NIMROD: Neonatal & Infant MRI of Respiratory Outcomes in Disease
Lead Research Organisation:
University of Sheffield
Department Name: Infection Immunity & Cardiovasc Disease
Abstract
Context:
Testing how well the lung "functions" usually involves the use of breathing tests. However, these tests are extremely difficult to do reliably and accurately in newborn babies and infants. We need new imaging techniques that can help visualise the best and worst functioning areas of the lungs. In adults, x-ray and computed tomography (CT) imaging is often used to study the lungs. However, these methods pose an increased harmful radiation risk to newborns and infants. In addition, the function of the heart is normally measured by invasive methods that are not safe for newborns and infants, or echocardiography, which is technically challenging in these populations.
As a result, our knowledge of newborn and infant diseases of the lung and heart is collectively poor compared to that of adolescents and adults. In particular, lung and heart problems in babies born pre-term are the major cause of death, yet remain not well understood.
Objectives:
The main purpose of this research is to develop safe, robust methods for imaging the lungs and heart in newborns and infants to better understand and manage debilitating diseases, in particular those related to pre-term birth. We will use magnetic resonance imaging (MRI); a safe imaging method that poses no harmful radiation risk to newborns and infants. The main objectives are as follows:
- Develop MRI methods to investigate how diseases affect the lungs and heart in newborns and infants:
-- Develop software to control the MRI scanner to obtain the best quality images that inform us about the structure and function of the lungs and heart in newborns and infants.
-- Develop MRI hardware that is comfortable for newborns and infants and helps to improve image quality.
- Test how well our developed methods and technology can detect changes to the structure and function of the lungs and heart in newborns and infant lung diseases, including diseases related to premature birth.
-- Measure how well these methods can detect the causes for changes in patient's health over time as disease progresses.
My research will be carried out at the University of Sheffield, a world-leading institution in MRI technique development with a unique interdisciplinary balance of scientists and clinicians to ensure that technological developments lead directly to NHS and patient benefit.
Potential Applications & Benefits:
The long-term benefit of this research is the potential to change the way lung and cardiac disease is managed in newborns and infants and improve patient quality-of-life.
In particular, the methods we develop will help identify early signs of disease that cannot easily be identified by other methods. In addition, MRI is safe, and scanning can be repeated often to monitor disease progress or visualise the changes due to treatment. This cannot be done with CT, and will aid our understanding of diseases and help identify new ways they can be treated.
We will develop these techniques for whole-body MRI scanners, of the sort available in most hospitals, which will increase accessibility of the technique to NHS clinicians nationally.
Testing how well the lung "functions" usually involves the use of breathing tests. However, these tests are extremely difficult to do reliably and accurately in newborn babies and infants. We need new imaging techniques that can help visualise the best and worst functioning areas of the lungs. In adults, x-ray and computed tomography (CT) imaging is often used to study the lungs. However, these methods pose an increased harmful radiation risk to newborns and infants. In addition, the function of the heart is normally measured by invasive methods that are not safe for newborns and infants, or echocardiography, which is technically challenging in these populations.
As a result, our knowledge of newborn and infant diseases of the lung and heart is collectively poor compared to that of adolescents and adults. In particular, lung and heart problems in babies born pre-term are the major cause of death, yet remain not well understood.
Objectives:
The main purpose of this research is to develop safe, robust methods for imaging the lungs and heart in newborns and infants to better understand and manage debilitating diseases, in particular those related to pre-term birth. We will use magnetic resonance imaging (MRI); a safe imaging method that poses no harmful radiation risk to newborns and infants. The main objectives are as follows:
- Develop MRI methods to investigate how diseases affect the lungs and heart in newborns and infants:
-- Develop software to control the MRI scanner to obtain the best quality images that inform us about the structure and function of the lungs and heart in newborns and infants.
-- Develop MRI hardware that is comfortable for newborns and infants and helps to improve image quality.
- Test how well our developed methods and technology can detect changes to the structure and function of the lungs and heart in newborns and infant lung diseases, including diseases related to premature birth.
-- Measure how well these methods can detect the causes for changes in patient's health over time as disease progresses.
My research will be carried out at the University of Sheffield, a world-leading institution in MRI technique development with a unique interdisciplinary balance of scientists and clinicians to ensure that technological developments lead directly to NHS and patient benefit.
Potential Applications & Benefits:
The long-term benefit of this research is the potential to change the way lung and cardiac disease is managed in newborns and infants and improve patient quality-of-life.
In particular, the methods we develop will help identify early signs of disease that cannot easily be identified by other methods. In addition, MRI is safe, and scanning can be repeated often to monitor disease progress or visualise the changes due to treatment. This cannot be done with CT, and will aid our understanding of diseases and help identify new ways they can be treated.
We will develop these techniques for whole-body MRI scanners, of the sort available in most hospitals, which will increase accessibility of the technique to NHS clinicians nationally.
Organisations
- University of Sheffield (Fellow, Lead Research Organisation)
- GE Healthcare (Project Partner)
- University of Cincinnati (Project Partner)
- Sheffield Teaching Hospitals NHS Foundation Trust (Project Partner)
- Sheffield Children's NHS Foundation Trust (Project Partner)
- King's College London (Project Partner)
- Hannover Medical School (Project Partner)
People |
ORCID iD |
| Neil James Stewart (Principal Investigator / Fellow) |
Publications
Stewart NJ
(2023)
Initial feasibility and challenges of hyperpolarized 129 Xe MRI in neonates with bronchopulmonary dysplasia.
in Magnetic resonance in medicine
| Description | Updated Feb 2024 - We have optimised methods and parameters for lung MRI to obtain a picture of the changes to the structure of the lungs caused by lung disease, and for visualising how well different parts of the lung are working. We are sharing such optimised "protocols" publically here: https://polaris-sheffield.github.io/sheffield-lung-protocol/ - the "UTE" row in particular was optimised during this award. We are actively working on comparing new "silent" MRI methods with conventional methods; these methods have very low noise associated with them, which should improve the comfort of infants and children in MRI. In addition, we are exploring ways to integrate AI technologies into the image processing to improve the image quality. With collaborators at Cincinnati Children's Hospital, who have a baby-sized MRI scanner in their neonatal intensive care unti, we have shown that we can use inhaled xenon gas to image how well the lung is ventilated with air after premature birth. This technique is widely used in adults and older children, but this is the first time we have demonstrated this in newborn babies. This work has recently been published in a scientific journal. |
| Exploitation Route | We are working to disseminate our methods to other sites around the world. Whilst this is mainly for research purposes at the moment, it should help standardise lung imaging methods and make it easier for the NHS and others to adopt such technology in the future. |
| Sectors | Digital/Communication/Information Technologies (including Software) Healthcare |
| Title | Mapping lung ventilation from free-breathing lung MRI |
| Description | We have developed a method to reconstruct images at different inflation states from 3D lung MRI data acquired during quiescent breathing. Using a minimum of 2 inflation state images, we can register the images together and compare the signal intensities to derive a pseudo measurement of lung ventilation - this builds upon previous literature in the area but is the first time we have applied to this particular MRI acquisition. A subject of ongoing work is comparing this method using 2 images vs several images (e.g. 6, 10). |
| Type Of Material | Data analysis technique |
| Year Produced | 2024 |
| Provided To Others? | No |
| Impact | We are able to apply this method both prospectively and retrospectively to data that has been collected from a number of studies over the past year or more. Using free-breathing proton MRI, this method offers an alternative means to inhaled gas MRI for assessment of lung ventilation. Validation of this method in patients with lung disease is ongoing. |