The proposed project responds to a public health concern: the growing incidence of premature births, in the United States. Over the last three decades, the rate of premature delivery has increased by 30%. Today, prematurity accounts for more than 500,000 births per year and results in an annual cost of at least $26 billion. With the steadily increasing public health and economic burden of premature births, there is a strong/compelling need for the routine use of low-cost and high-performance diagnostic imaging systems in neonatal patients within the Neonatal Intensive Care Unit (NICU). Magnetic resonance imaging (MRI) has been recognized as a safe and powerful tool for neonatal imaging. However, MRI systems are typically placed in Radiology departments far from the NICU and the transportation of a premature infant between the NICU and the MRI facility places the infant at significant medical risk. Furthermore, the image quality for neonates is sub- optimal since existing MRI techniques have been optimized for adult patients. At Cincinnati Children's Hospital Medical Center (CCHMC), we are addressing both the logistical and technical challenges of neonatal MRI. Two low-cost, small-bore (28 cm) 1.5 Tesla MRI scanners have been installed: One is placed in a biosafety level 2 laboratory for preclinical development. The other is within the NICU and dedicated for neonatal imaging. The work proposed here is part of a larger effort to bring high-performance MRI into the NICU using the platform provided by these two small-footprint MRI scanners. In this project, our effort will be focused on MRI of the pulmonary and cardiovascular systems of premature babies. The preclinical scanner will be used to develop specialized radiofrequency (RF) coils and k-t space imaging techniques for neonatal chest MRI. By integrating the new technology into the NICU MRI system, we will create a new clinical standard for imaging neonatal chest within the NICU. This will lay a strong foundation for clinical MRI studies directed towards the diagnosis and management of pulmonary and cardiovascular complications that have been leading causes of morbidity and mortality of premature babies. As such, this project promises to improve clinical care of neonatal patients, advance MRI for the neonatal population, and provide new research tools for investigating early human development. The technological innovation in this project, although targeted at neonatal imaging, may be used to improve the clinical utility of MRI in general.

Public Health Relevance

This project will overcome the major problems that have prevented the use of Magnetic Resonance Imaging (MRI) for premature babies by creating novel MR receive coils and k-t space imaging techniques for use with a new MR scanner that can be placed and operated in the Neonatal Intensive Care Unit (NICU). The new scanner will bring high quality MR imaging to babies that until now, were too sick to bring to a conventional MR scanner for imaging. The development of high-performance MRI within the NICU responds to a major public concern: the growing incidence of premature births. This novel approach promises to improve NICU patient outcomes by providing increased access, improved safety, and higher diagnostic image quality in neonatal MRI. It will also serve as a research tool in clinical MRI studies directed towards the diagnosis and management of complications due to prematurity.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-BMIT-J (01))
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Raju, Tonse N
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Cincinnati Children's Hospital Medical Center
United States
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Tkach, Jean A; Li, Yu; Pratt, Ronald G et al. (2014) Characterization of acoustic noise in a neonatal intensive care unit MRI system. Pediatr Radiol 44:1011-9
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