Robust and Rapid 3D High-Resolution Cranial bone imaging for pediatric patients using MRI

使用 MRI 为儿科患者提供稳健、快速的 3D 高分辨率颅骨成像

• 批准号: 10532253
• 负责人: Hongyu An
• 金额: $ 62.79万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-01 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10532253
• 关键词: 3-Dimensional; Accident and Emergency department; Address; Adoption; Adult; American College of Radiology; Bayesian neural network; Black race; Bone Marrow; Cardiopulmonary; Cephalic; Child; Childhood; Clinical; Consensus; Craniocerebral Trauma; Craniosynostosis; Data; Development; Developmental Delay Disorders; Diagnosis; Enrollment; Evaluation; Fracture; Goals; Head; Health; Image; Ionizing radiation; Joint structure of suture of skull; Legal patent; Magnetic Resonance Imaging; Malignant neoplasm of brain; Manuals; Maps; Medical center; Methods; Modeling; Morphologic artifacts; Motion; Movement; National Cancer Institute; Noise; Patient risk; Patients; Pilot Projects; Postoperative Care; Postoperative Period; Public Health; Radiation; Radiation Tolerance; Radiation exposure; Rapid diagnostics; Reporting; Research; Resolution; Risk; Safety; Scanning; Sedation procedure; Signal Transduction; Skull Fractures; Surgical sutures; Techniques; Time; Tissues; Translating; Trauma; Uncertainty; United States; United States Food and Drug Administration; Work; X-Ray Computed Tomography; age related; bone; bone imaging; brain tissue; clinical care; clinical diagnosis; clinical practice; clinical translation; cranium; deep learning; diagnostic tool; disability; follow-up; image processing; image reconstruction; imaging modality; indexing; leukemia; novel; patient subsets; pediatric patients; premature; radiation risk; reconstruction; skull base; success; temporal measurement; transfer learning

Project Summary Pediatric patients are more vulnerable to radiation exposure when compared to adults. Each year, 2.2 million pediatric head computed tomography (CT) scans utilizing ionizing radiation are performed in the United States. Head trauma and craniosynostosis are two of the most common pediatric conditions requiring head CT scans. Multiple CT scans are often performed during clinical follow-up, exacerbating the cumulative risk of radiation exposure. Head trauma is common in children, frequently resulting in a skull fracture. Craniosynostosis is a congenital disability defined by a prematurely fused cranial suture. Standard clinical care for pediatric patients with head trauma or craniosynostosis employs 3D high-resolution cranial CT images to identify cranial fractures or cranial suture patency. The National Cancer Institute reported that radiation exposure from multiple head CT scans in children has the potential to triple the risk of leukemia and brain cancer due to radiosensitivity of their bone marrow and brain tissue. Magnetic resonance imaging (MRI) is a safe alternative without ionizing radiation. Existing “black bone” MRI methods rely on a diminished bone signal in a standard gradient echo scan to image the skull. Though these methods have shown encouraging results, they have not translated into clinical practice due to several challenges: motion artifacts, long acquisition time, and subjective manual image processing. Since pediatric patient movement is very common, sedation has been routinely used to minimize motion artifacts in an MR scan. Unfortunately, sedation is associated with risks including developmental delay and cardiopulmonary complications. It takes several minutes to acquire high-resolution MR images, which can be challenging for pediatric subject compliance and limits clinical adoption. Due to poor signal contrast between bone and its surrounding tissues in MR images, existing manual signal intensity-based approaches are challenging and not suitable for clinical translation. Our primary goal is to develop novel MR techniques to provide CT-equivalent 3D high-resolution cranial bone imaging. Four specific aims are proposed: 1) develop motion correction to address head motion in unsedated pediatric patients; 2) develop an MR image reconstruction method regularized by a deep-learning prior to reduce MR acquisition time to 1 minute or below; 3) develop a 3D Bayesian neural network to estimate pseudo-CT (pCT) and uncertainty maps from MRI for robust and automated image post-processing; and 4) determine the clinical utility of pCT in identifying cranial fractures and cranial suture patency. This study will have a profound impact on pediatric health by removing the risks associated with radiation and sedation.

项目概要 与成人相比，每年有 220 万名儿童患者更容易受到辐射照射。 美国利用电离辐射进行小儿头部计算机断层扫描 (CT) 扫描。 头部外伤和颅缝早闭是两种最常见的需要头部 CT 扫描的儿科疾病。 临床随访期间经常进行多次 CT 扫描，加剧了辐射的累积风险 头部外伤在儿童中很常见，经常导致颅骨骨折。 由颅骨缝线过早融合定义的先天性残疾 儿科患者的标准临床护理。 患有头部外伤或颅缝早闭的患者采用 3D 高分辨率颅骨 CT 图像来识别颅骨骨折 或颅骨缝合线是否通畅，国家癌症研究所报告称，多头 CT 的辐射暴露。 由于儿童的放射敏感性，扫描可能使儿童患白血病和脑癌的风险增加三倍 骨髓和脑组织磁共振成像 (MRI) 是一种安全的替代方法，无需电离辐射。 现有的“黑骨”MRI 方法依赖于标准梯度回波扫描中减弱的骨信号来成像 尽管这些方法显示出令人鼓舞的结果，但尚未转化为临床实践。 由于以下几个挑战：运动伪影、较长的采集时间和主观的手动图像处理。 儿科患者的运动非常常见，因此通常使用镇静剂来最大程度地减少儿科患者的运动伪影。 不幸的是，镇静会带来发育迟缓和心肺损伤等风险。 获取高分辨率 MR 图像需要几分钟的时间，这对患者来说可能具有挑战性。 由于骨骼与其之间的信号对比度较差，因此儿童受试者的依从性受到限制。 MR 图像中的周围组织，现有的基于手动信号强度的方法具有挑战性，而且不 我们的主要目标是开发新颖的 MR 技术以提供 CT 等效的 3D。 提出了四个具体目标：1）开发运动校正来解决问题。 未镇静的儿科患者的头部运动；2）开发一种通过 先进行深度学习，将 MR 采集时间缩短至 1 分钟或以下 3) 开发 3D 贝叶斯神经网络； 估计伪 CT (pCT) 和 MRI 的不确定性图，以实现稳健且自动化的图像后处理； 4) 确定 pCT 在识别颅骨骨折和颅缝通畅方面的临床效用。 通过消除与辐射和镇静相关的风险，将对儿科健康产生深远影响。