Joëlle Karine Barral¹, Juan M Santos², Edward J Damrose³, Nancy J Fischbein^3,4, and Dwight G Nishimura^5
1Bioengineering, Stanford University, Stanford, CA, United States, ²Heart Vista, Inc., Los Altos, CA, United States, ³Otolaryngology, Stanford University, Stanford, CA, United States, ⁴Radiology, Stanford University, Stanford, CA, United States, ⁵Electrical Engineering, Stanford University, Stanford, CA, United States

Motion is the main limitation to in vivo, high-resolution larynx MR imaging. A new real-time motion-compensation algorithm is introduced, which extends the Diminishing Variance Algorithm (DVA) to improve its robustness. Navigator data are processed in real time to compute rigid-body motion, and projections are corrected using phase modulation in k-space. Upon automatic feedback, the system immediately reacquires the data most heavily corrupted by non-rigid motion, i.e., the data whose corresponding projections could not be properly corrected using phase modulation. Larynx imaging was performed on healthy volunteers, and substantial reduction of motion artifacts caused by bulk shift, swallowing, and coughing was achieved.

Andre J.W. van der Kouwe¹, Pallavi Sagar², Amanda L Silver³, Stephen Maturo³, Katherine Nimkin², and Christopher J Hartnick^3
1Athinoula A. Martinos Center, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States, ²Pediatric Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States, ³Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, United States

Velopharyngeal Insufficiency (VPI) is a condition in which the velopharynx does not properly close during speech production. The condition can be improved with surgery after evaluation with videofluoroscopy and/or nasendoscopy. MRI may provide a non-invasive and non-radiative alternative. We present a protocol for acquiring two images per second of the velopharyngeal anatomy during speech production and a method implemented on the scanner for automatically generating an mpeg movie from the image series along with a synchronized audio recording using an optical microphone. The movie is available for review on the scanner immediately after imaging.

Hao Shen¹, Nan Sun², Guang Cao³, Jinfeng Li⁴, and Ailian Zhang^4
1Global Applied Science Laboratory, GE Healthcare, Beijing, Beijing, China, People's Republic of, ²MR Modality, GE Healthcare, Beijing, Beijing, China, People's Republic of,³Global Applied Science Laboratory, GE Healthcare, Hong Kong, China, People's Republic of, ⁴Department of Radiology, Chinese PLA General Hospital, Beijing, Beijing, China, People's Republic of

The cerebrospinal fluid flow imaging has been used to diagnose several diseases in the clinical practice. In this study, we developed a sequence with multiple flexible labeling bands to visualize the CSF flow based on the concept of time-spatial labeling inversion pulse. Phantom study and human study were both done at a 3.0T scanner. The sequence can image the CSF flow of the aqueduct and foramen magnum simultaneously and improve the scan efficiency.

Ivana Despotovic¹, Ief Segers¹, Ljiljana Platisa¹, Ewout Vansteenkiste¹, Aleksandra Pizurica¹, Karel Deblaere², and Wilfried Philips^1
1Department of Telecommunications and Information Processing TELIN-IPI-IBBT, Ghent University, Ghent, Belgium, ²Department of Radiology, Ghent University Hospital, Ghent, Belgium

Focal cortical dysplasia (FCD) is a major cause of refractory epilepsy and is characterized with subtle brain lesions. Identification of FCD lesions using MRI scans is the first and most difficult step in medical treatments. Most of the existing FCD detection algorithms are based on cortical thickness measurement, which requires brain MRI segmentation. In this work, we propose an improved technique for 3D brain MRI segmentation based on graph cuts algorithm. The performance of our algorithm is validated on both phantom and real patient MRI. Experimental results show that our method is effective and successfully indicates the FCD lesions.

Zhaoying Han^1,2, Xue Yang¹, Bennett A Landman^1,2, John C Gore², and Benoit M Dawant^1
1Electrical Engineering, Vanderbilt University, Nashville, TN, United States, ²Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States

Deformation Based Morphometry (DBM) aims to detect morphological differences between groups based on statistical analysis of deformation fields generated by non-rigid registrations. Few studies have compared the effects of registration algorithms on DBM. We simulated two groups of normal brain images and deformation fields using the Statistical Simulation of Deformations (SSD) model, introduced known growths in one group, and evaluated the effect of five non-rigid registration methods (ABA, IRTK, FSL, ART, and SPM normalization) on DBM analysis of the groups without and with growths. The “ground truth” Jacobian map from the known growths was used as the basis for comparison.

Marc LABROUSSE^1,2, Guillaume CALMON¹, Gabriela HOSSU^1,3, André CHAYS², Jacques FELBLINGER¹, and Marc BRAUN^1,4
1IADI, INSERM U947, NANCY, France, ²Faculty of Medecine and University Hospital, REIMS, France, ³CIC-IT NANCY (INSERM CIT801), NANCY, France, ⁴Faculty of Medecine and University Hospital, NANCY, France

Phase-contrast MRI was used at the level of the cerebello-pontine angle in 28 volunteers to measure the cranio-caudal and antero-posterior motion of the cisternal, meatic part of the vestibulo-cochlear nerve (VCN), and the pons. ROIs were manually drawn on T2 sequences. VCN motion is a cardiac-cycle-dependent movement like brain motion. We made a “string oscillated” model of the VCN explaining the differences between the amplitudes of the cisternal and meatic parts. Phase contrast MRI can be used to assess the VCN motion at the level of the cerebello-pontine angle.

Daniel Guo Quae Chong¹, Dechen Wangmo Tshering Vogel¹, Josef Pfeuffer², Andre de Oliveira², Berthold Kiefer², Johnannes Micheal Froehlich^1,3, and Harriet Thoeny^1
1Dept. of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern, Switzerland, ²Siemens AG, Erlangen, Germany, ³Guerbet AG, Zurich, Switzerland

Zoomed-EPI was compared with conventional EPI for imaging of the larynx and oral cavity/oropharynx being regions highly susceptible for artifacts, but with a high incidence of tumors warranting a reliable DW-MRI technique. Zoomed-EPI allows a reduced field of view readout scheme leading to a reduced phase evolution induced by the local field inhomogeneities. The aim of our study was to prospectively compare both EPI and Zoomed-EPI at 3T for DW-MRI of the larynx and oral cavity/oropharynx. Our results show that Zoomed-EPI provides less distortion artifacts, higher resolution in equal scan time and similar resultant ADC values.

Yonggang Lu¹, Jacobus F.A. Jansen², Hilda E Stambuk¹, Nancy Lee¹, Jason A. Koutcher¹, and Amita Shukla-Dave^1
1Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ²Maastricht University Medical Center, Maastricht, Netherlands

This study compares DCE- and IVIM- MRI derived parameters reflecting tumor vascularity between the primary tumor and neck nodal metatases. The initial results with twelve patients revealed that metastatic nodes have significant higher diffusion coefficients (ADC-apparent diffusion coefficient and D-pure diffusion coefficient) than primary tumors but showed no significant difference in perfusion properties. Additionally, a significant correlation of parameters D and ve (extravascular extracellular space) between primary tumor and neck nodal metastases was observed. These findings after validation in larger patient population and with appropriate molecular correlates may provide better understanding of the underlying tumor biology, and help in treatment planning.

Peter A Wassenaar¹, Kathryn Richdale², Petra Schmalbrock¹, and Michael V. Knopp^1
1Wright Center of Innovation, Department of Radiology, The Ohio State University, Columbus, OH, United States, ²College of Optometry, The Ohio State University, Columbus, OH, United States

Imaging of the human eye is important in the assessment of ocular diseases. With the introduction of eye imaging at 7T comes increased signal and higher resolution visualization of the orbit and ocular structures. This work compares different single loop receive coils for in vivo eye imaging at 7T. It is shown that a small custom-built coil provides the best approach for imaging the lens and ciliary body, while slightly larger coils are best suitable for imaging of the retinal wall and retro-bulbar structures.

Mami Iima¹, Akira Yamamoto¹, Tomohisa Okada¹, Mitsunori Kanagaki¹, Denis Le Bihan^2,3, Seiko Kasahara¹, Emiko Morimoto¹, Satoshi Nakajima¹, Ryo Sakamoto¹, Taha Mohamed Mehemed¹, and Kaori Togashi^1
1Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan, ²Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan, ³Neurospin, CEA-Saclay Center, Gif-sur-Yvette, France

We implemented GRAPPA-accelerated RS-EPI DTI and SS-EPI DTI at 3T MR scanner with 32-channel head coil, and evaluated the feasibility of clinical application by comparing these two acquisition methods. RS-EPI has much reduced susceptibility compared with SS-EPI and can be a potential to be an alternative to SS-EPI DTI for evaluating CVJ lesion, such as demyelinating disease, neurodegenerative disease, brain tumors, skull base tumor, and inflammation.

Charng-Chyi Shieh^1,2, Yu-Chun Lin^1,2, Jiun-Jie Wang^2,3, Yau-Yau Wai^1,2, Chun-Huang Hsieh¹, Sheng-Chieh Chan^3,4, Tzu-Chen Yen^3,4, and Shu-Hang Ng^1,2
1Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ²Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan, ³Molecular Imaging Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ⁴Nuclear Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

We prospectively compared the diagnostic capability of 3.0-Tesla whole-body (WB) MRI and FDG-PET-CT for bone metastasis in nasopharyngeal carcinoma (NPC). Twenty-four (6.2%) of our 388 NPC patients were diagnosed as having bone metastases. On a patient-based analysis, WB-MRI and FDG-PET-CT showed the similar sensitivity and specificity for bone metastasis (70.8 % vs 75.0 %, P=0.999; 99.5% vs 98.4%, P=0.289, respectively). Their diagnostic capabilities were equal (0.909 vs 0.909). We concluded that 3.0-Tesla WB-MRI is a feasible technique for the detection of bone metastasis in NPC patients, with similar sensitivity and equal diagnostic capacity to FDG-PET-CT.

Masami Yoneyama¹, Masnobu Nakamura¹, Tomoyuki Okuaki¹, Takashi Tabuchi¹, Atsushi Takemura², Makoto Obara², and Junko Ogura^1
1Medical Satellite Yaesu Clinic, Tokyo, Japan, ²Philips Electronics Japan, Tokyo, Japan

3D RARE (TSE) sequence is promising for black-blood angiography. In this study, we propose a new scheme of sequence parameter optimization for "flow-void enhanced" volumetric black-blood angiography. All experiments were performed on a 3.0T imager. Methods were flowing phantom study and volunteer study. From the results, optimal parameter for black-blood angiography was: very low refocusing flip angles, pseudo steady-state preparation chosen "90+alpha/2" preparation. Furthermore, "sensitized" flow-compensation at the "in-plane flow" imaging plane, that was more flow-voided in parallel direction of flow and phase-encode. This optimal sequence can be used for 3D volumetric black-blood angiography and vessel wall imaging.

Elizabeth Nye¹, Shaokoon Cheng¹, Simon Gandevia², David McKenzie³, Ralph Sinkus⁴, and Lynne Bilston^2
1Neuroscience Research Australia, Sydney, NSW, Australia, ²Neuroscience Research Australia, Australia, ³University of New South Wales, Australia, ⁴Centre de Recherches Biomédicales Bichat-Beaujon, France

The pathophysiological mechanisms of obstructive sleep apnoea (OSA) are unclear and the change in mechanical properties of soft tissues and tongue muscles is likely to play an important role in the disorder. In this study, magnetic resonance elastography is used to probe the mechanical properties of the tongue and soft palate in five OSA patients and healthy normal subjects. Results shows that while the shear moduli of the tongue is significantly softer in the OSA patients (p < 0.05), the mechanical properties of the soft palate between the 2 subject groups are not significantly different (p > 0.05).

Scott Hanvey¹, Martin Glegg², and John Foster^3
1Department of Clinical Physics and Bioengineering, Beatson West of Scotland Cancer Centre, Glasgow, Lanarkshire, United Kingdom, ²Beatson West of Scotland Cancer Centre, ³Glasgow Cardiac Magnetic Resonance Unit

In radiotherapy accurate localisation and definition of the planning target volume and its relationship to organs at risk is very important. For head and neck cancer patients MRI offers superior target delineation over CT. However, if the MRI scan is not acquired in the treatment position this can lead to a mismatch when registering with CT. The purpose of this study was to investigate 20 oropharynx cancer patients to determine whether it is necessary to immobilise patients for their MR radiotherapy planning scan or if a normal diagnostic MRI would suffice.

Sidhartha Nagala¹, Mary A McLean², Daniel Scoffings³, Andrew N Priest³, Piyush Jani¹, and John R Griffiths^2
1Otolaryngology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom, ²Cancer Research UK, Cambridge Research Institute, United Kingdom, ³Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom

Diffusion weighted imaging has recently been used to differentiate between benign and malignant thyroid nodules. We compared the successfulness of EPI versus PROPELLER at 3T in the thyroid region. Images were evaluated by a consultant neuroradiologist on Functool software. We report visibly less distorted images using PROPELLER resulting in an increase in interpretable images. Our preliminary results show promise in differentiating between benign and malignant nodules. However, PROPELLER consistently produced higher ADC values than EPI. The cause of this is unclear and requires further investigation before PROPELLER can be recommended as the sequence of choice in this region.

Matthias Echternach¹, Louisa Traser², Bernhard Richter¹, and Michael Markl^3
1Institute of Musicians`Medicine, Freiburg University Medical Center, Freiburg, Germany, ²Charite, Berlin, Germany, ³Department of Radiology, Medical Physics, Freiburg University Medical Center, Freiburg, Germany

Aim of this study was to analyse vocal tract shapes in male alto register functions. Dynamic real time MRI of 8 frames per second was used to analyze the vocal tract profile in 7 professional male altos who sang on the vowel /a/ an ascending and descending scale from G3 to E4. The scale included their register transition from modal register falsetto. Register transitions from modal register to stage falsetto were associated with increased lip opening, jaw retraction, elevation and back positioning of the tongue, pharynx narrowing, uvula elevation, drop of larynx height and tilting of the larynx.

Feng Shi¹, Guorong Wu¹, Pew-Thian Yap¹, Hongjun Jia¹, John H. Gilmore², Weili Lin¹, and Dinggang Shen^1
1Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States, ²Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States

Direct applying adult or even pediatric atlases may compromise accuracy in analyzing infant brain images. In this abstract, we introduce a set of brain atlases which are dedicated for neonates, 1-year-olds, and 2-year-olds. Each atlas comprises a set of 3D images made up of the intensity model, tissue probability maps, and anatomical parcellation map. These components are constructed with the help of state-of-the-art infant MR segmentation and groupwise registration methods, applied on a set of infant images which are longitudinally acquired from 95 healthy infants. These atlases are publicly available on our website, http://bric.unc.edu/ideagroup/free-softwares/.

Linda Chang¹, Kazim Gumus¹, Ashley Saito¹, Aaron Hoo¹, Alexandra Pritchett¹, Daniel Alicata¹, Christine Cloak¹, and Thomas Ernst^1
1Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, United States

Methamphetamine is a neurotoxic drug but its effects on brain development has not been well studied. 118 children were enrolled at ages 3-4 years (50 METH-exposed prenatally, 68 un-exposed controls); DTI was performed annually over 3 years. An automated-atlas approach with LDDMM in MRIStudio was used for data analyses. Despite similar physical characteristics (including head circumference), global cognitive function (on Stanford-Binet), and parental education, intelligence and mood, METH-exposed children had lower mean diffusion throughout and abnormal fractional anisotropy compared to un-exposed controls. These diffusion abnormalities persisted over the 3-year follow-up period. Further correlations will be performed with cognitive measurements.

L. Tugan Muftuler¹, Angela T Cheriyan², Kevin M Head³, Min-Ying Su¹, Claudia Buss³, Curt A Sandman³, and Elysia P Davis^3
1Center for Functional Onco-imaging, University of California, Irvine, CA, United States, ²Biological Sciences, University of California, Irvine, CA, ³Psychiatry and Human Behavior, University of California, Orange, CA

There is evidence that abnormal brain development during childhood is a risk factor for various cognitive and psychiatric disorders. Although cortical development from childhood until early adulthood has been studied by several groups, there is very limited normative data available on subcortical structures of typically developing children, especially within the narrow preadolescent age range. We analyzed high resolution MRI images from 103 normally developing preadolescent children to study age associated differences in major subcortical structures. We found that the major age-associated changes were seen in the medial dorsal thalamus between ages 6 and 10.

Andrea Kassner^1,2, Jackie Leung², Fatima Nathoo³, Stephanie Dorner⁴, Joseph A Fisher⁵, Manohar Shroff², Gabrielle de Veber⁶, and Suzan Williams^7
1Medical Imaging, University of Toronto, Toronto, Ontario, Canada, ²Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada, ³Respiratory therapy, The Hospital for Sick Children, Toronto, Ontario, Canada, ⁴Thornhill Research Inc., Toronto, Ontario, Canada, ⁵Physiology, University of Toronto, Toronto, Ontario, Canada, ⁶Neurology, Hospital for Sick Children, Toronto, Ontario, Canada, ⁷Hematology, Hospital for Sick Children, Toronto, Ontario, Canada

Sickle cell disease (SCD) is the major cause of stroke in children leading to mortality or long-term disability. A noninvasive means of measuring cerebral blood flow (CBF) reserve would facilitate assessment and clinical management of these patients. BOLD MRI has been used as a surrogate for CBF changes in response to a vasoactive stimulus such as partial pressure of CO2 (PCO2). However, within the pediatric population, CVR studies are not common. We imaged 11 SCD patients using a system able to target end-tidal PCO2 in synchrony with BOLD MRI, and found a strong concordance between CVR and angiographic findings.

Jack Knight-Scott¹, and Sarah Andrea Wijtenburg^1
1Radiology, CHOA, Atlanta, Georgia, United States

Understanding normal brain development is essential to all basic and clinical research on pediatric brain disorders. In this work, we examine neurochemistry in the pediatric brain using STEAM at 3-T. In general, we detect higher neurogenetic activity in the pediatric brain, with nine metabolites showing significant differences from the adult brain. Relative to the adult brain, phosphorylethanolamine and GABA showed the largest increase; however, the most striking difference was the elevation of the 1.63-ppm M4 macrocmolecule resonance in the adult brain.

Yasheng Chen¹, Hongtu Zhu², Jiaping Wang², Hongyu An¹, Dinggang Shen¹, and Weili Lin^1
1Radiology, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC, United States, ²Biostatistics, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC, United States

With 105 longitudinal DTI datasets acquired from 35 healthy full-term infants, we have demonstrated that almost all brain regions (excluding corpus callosum splenium) demonstrating a significant change in growth velocities after 100 days during the first postnatal year for DTI parameters including FA and MD. These results agree with previous postmortem histological findings that a more rapid myelination occurs within the 43~54 post conceptual weeks. Thus, it is very promising to correlate the growth trajectories of DTI parameters with the development of early postnatal white matter myelination.

L. Tugan Muftuler¹, Anna Wiebel², Sandra Waeldin², Min-Ying Su¹, Claudia Buss³, Curt A Sandman³, and Elysia P Davis^3
1Center for Functional Onco-imaging, University of California, Irvine, CA, United States, ²University of Trier, Germany, ³Psychiatry and Human Behavior, University of California, Orange, CA

Abnormal brain development during childhood increases the risks for various cognitive and psychiatric disorders. Therefore understanding normal brain development is important to study these abnormalities. We studied age-associated changes in major pathways of the cerebral white matter in children using high resolution DTI. We focused our study on a narrow age range during late childhood, which is a critical phase in cognitive development. Furthermore, we conducted whole brain analysis to study changes in FA and MD along all major fiber tracts. Our findings illustrate changes in fiber pathways of the brain at a higher detail than previously reported.

Yang Yang¹, Hongyu An², Feng Shi², Wei Gao², Dinggang Shen², and Weili Lin^2
1Department of Biomedical Engineering and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States, ²Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States

In this study, a 3D 1H-MRS method was employed to investigate early brain metabolic maturation in the first months of life in human. We found that development of neuronal functions largely occurs during the first 3 months of life, followed by a plateau from 3 to 6 months. We also found that rather stable NAA/Cr ratio in the occipital lobe may suggest that a large part of metabolic substrate of visual function may have already completed by the time of birth.

Petronella Anbeek¹, Britt J.M. van Kooij¹, Floris Groenendaal¹, Linda S. de Vries¹, and Manon J.N.L. Benders^1
1Neonatology, Wilhelmina Children's Hospital, Utrecht, Netherlands

A powerful fully automatic technique for neonatal brain segmentation is proposed, based on elastic registration combined with K-nearest neighbor classification. The method uses two routine diagnostic MR images: 3D-T1- and T2-weighted, and segments 8 brain structures simultaneously: (un)myelinated white matter, cortical gray matter, basal ganglia, cerebro-spinal fluid, ventricles, brainstem and cerebellum. Results are evaluated by comparison with a gold standard, showing high Dice similarity indexes (0.80-0.92) for 7 tissues. This technique is suitable for large and longitudinal neonatal brain analysis studies.

Emilie Ruth Muelly¹, Don C. Bigler¹, Kevin A. Strauss², Pavlina Todorova³, D. Holmes Morton², Julie Mack⁴, Arabinda Choudhary⁴, David O. Aleman¹, Jeff Vesek⁴, Megan Taylor Sutton¹, Scott C. Bunce¹, and Gregory J. Moore^5
1Center for Emerging Neurotechnology & Imaging, Penn State Hershey Neurosciences Institute, Penn State College of Medicine, Hershey, PA, United States, ²Clinic for Special Children, Strasburg, PA, ³Division of Basic Sciences, University of Texas Southwestern Medical Center, Dallas, TX, ⁴Radiology, Penn State College of Medicine, Hershey, PA, United States, ⁵Radiology, Geisinger Medical Center, Danville, PA

Maple Syrup Urine Disease (MSUD) is an inborn error of metabolism of branched-chain amino acids. Illness and stress puts MSUD patients at risk of acute crises and encephalopathy despite adequate dietary treatment. Chronically, neuropsychiatric sequelae such as depression, anxiety may develop. The effects of MSUD on neurochemistry in the chronic state is unknown. We conducted single voxel proton magnetic resonance spectroscopy in three brain regions in MSUD patients and their unaffected siblings. MSUD patients exhibited decreased N-acetylaspartate, creatine, and glutamate. These findings suggest impaired energy production and neurotransmitter depletion, two theories of pathogenesis of neuropsychiatric sequelae in MSUD.

Li Wang¹, Feng Shi¹, John H Gilmore², Weili Lin³, and Dinggang Shen^1
1IDEA Lab, Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States, ²Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States, ³MRI Lab, Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States

Accurate segmentation of neonatal brain MR images in longitudinal MRI studies plays an important role in revealing neurodevelopmental disorders. Due to poor image quality, it still remains challenging to segment neonatal brain images. Most existing methods are voxel-based and work on only the single time-point image, and thus cannot benefit from the tissue distribution information which can be provided by the late-time-point images. In this paper, we propose a novel longitudinal guided level-sets method for consistent neonatal image segmentation, by combining intensity information, atlas prior, cortical thickness, and longitudinal information into a variational framework.

Jeong-Won Jeong^1,2, Ajay Kumar^1,2, Senthil K. Sundaram^1,2, Harry T. Chigani^1,2, and Diane C. Chugani^2,3
1Pediatrics, Neurology, Wayne State University, Detroit, Michigan, United States, ²PET center, Children's Hospital of Michigan, Detroit, Michigan, United States, ³Radiology, Wayne State University, Detroit

The purpose of this study was to examine the curvature of frontal lobe tracts in ASD children using an objective tract based morphometry analysis and investigate the curvature-specific changes in diffusion parameters of these tracts. Significantly higher curvatures were found in children with ASD, especially at the parieto-temporal junction for arcuate fasciculus, at the fronto-temporal junction for uncinate fasciculus, and at the midline of the corpus callosum in genu. In addition, the children with ASD showed higher radial diffusivity at the bending regions of arcuate fasciculus, uncinate fasciculus, ang corpus callosum in genu, respectively.

Tetsu Niwa¹, Noriko Aida¹, Yasuhiko Tachibana¹, Reiko Watanabe¹, Tetsuhiko Okabe^1,2, and Jun Shibasaki^3
1Radiology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan, ²Radiology, Yokohama City University, Yokohama, Japan, ³Neonatology, Kanagawa Children's Medical Center

Subependymal hemorrhage (SEH) occurs with a hypoxic-ischemic injury especially in preterm infants. We assessed the visualization of the branches of the deep veins in infants with SEH according to SEH grade. We found more frequently impaired branches of the medullary veins in infants with SEH-Grade IV. On the contrary, SEH with lower grade showed less frequent relation to the impairment of the medullary veins. SEH with parenchymal hemorrhage may be accompanied with more frequent impairment of the branches of the medullary veins.

Yuxiang Zhou¹, Nehal A. Parikh², Katrina Burson², and Ponnada A Narayana^1
1Diagnostic & Interventional Imaging, University of Texas Health Science Center at Houston, Houston, Texas, United States, ²Dept. of Pediatrics, University of Texas Health Science Center at Houston, Houston, Texas, United States

Cerebral proton MR spectroscopy was performed on 65 very preterm and 12 healthy term neonates, which offers a wealth of data on tissue biochemistry in various brain regions. Significant variations in the metabolite levels have been observed in the neonatal brains at different locations and between term and preterm neonates. These metabolites can represent potential biomarkers of the underlying pathology in extremely preterm neonates. Our ongoing work, correlating metabolites with neonatal risk factors and NDI, will further determine the value of MRS cerebral metabolites as biomarkers of brain development/injury in extremely preterm infants.

Ahmed Serag¹, Paul Aljabar¹, Gareth Ball², Serena J Counsell², James P Boardman^2,3, Daniel Rueckert¹, and Jo V Hajnal^2
1Department of Computing, Imperial College London, London, United Kingdom, ²Imaging Sciences Department, MRC Institute of Clinical Sciences, Imperial College London, London, United Kingdom, ³Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom

Preterm birth is associated with abnormal brain development and long-term neurodevelopmental impairment. Quantitative magnetic resonance (MR) studies of preterm brain injury have focused on morphological features such as shape and volume and on measures of tissue microstructure obtained from diffusion tensor imaging. In this work, we focus on longitudinal changes in signal intensity, which can offer a useful marker for mapping developmental changes. The study shows that signal change analysis on a large cohort is feasible, and it can serve as a marker for developmental brain changes, both normal and abnormal, which might ultimately lead to a better understanding of the trajectory of early brain maturation.

Dallas Card¹, Revital Nossin-Manor^1,2, and John G Sled^3,4
1Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada, ²Neurosciences & Mental Health, Research Institute, The Hospital for Sick Children, Toronto, Ontaro, Canada, ³Physiology & Experimental Medicine, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada, ⁴Medical Biophysics, The University of Toronto, Toronto, Ontario, Canada

Automated tissue classification in very preterm neonates presents unique challenges which commonly result in the misclassification of partial volume voxels. This abstract presents an alternative approach to this problem, based on the trimmed minimum covariance determinant method. This algorithm was used to segment the brains of 44 very preterm neonates into white matter, grey matter, cerebral spinal fluid, and two partial volume classes. Our results show clear differentiation between classes with the partial volume voxels correctly labeled in most cases. An inter-rater comparison involving 12 subjects confirmed its reliability, with all mean Dice coefficients greater than 0.8.

Michael Dayan¹, Monica Munoz^2,3, Sebastian Jentschke^2,4, Martin J Chadwick^2,5, Janine Cooper², Kate Riney⁶, Faraneh Vargha-Khadem², and Chris Alan Clark^1
1Imaging & Biophysics, UCL Institute of Child Health, London, United Kingdom, ²Developmental Cognitive Neuroscience Unit, UCL Institute of Child Health, London, United Kingdom, ³School of Medicine, University of Castilla–La Mancha, Albacete, Spain, ⁴Free University, Cluster of Excellence "Languages of Emotion", Berlin, Germany,⁵Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, United Kingdom, ⁶Neurosciences Unit, UCL Institute of Child Health, London, United Kingdom

The optic radiation is a white matter structure part of the visual pathway known to be myelin mature by the age of 3 years old. This study based on a cohort of 70 children assessed if any age related change and any effect of gender and hemisphere could be found through multiple regression analysis applied to the diffusion tensor imaging (DTI) parameters (FA, ||, ¬) computed within tracts reconstructed from probabilistic tractography. For || and ¬ a significant dependence on hemisphere was demonstrated. An age effect was shown for || in males left hemisphere (p < 0.008) and for ¬ for both hemisphere in males (p<0.01) but only in the right hemisphere for females (p < 0.01). Strong evidence for an age effect was also found for FA (p=0.00001). This work suggests that changes in the optic radiation are occurring up to adulthood and are varying according to hemisphere and gender.

Nathalie Bednarek¹, Jared Wilkinson¹, Amit Mathur¹, Preethi Srinivasakumar¹, Jeff Neil¹, Terrie Inder¹, and Joshua Shimony^1
1Washington University School of Medicine, St. Louis, MO, United States

Hypoxic ischemic encephalopathy (HIE) in infants is often treated with hypothermia during the early days of life. Knowledge of the time course of diffusion changes after ischemia is critical for accurate radiologic interpretation and deciding the optimal time to order the MRI. This study demonstrates that the time course of diffusion changes in infants with HIE treated with hypothermia is different from those not treated with hypothermia.

Salil Soman¹, Samantha J Holdsworth², Patrick David Barnes¹, Roland Bammer², and Kristen Yeom^1
1Department of Radiology, Stanford University, Stanford, California, United States, ²Department of Radiology, Lucas Center, Stanford University, Stanford, California, United States

Susceptibility Weighted imaging (SWI) utilizes 3D gradient echo (GRE) acquisition post-processing to accentuate blood products, but takes up to 10 minutes, (compared to the 2-3 minutes for conventional 2D GRE ), limiting its utility. We performed SWI post processing on 50 conventional 2D GRE studies and found more than half demonstrated either additional or more conspicuous findings. We also found the SWI phase unwrapped image could help distinguish hemorrhage from calcification. COnventional 2D GRE findings such as venous thromboses were less distinctive on SWI processed images due to increased conspicuity of thrombosed and non thrombosed venous structures. Overall, we found the SWI post processed technique of 2D GRE sequences enhanced clinical utility.

Dallas Card¹, John G Sled^2,3, Aideen M Moore^4,5, Hilary E Whyte^4,5, and Margot J Taylor^1,6
1Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada, ²Physiology & Experimental Medicine, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada, ³Medical Biophysics, The University of Toronto, Toronto, Ontario, Canada, ⁴Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada, ⁵Paediatrics, The University of Toronto, Toronto, Ontario, Canada, ⁶Medical Imaging, The University of Toronto, Toronto, Ontario, Canada

Magnetic Resonance Spectroscopic Imaging (MRSI) provides a metabolic snapshot of the brain, and therefore has the potential to provide important insight into preterm brain development. We have combined a short MRSI scan with a fully-automated spectroscopy analysis pipeline and tissue classification to provide estimates of metabolite ratios in 55 very preterm neonates scanned within two weeks of birth. A one-way ANOVA demonstrated a significant difference between white matter and grey matter for both N-Acetylaspartate (NAA) / Choline and NAA / Creatine. In addition, NAA/Choline significant increased with age in grey matter over the preterm period.

Veronika Schöpf^1,2, Gregor Kasprian¹, Christian M Mitter¹, Peter C Brugger³, and Daniela Prayer^1
1Department of Radiology, Division of Neuroradiology, Medical University Vienna, Vienna, Vienna, Austria, ²MR Centre of Excellence, Medical University Vienna, Vienna, Vienna, Austria, ³Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University Vienna, Vienna, Vienna, Austria

FMRI has already been used to study fetal brain activity in utero using different kind of stimulation methods. The underlying neuronal mechanisms strongly connected to gestational weeks of these activity networks have not been described yet. In this study we used functional connectivity analyses allowing the characterization of interregional neural interactions during spontaneous activity during rest to study those underlying mechanisms, aiming at specifying the differences of functionally connected cortical networks over fetal brain development stages.

Christian Mitter¹, Gregor Kasprian¹, Peter Christian Brugger², Laura Perju-Dumbrava³, Ivica Kostovic⁴, and Daniela Prayer^1
1Department of Radiology, Division of Neuroradiology, Medical University of Vienna, Vienna, Austria, ²Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria, ³Institute of Neurology, Medical University of Vienna, Vienna, Austria, ⁴Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia

Various fetal brain abnormalities are associated with MR signal alterations of periventricular crossroad regions. We used DTI and tractography to segment and characterize individual white matter fiber tracts within periventricular crossroad regions in living unsedated fetuses in utero between gestational week 20 and 34. 7 Fetuses underwent 1.5 Tesla MR imaging during routine clinical fetal MR examinations. DTI postprocessing with tractography was performed by using a multiple ROI approach. By using tractography we were able to segment the posterior periventricular crossroad region into sagitally oriented strata of thalamocortical, corticopontine, external capsule and association fibers.

Khader M Hasan¹, Indika S Walimuni¹, Larry A Kramer¹, and Linda Ewing-Cobbs^2
1Radiology, UTHSCH, Houston, Texas, United States, ²Pediatrics, UTHSCH, Houston, Texas, United States

Compared to contradictory and amble volumetric reports on the developing child brain, there has been no comprehensive account of the application of brain atlas-based methods to map the regional tissue relaxation. In this work, we present for the first time a T2 relaxation vs. age atlas of the developing child brain. We have also compared the relaxation times between the right and left hemispheres. Given several previous reports on the accumulation of non-heme iron in deep subcortical and cortical gray matter (GM) structures as reflected by the decrease in T2 relaxation time, we also hypothesized that serial monitoring of the deep gray mater T2 relaxation time would offer a reliable means to assess sensitivity of for serial changes. We demonstrate weak gender effects, regional hetrogeniety, laterality, age-dependence and the sensitivity of the T2 relaxation time and utility in following development-related changes.

Thomas Benner¹, Allison Stevens¹, Michelle Roy¹, and Bruce Fischl^1
1Radiology, Athinoula A. Martinos Center, Charlestown, MA, United States

A fetal ex-vivo brain was imaged using diffusion-weighted steady state free procession (DW-SSFP) imaging for simultaneous fiber tracking of white matter and muscle tissue. The sample was scanned for 56 hours at 7 T at a spatial resolution of 0.4x0.4x0.4 mm3 isotropic using a custom solenoid coil. White matter fiber tracking worked well and facial, neck, and extraocular muscles were clearly visible.

Michael John Paldino¹, Rudolph Pienaar², Annapurna Poduri³, Katyucia Macedo Rodrigues¹, and Patricia Ellen Grant^1
1Radiology, Children's Hospital Boston, Boston, MA, United States, ²Newborn Medicine, Children's Hospital Boston, Boston, MA, United States, ³Neurology, Children's Hospital Boston, Boston, MA, United States

Polymicrogyria consists of abnormal cortical lamination, with most severe involvement of layer 5. This pathologic description predicts abnormal white matter connectivity primarily within projection pathways. We have demonstrated a clinically-relevant impact of polymicrogyria on the arcuate fasciculus in pediatric patients with polymicrogyria. These preliminary results suggest a significant effect on the establishment of cortico-cortical connections and furthermore imply abnormal cortical structure beyond layer 5 in patients with polymicrogyria. These data promulgate the potential for tract-based measures of connectivity to probe cortical structure.

Rabia Liamlahi¹, Walter Knirsch¹, Bea Latal², Michael von Rhein³, Ianina Scheer⁴, Hintendu Dave⁵, Achim Schmitz⁶, Vera Bernet⁷, Christian Kellenberger⁴, and Malek I Makki^4
1Cardiology, University Children Hospital, Zurich, Switzerland, ²Child Development, University Children Hospital, Zurich, Switzerland, ³Child Development Center, University Children Hospital, Zurich, Switzerland, ⁴Diagnostic Imaging, University Children Hospital, Zurich, Switzerland, ⁵Congenital Cardiovascular Surgery, University Children Hospital, Zurich, ⁶Anesthesia, University Children Hospital, Zurich, Switzerland, ⁷Pediatric Intensive Care, University Children Hospital, Zurich, Switzerland

Using DTI we studied the cortico-spinal tracts (posterior limb internal capsule, cerebral peduncle and inferior cortico-spinal) of neonates with severe congenital heart disease before and after cardiopulmonary bypass surgery during first weeks of life. In addition we performed neurodevelopmental assessment, and generated a combined score of bearing, muscle tone and movement, and correlated it with white-matter microstructural changes. Before surgery there was no significant correlation between any DTI indices (ADC, FA, parallel and perpendicular diffusions). After surgery, our results clearly demonstrate an association between low FA in the left cerebral peduncle and poor motor fucntion (p < 0.001).

Ash Ederies¹, Amy K McGuinness², Nora Tusor¹, Joanna M Allsop², Serena J Counsell², Rita G Nunes², Zhi Qing Wu², Jo V Hajnal², Mary A Rutherford², and Christina Malamateniou^2
1Neonatal Imaging Group, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London, United Kingdom, ²Robert Steiner MRI Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London, United Kingdom

Previous studies on fetal patients have shown that Snapshot Inversion Recovery (SNAPIR) is a potentially robust motion-resistant T1-weighted alternative, offering improved anatomy delineation. Although multi-shot are the preferred acquisitions for imaging the neonatal brain, single-shot acquisitions such as SNAPIR may be advantageous for delineating the anatomy in the presence of neonatal motion. To compensate for the lower signal-to-noise-ratio and resolution introduced by single-shot techniques, dynamic scanning and image registration in the form of Snapshot-to-Volume-Reconstruction (SVR) may be used in combination. This pilot study discusses the benefits and challenges of SNAPIR and SVR in neonates and suggests areas for future optimisation.

Nancy K Rollins^1,2, Youngseob Seo^1,2, Lina Chalak^1,2, Jonathan M Chia³, Gareth Ball⁴, and Zhiyue J Wang^1,2
1University of Texas Southwestern Medical Center, Dallas, Texas, United States, ²Children's Medical Center, Dallas, Texas, United States, ³Philips Healthcare, Cleveland, Ohio, United States, ⁴Imperial College and MRC Clinical Science Center, London, United Kingdom

Diffusion tensor imaging (DTI) is being used to study brain maturation and disease effects on white matter. Manual region-of-interest (ROI) analysis which is widely used is operator-dependant, tedious, hypothesis driven, and impractical for comparison of groups or large numbers of subjects but does not require potentially confounding spatial normalization. Tract Based Spatial Statistics (TBSS) is an open source operator-independent platform which spatially normalizes tensor data; potentially problematic in neonates as the normalization templates used in adults have not been proven reliable to infants. We performed a direct comparison between manual ROI analysis and TBSS in infants using the modifications proposed by Ball to improve the reliability of TBSS in neonates and then report region-specific tensor metrics in infants 32 -49 weeks post conception age at the time of imaging.

Malek I Makki¹, Rabia Liamlahi², Hintendu Dave³, Ianina Scheer¹, Walter Knirsch², Bea Latal⁴, Achim Schmitz⁵, Vera Bernet⁶, and Christian Kellenberger^1
1Diagnostic Imaging, University Children Hospital, Zurich, Switzerland, ²Cardiology, University Children Hospital, Zurich, Switzerland, ³Congenital Cardiovascular Surgery, University Children Hospital, Zurich, ⁴Child Development Center, University Children Hospital, Zurich, Switzerland, ⁵Anesthesia, University Children Hospital, Zurich, Switzerland, ⁶Pediatric Intensive Care, University Children Hospital, Zurich, Switzerland

We performed DT-MRI to study major white matter tracts of neonates with congenital heart disease. This investigation was carried out before and after cardiopulmonary bypass surgery. The inferior corticospinal tracts (CS), the cerebral peduncle (CP) and the posterior limb of internal capsule (PLIC) were studied bilaterally. In both pre-surgery and post-surgery groups we observed that: 1) left and right CS are statistically identical and 2) left and right CP are statistically identical. The PLIC demonstrated an asymmetric delay of white matter maturation observed pre-surgery (FAleft < FAright, p = 0.003) and post-surgery (FAleft < FAright, p = 0.022).

Zhengrong Xia¹, Yuhua Li¹, and He Wang^2
1Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, Shanghai, China, People's Republic of, ²Global Applied Science LaboratoryGlobal Applied Science Laboratory, GE Healthcare

The value of T2 Star Weighted Angiography(SWAN) in hypoxic-ischemic encephalopathy(HIE) was investigated. 105 neonates who suspected HIE underwent MR scanning on a GE HDx twin speed 3.0T MR scanner. All of these patients were evaluated with SWAN in addition to other conventional MRI techniques, including FLAIR, FSE, DWI. SWAN had higher sensitivity than other sequences for the detection of germinal matrix hemorrhage, intraventricular hemorrhage, which is a strong predictor for long-term neurologic and neuropsychologic outcomes. Furthermore, SWAN demonstrated that the lesions in preventricular white matter rarely contain hemorrhage. SWAN is recommended to become a part of routine HIE MRI protocols.

Ivan Kirov¹, Sarah Milla¹, Joseph Oved², Orrin Devinsky³, Howard Weiner³, and Oded Gonen^1
1Radiology, New York University, New York, NY, United States, ²School of Medicine, New York University, New York, United States, ³Neurosurgery, New York University, New York, NY, United States

Refractory epilepsy in Tuberous Sclerosis Complex (TSC) is treated by resection of the seizure locus localized by electro-encephalography. The traditional surgery target is the tuber, which is considered to be intrinsically epileptogenic. A subset of patients, however, experience epilepsy, but are tuber-free on conventional MRI and are often excluded from surgery. We used three-dimensional proton MR spectroscopy (1H-MRS) to examine the normal-appearing tissue in these patients. Our initial results reveal metabolic abnormalities in the tuber-free brain in TSC. 1H-MRS in this subset of patients may be a useful marker for identifying MR-occult pathology.

Michael Paldino^1,2, Daniel Ginsburg¹, Patricia Ellen Grant^1,2, and Rudolph Pienaar^1,2
1Radiology, Children's Hospital Boston, Boston, MA, United States, ²Radiology, Harvard Medical School, Boston, MA, United States

We perform a curvature-based analysis on a group of normal and a group of polymicrogyria brain surfaces. Our analysis is lobar based, and we consider the distribution of several intrinsic and extrinsic curvature functions. We show that PMG, even if presented locally, has general affects on the other brain regions.