The goal of the present project is to develop a clinically practical technique to quantify oxygen utilization in neonatal brain. Oxidative metabolism is the primary form of energy production in the human brain. Therefore, cerebral metabolic rate of oxygen (CMRO2) is an important index of brain function and tissue viability. Neonatal stage is particularly susceptible to disruptions in oxygen supply and metabolism, for example in the case of hypoxic ischemic encephalopathy (HIE) which is a consequence of oxygen deprivation in neonates due to birth asphyxia. Therefore, the availability of a non-invasive technique to determine CMRO2 in neonates may find immediate application in the diagnosis of HIE as well as in the treatment monitoring of HIE using hypothermia, which aim to reduce the brain's metabolic rate and preserve ATP. At present, there exist no practical techniques to determine CMRO2 in human neonates, because the conventional method of Positron Emission Tomography (PET) is not applicable due to radiation concerns. In this project, we will develop MR based techniques to measure CMRO2 in neonates. Our goal is to provide the clinical community a CMRO2 tool for neonatal applications that is completely non-invasive (no exogenous agent), rapid (<5 min of scan time), and can be performed on a standard 3 Tesla MRI. The PI's previous work has demonstrated that this goal is feasible in adult brain. Thus, the present project will benefit from our extensive experiences of developing this technique in adults. We have two Specific Aims.
Aim 1 will focus on in vivo studies of developing MR imaging protocols for the measurement of global CMRO2 in human neonatal subjects. We will conduct separate sub-studies to optimize several technical aspects of the venous oxygenation (TRUST MRI) and blood flow (phase-contrast MRI) techniques, including developing an automated, individualized labeling-slab positioning, comparison between triggered and non-triggered phase- contrast MRI, and determining optimal spatial resolution for neonatal imaging.
Aim 2 will focus on in vitro studies of neonatal blood T2 relaxometry, conducted on fresh cord blood of human neonates. This will allow us to obtain a calibration plot specifying blood T2 dependence on oxygenation, which is needed for calibrating the in vivo data. We clarify that, once the calibratio plot is established, it can be used for all future in vivo data, not just data collected in Aim 1. he neonatal T2 relaxometry will also provide important reference for many other MRI pulse sequences in neonates beyond the techniques in the proposed study, such as T2-prepared angiogram and susceptibility weighted imaging (SWI). Upon finishing this project, we will be able to provide researchers and clinicians with a set of MRI techniques for CMRO2 measurements that are ready for immediate applications in brain development and neonatal brain disorders.

Public Health Relevance

Brain's energy utilization can be an important biomarker of neural development and brain tissue viability in neonates. The present project aims to develop non-invasive MR imaging techniques to evaluate the brain's energy utilization in neonates.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21NS085634-03
Application #
8847817
Study Section
Special Emphasis Panel (NOIT)
Program Officer
Hirtz, Deborah G
Project Start
2014-06-01
Project End
2016-05-31
Budget Start
2015-06-01
Budget End
2016-05-31
Support Year
3
Fiscal Year
2015
Total Cost
$202,500
Indirect Cost
$77,500
Name
Johns Hopkins University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Mao, Deng; Li, Yang; Liu, Peiying et al. (2018) Three-dimensional mapping of brain venous oxygenation using R2* oximetry. Magn Reson Med 79:1304-1313
Li, Yang; Mao, Deng; Li, Zhiqiang et al. (2018) Cardiac-triggered pseudo-continuous arterial-spin-labeling: A cost-effective scheme to further enhance the reliability of arterial-spin-labeling MRI. Magn Reson Med 80:969-975
De Vis, Jill B; Lu, Hanzhang; Ravi, Harshan et al. (2018) Spatial distribution of flow and oxygenation in the cerebral venous drainage system. J Magn Reson Imaging 47:1091-1098
Wei, Zhiliang; Xu, Jiadi; Liu, Peiying et al. (2018) Quantitative assessment of cerebral venous blood T2 in mouse at 11.7T: Implementation, optimization, and age effect. Magn Reson Med 80:521-528
Wei, Zhiliang; Chen, Lin; Lin, Zixuan et al. (2018) Optimization of phase-contrast MRI for the estimation of global cerebral blood flow of mice at 11.7T. Magn Reson Med :
Jiang, Dengrong; Liu, Peiying; Li, Yang et al. (2018) Cross-vendor harmonization of T2 -relaxation-under-spin-tagging (TRUST) MRI for the assessment of cerebral venous oxygenation. Magn Reson Med 80:1125-1131
Lin, Zixuan; Li, Yang; Su, Pan et al. (2018) Non-contrast MR imaging of blood-brain barrier permeability to water. Magn Reson Med 80:1507-1520
Liu, Peiying; Welch, Babu G; Li, Yang et al. (2017) Multiparametric imaging of brain hemodynamics and function using gas-inhalation MRI. Neuroimage 146:715-723
Su, Pan; Mao, Deng; Liu, Peiying et al. (2017) Multiparametric estimation of brain hemodynamics with MR fingerprinting ASL. Magn Reson Med 78:1812-1823
Liu, Peiying; Li, Yang; Pinho, Marco et al. (2017) Cerebrovascular reactivity mapping without gas challenges. Neuroimage 146:320-326

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