA, United States, ⁶Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA, United States, ⁷Department of Radiology, Harvard Medical School, Cambridge, MA, United States, ⁸Harvard-MIT Health Sciences and Technology, Cambridge, MA, United States, ⁹Institute for Medical Engineering and Science, Cambridge, MA, United States

Fetal MRI utilizes Half-Fourier-acquisition-single-shot-turbo-spin-echo (HASTE) for rapid T₂-weighted imaging to mitigate motion.  However, specific-absorption-rate (SAR) constraints from the refocusing pulse train reduce acquisition efficiency. Variable refocusing flip angle (VFA) acquisitions can improve efficiency, but may suffer from low signal-to-noise ratios (SNR).  Here, we propose a VFA scheme and incorporate a rapid, low-SAR calibration scan.  We simulate and prospectively evaluate the SNR and SAR properties of the VFA scheme and utilize the calibration scan for LORAKS parallel imaging and retrospective evaluation of wave-encoded simultaneous-multislice (SMS).  VFA prospectively reduces acquisition time by ~2.3-2.5x and incorporating SMS could further improve efficiency.

Christopher W Roy¹, Leonor Alamo¹, Estelle Tenisch¹, John Heerfordt^1,2, Milan Prsa³, Meritxell Bach Cuadra^1,4,5, Davide Piccini^1,2, Jérôme Yerly^1,4, and Matthias Stuber^1,4
1Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, ²Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland, ³Division of Pediatric Cardiology, Department Woman-Mother-Child, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, ⁴Center for Biomedical Imaging (CIBM), Lausanne, Switzerland, ⁵Signal Processing Laboratory 5 (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland

A novel framework for 3D MRI of the fetus with retrospective motion compensation is developed and its initial feasibility demonstrated. This approach enables imaging with high isotropic resolution and allows for retrospective evaluation of the complex fetal anatomy in arbitrary scan planes, setting the stage for new possibilities in the assessment of fetal diseases in utero.

Shuo Zhang¹, Janine Knapp², Roland Cronenberg³, Björn Schönnagel², Manuela Tavares de Sousa⁴, Barbara Ulm⁵, Daniela Prayer³, Vanessa Berger-Kulemann³, and Fabian Kording^2,6
1Philips, Hamburg, Germany, ²Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany, ³Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria, ⁴Department of Obstetrics and Fetal Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany, ⁵Department of Gynecology and Obstetrics, Division of Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria, ⁶northh medical GmbH, Hamburg, Germany

Cardiovascular MRI is considered a valuable diagnostic tool for studying congenital abnormalities in children and adults. However, simple, high-quality imaging of the fetal heart is challenging due to lack of direct in-utero cardiac gating. We aimed to employ a recently introduced Doppler ultrasound (DUS) device and combine with optimized routine imaging techniques for structural and functional studies of the fetal heart and to establish a standard acquisition approach for high-quality fetal cardiovascular MRI in the clinical practice.

ZHAN-QIU LIU¹, Nyasha Maforo², Seraina Dual³, Ashley Prosper⁴, Pierangelo Renella⁴, Nancy Halnon⁵, Holden Wu⁴, and Daniel Ennis^3
1Cardiovascular Institute, Stanford University, Stanford, CA, United States, ²Physics and Biology in Medicine Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, United States, ³Department of Radiology, Stanford University, Stanford, CA, United States, ⁴Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA, United States, ⁵Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, United States

Left ventricular(LV) peak mid-wall circumferential strain (Ecc) is a sensitive early biomarker for evaluating the subtle and highly variable onset and progression of cardiomyopathy in pediatric subjects with Duchenne muscular dystrophy (DMD). Cine Displacement Encoding with Stimulated Echoes (DENSE) has proven sensitive to changes in Ecc. Using cine DENSE we show a significantly decreased septal Ecc in LGE negative(-) boys with DMD absent identifiable focal fibrosis compared with controls. A binomial logistic regression model that combines septal Ecc, LV pre-contrast T1, and LV ejection fraction can sensitively distinguish LGE(-) boys with DMD from healthy boys without the need for contrast.

Wenqi Wang¹, Xuan Jia², Jiawei Liang², Xiaohui Ma², Weibo Chen³, Dan Wu¹, Can Lai², and Yi Zhang^1
1Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China, ²Department of Radiology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China, ³Philips Healthcare, Shanghai, China

Neuroblastoma (NB) most often occurs in young children, and accurate diagnosis of NB with anatomical MRI remains challenging. Here, we explored the potential of amide proton transfer (APT) imaging in evaluating the risk of pediatric abdominal NB. A total of 25 patients were enrolled, including 12 with low-risk NB and 13 with high-risk NB. An automatic shrinkage algorithm was applied to the initial region of interest delineated by an experienced radiologist to focus on the most aggressive part of tumors. We obtained an AUC of 0.917 for stratifying the risk of NB with APT, demonstrating the potential of clinical application.

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). The combination of wave polarity-inversion motion encoding and compressed-SENSE enables volumetric three-dimensional (3D) MRE data acquisition in a single breath-hold of <16 s, with identical spatial resolution and 5 slice equivalent coverage (3D_5Sl_SBH). In 19 participants, mean liver shear stiffness values estimated with SC_2D_4BH and 3D_5sl_SBH correlated very strongly (ICC=0.96) with a mean bias of 0.13 kPa (<5 %). 3D_5sl_SBH MRE provides similar stiffness estimates as SC_2D_4BH with increased coverage in a single breath-hold compared to 4 breath-holds.

Xiaoxu Na¹, Natalie E. Phelan¹, Marinna R. Tadros¹, Aline Andres^2,3, Thomas M. Badger^2,3, Charles M. Glasier¹, Raghu H. Ramakrishnaiah¹, Amy C. Rowell¹, Li Wang⁴, Gang Li⁴, Zhengwang Wu⁴, David K. Williams⁵, and Xiawei Ou^1,3,6
1Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States, ²Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States, ³Arkansas Children's Nutrition Center, Little Rock, AR, United States, ⁴Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States, ⁵Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, United States, ⁶Arkansas Children's Research Institute, Little Rock, AR, United States

This study examined the relationships between maternal obesity during pregnancy and newborn’s brain cortical development. Healthy normal weight or obese pregnant women were recruited at early pregnancy and their newborns underwent a brain MRI examination at 2 weeks of age. Structural MR images of the brain were post-processed to reconstruct cortical surfaces, and mean cortical thickness in different brain regions was measured. Significant differences in cortical thickness between infants born to normal weight vs. obese mothers were found in multiple brain regions, and negative correlations between maternal body fat mass percentage and infant cortical thickness were also observed.

Jacob Story¹, Sevgi Gokce Kafali^2,3, Shu-Fu Shih^2,3, Kara L. Calkins⁴, Shahnaz Ghahremani³, and Holden H. Wu^2,3
1David Geffen School of Medicine at UCLA, Los Angeles, CA, United States, ²Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States, ³Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States, ⁴Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, United States

Metabolic dysfunction in children is a major health issue. Pancreatic fat is a potential biomarker of metabolic dysfunction, but methodological difficulties have limited research on its role in at-risk children. This work used free-breathing abdominal MRI to quantify pancreatic fat and to characterize its heterogeneity in children with and without nonalcoholic fatty liver disease (NAFLD). Children with NAFLD had increased pancreatic fat that was heterogeneously distributed and predominantly located in the superior region. A simple region-of-interest-based measurement method failed to account for this heterogeneity, and thus underestimated pancreatic fat. Full segmentation pancreatic fat measurements correlated with markers of metabolic dysfunction.

Alexandra F Bonthrone¹, Ralica Dimitrova^1,2, Andrew Chew¹, Christopher J Kelly¹, Lucilio Cordero-Grande^1,3, Olivia Carney¹, Alexia Egloff¹, Emer Hughes¹, Katy Vecchiato^1,2, John Simpson⁴, Joseph V Hajnal^1,5, Kuberan Pushparajah⁴, Suresh Victor¹, Chiara Nosarti^1,6, Mary A Rutherford¹, A. David Edwards¹, Jonathan O’Muircheartaigh^1,2, and Serena J Counsell^1
1Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom, ³Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid and CIBER-BBN, Madrid, Spain, ⁴Paediatric Cardiology Department, Evelina London Children's Healthcare, London, United Kingdom, ⁵Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ⁶Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom

Infants with Congenital Heart Disease (CHD) are at high risk of neurodevelopmental disorders. We acquired presurgical neonatal T2-weighted MRI (N=66), cerebral oxygen delivery (CDO₂; N=53), and 22-month cognitive and motor scores (N=44). Atypicality indices, representing the degree of deviation of a regional brain volume from the normative neonatal mean for a given gestational age, sex and postnatal age, were calculated. Reduced CDO₂ was indirectly associated with lower cognitive scores through the mediating effect of negative bilateral caudate and thalami atypicality indices. The aetiology of cognitive impairments in CHD may encompass poor CDO₂ leading to impaired caudate and thalamus growth.

Chenying Zhao^1,2, Gabriel Santpere³, Minhui Ouyang¹, David Andrijevic⁴, Nenad Sestan⁴, and Hao Huang^1,5
1Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States, ²Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States, ³Neurogenomics group, Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), DCEXS, Universitat Pompeu Fabra, Barcelona, Spain, ⁴Department of Neuroscience and Kavli Institute for Neuroscience, Yale School of Medicine, New Haven, CT, United States, ⁵Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States

Transcriptome, the set of gene expression, is spatiotemporally heterogeneous across brain development. Under its regulation, dramatic changes in brain connectivity estimated through diffusion MRI is observed in early childhood. However, the association between the macroscopic structural connectome and microscopic transcriptome across early postnatal years is not clear. Here, we revealed this dynamic association between structural connectome and gene expression from a large cohort of 200 neonates and children through the 3^rd trimester and early childhood. The changes of associated genes’ enrichment in cell types and biological processes across different ages shed light into the dynamic transcriptomic roles in connectome development.