Motivation: This is a competing renewal of our successful project Rapid Robust Pediatric MRI, R01 EB009690. MRI offers superb soft tissue contrast and high resolution for children, without the ionizing radiation and cancer risk of CT. However, its use has been limited as children often cannot voluntarily suspend respiration or tolerate long exams. MRI often requires anesthesia with attendant risk;hence, children often lack the benefits of cross-sectional imaging altogether or are exposed to ionizing radiation. The previous project addressed these concerns by creating a dedicated pediatric imaging system. Highly parallel, high SNR 3T receive arrays were designed and constructed specifically for pediatric body imaging. The high SNR was used to accelerate scans reconstructed with a combination of parallel imaging, new motion correction algorithms, and compressed sensing (CS). Parallel computing reconstruction algorithms produced 3D volumes in 1 minute. The resulting system is being used extensively in clinical practice, significantly reducing anesthesia, and has markedly increased our abdominal MRI utilization. Key technologies are now being commercialized with GE Healthcare, including the pediatric receive array, CS, and coil compression. Despite significant progress, with markedly reduced scan times, anesthesia has not been eliminated. Patient motion remains the main limitation. Therefore the major emphasis here is addressing motion through robust imaging, motion correction, and dynamic MRI. This will (1) extend the benefits of MRI to younger, less cooperative patients, (2) allow the correction and depiction of respiratory motion, and (3) provide the temporal resolution that captures the faster contrast dynamics in children for free-breathing 3D dynamic studies. Approach: The project has three interrelated development aims, validated by clinical studies.
Aim 1 is to enable robust acquisition and reconstruction in the presence of motion in 3D studies. This uses robust parallel imaging calibration and reconstruction, outlier insensitive optimization and a new approach for measuring localized non-rigid motion throughout the body using array coil elements.
A second aim i s to develop ultrafast multi band 2D approaches for faster imaging of uncooperative patients. This freezes motion in each set of slices, simplifying motion correction over the volume. The impact of these developments in the clinic will then be assessed in the setting of appendicitis, a representative common and challenging pediatric abdominal imaging application. Then we will exploit temporal correlations and dynamics in time-resolved 3D contrast studies and further speed 2D scans, and again assess the impact in children with suspected appendicitis. Significance: This work will lead to fast, robust, broadly-applicable pediatric body MRI protocols with less anesthesia, making MRI safer, cheaper, and more available to children, transforming it into a workhorse modality and decreasing CT radiation burden. The techniques will facilitate wide application in the community setting and permit new MRI applications, for both pediatric and adult disease.

Public Health Relevance

Clinical pediatric MRI has been limited primarily by inadequate spatial resolution and patient motion, which often requires anesthesia. After considerable progress to make MRI faster and sharper to enable diagnostic imaging, this work aims to completely address motion through a synergistic combination of motion correction and ultrafast scanning. Ultimately this will make MRI more widely available to children, reducing the overall population risk of radiation from CT and additionally improving MRI in adults.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
2R01EB009690-05
Application #
8696566
Study Section
Special Emphasis Panel (ZRG1-SBIB-V (82))
Program Officer
Liu, Guoying
Project Start
2009-07-01
Project End
2018-05-31
Budget Start
2014-06-15
Budget End
2015-05-31
Support Year
5
Fiscal Year
2014
Total Cost
$303,977
Indirect Cost
$78,977
Name
Stanford University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Zhang, Tao; Grafendorfer, Thomas; Cheng, Joseph Y et al. (2016) A semiflexible 64-channel receive-only phased array for pediatric body MRI at 3T. Magn Reson Med 76:1015-21
Yoruk, Umit; Saranathan, Manojkumar; Loening, Andreas M et al. (2016) High temporal resolution dynamic MRI and arterial input function for assessment of GFR in pediatric subjects. Magn Reson Med 75:1301-11
Zhang, Tao; Chen, Yuxin; Bao, Shanshan et al. (2016) Resolving phase ambiguity in dual-echo dixon imaging using a projected power method. Magn Reson Med :
Levine, Evan; Daniel, Bruce; Vasanawala, Shreyas et al. (2016) 3D Cartesian MRI with compressed sensing and variable view sharing using complementary poisson-disc sampling. Magn Reson Med :
Cheng, Joseph Y; Hanneman, Kate; Zhang, Tao et al. (2016) Comprehensive motion-compensated highly accelerated 4D flow MRI with ferumoxytol enhancement for pediatric congenital heart disease. J Magn Reson Imaging 43:1355-68
Lai, Lillian M; Cheng, Joseph Y; Alley, Marcus T et al. (2016) Feasibility of ferumoxytol-enhanced neonatal and young infant cardiac MRI without general anesthesia. J Magn Reson Imaging :
Hanneman, Kate; Kino, Aya; Cheng, Joseph Y et al. (2016) Assessment of the precision and reproducibility of ventricular volume, function, and mass measurements with ferumoxytol-enhanced 4D flow MRI. J Magn Reson Imaging 44:383-92
Uecker, Martin; Lustig, Michael (2016) Estimating absolute-phase maps using ESPIRiT and virtual conjugate coils. Magn Reson Med :
Chen, Feiyu; Zhang, Tao; Cheng, Joseph Y et al. (2016) Autocalibrating motion-corrected wave-encoding for highly accelerated free-breathing abdominal MRI. Magn Reson Med :
Zhang, Tao; Cheng, Joseph Y; Chen, Yuxin et al. (2016) Robust self-navigated body MRI using dense coil arrays. Magn Reson Med 76:197-205

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