Luis Miguel Lacerda¹, Jon Clayden¹, Sian Handley², Martin Tisdall³, Enrico Kaden⁴, Gavin Winston⁵, Alki Liasis^2,6, Helen Cross⁷, and Chris Clark^1
1Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, United Kingdom, ²Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom, ³Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom, ⁴Centre for Medical Image Computing, University College London, London, United Kingdom, ⁵Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom, ⁶University of Pittsburgh Medical Centre, Children’s Hospital of Pittsburgh, Pittsburgh, PA, United States, ⁷Clinical Neurosciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom

We used multi-shell diffusion imaging to investigate differences in the visual pathways of children undergoing epilepsy surgery and demonstrated its potential for clinical practice. In particular, we compared the traditional Diffusion Tensor Imaging model with the Spherical Mean Technique model and evaluated its potential to produce measures of tissue microstructure not confounded by orientation effects in both a healthy and patient population. Furthermore, we explored the effect of brain surgery and applied Constrained Spherical Deconvolution derived tractography to determine the frequency and influence of the extent and location of resection on the integrity of the visual system after the operation.

Luis Miguel Lacerda¹, Pedro Luque Laguna^2,3, Flavio Dell'acqua^2,3, and Chris Clark^1
1Developmental Imaging and Biophysics Section, Institute of Child Health, University College London, London, United Kingdom, ²Forensic & Neurodevelopmental Sciences, King's College London, London, United Kingdom, ³Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom

We compared Tract-based Spatial Statistics (TBSS) with a recent method which relies on non-statistical parametric mapping in a tractography derived anatomical framework – tract-based cluster analysis (TBCA) - to explore the effect of surgery in Temporal Lobe Epilepsy. In particular, we investigated differences in fractional anisotropy (FA) as an effect of surgery, and if those changes depended on operated hemisphere. We found the same patterns of increased FA on the corona radiata and decreased FA in tracts traversing the temporal lobe with TBSS, whilst TBCA allowed for an increase in anatomical specificity when interpreting differences in this group.  

Sara Lorio¹, Sophie Adler², Roxana Gunny³, Felice D'Arco³, Enrico Kaden², Konrad Wagstyl², Thomas Jacques^2,3, Chris Clark², Helen Cross², Torsten Baldeweg², and David W. Carmichael^1
1King's College London, LONDON, United Kingdom, ²UCL, London, United Kingdom, ³Great Ormond Street Hospital, London, United Kingdom

Lesion detection and sub-typing for focal cortical dysplasia (FCD), a frequent cause of drug-resistant epilepsy, remain challenging on conventional MRI. New diffusion models such as the spherical mean techniques (SMT) and the neurite orientation dispersion and density imaging (NODDI) provide measurements that are potentially more specific to abnormal tissue microstructure. Quantitative analysis of lesion profiling demonstrated significant changes on NODDI and SMT maps proportional to neurites density, as well on microscopic mean, radial and axial diffusivities. Moreover, signal changes specific to FCD lesions sub-types were observed on those maps, suggesting they can provide features useful for automated lesion detection.

Joseph Yuan-Mou Yang^1,2,3,4, Ramshekhar Menon^5,6, Sarah Barton^2,3,4,5, Simone Mandelstam^7,8,9, Rachel Kerr¹⁰, Jacquie Wrennall^11,12, Catherine Bailey⁵, Jeremy Freeman^2,5, Wirginia Maixner^1,2, and A Simon Harvey^2,3,5
1Neurosurgery, Royal Children's Hospital, Melbourne, Australia, ²Neuroscience Research group, Murdoch Children's Research Institution, Melbourne, Australia, ³Paediatrics, University of Melbourne, Melbourne, Australia, ⁴Developmental Imaging group, Murdoch Children's Research Institution, Melbourne, Australia, ⁵Neurology, Royal Children's Hospital, Melbourne, Australia, ⁶Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India, ⁷Medical Imaging, Royal Children's Hospital, Melbourne, Australia, ⁸Medicine and Radiology, University of Melbourne, Melbourne, Australia, ⁹The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia, ¹⁰Speech pathology, Royal Children's Hospital, Melbourne, Australia, ¹¹Clinical neuropsychology, Royal Children's Hospital, Melbourne, Australia, ¹²Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia

Language dominant, insular-opercular epilepsies are challenging to manage due complex seizure presentations and proximity to language cortex and associated white matter tracts. Most centres elected for extensive invasive stereo-electroencephalogram recordings and ablative procedures. We demonstrated in our retrospective cohort of 11 patients that focal resections can be undertaken safely and effectively using neuroimaging of seizures, lesions, language fMRI and high order tractography reconstructions based on a multi-fibre white matter modelling technique, and careful microsurgical techniques. This avoids risks associated with invasive procedures. Surgery performed under direct vision is more precise, likely safer, allows tailoring with intraoperative electrocorticography, and provides histopathology.

Evita Wiegers¹, Kim Annink², Niek van der Aa², Jeroen Dudink², Thomas Alderliesten², Floris Groenendaal², Maarten Lequin¹, Floor Jansen³, Koenraad Rhebergen⁴, Peter Luijten¹, Jeroen Hendrikse¹, Hans Hoogduin¹, Erik Huijing¹, Edwin Versteeg¹, Fredy Visser¹, Alexander Raaijmakers¹, Dennis Klomp¹, Manon Benders², and Jannie Wijnen^1
1Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands, ²Department of Neonatology, University Medical Center Utrecht, Utrecht, Netherlands, ³Department of Paediatric neurology, University Medical Center Utrecht, Utrecht, Netherlands, ⁴Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands

The aim of this study was to investigate the safety and feasibility of 7T MRI in neonates. RF safety simulations showed that the global and peak specific absorption rates in a baby model do not exceed the specific absorption rates in adult models at 7T. Furthermore an (acoustic) noise damping hood was developed to guarantee hearing protection. In 10 neonates, we show that it is feasible to obtain good quality images at 7T; safety parameters (heart rate, peripheral oxygen saturation, peripheral temperature and comfort scales) were monitored before, during and after the MR scans, no (MRI related) adverse events occurred.

Jeong-Won Jeong^1,2,3,4, Min-Hee Lee^1,2, Nolan O'Hara^2,4, Eishi Asano^1,3,4, and Csaba Juhasz^1,2,3,4
1Pediatrics, Wayne State University, Detroit, MI, United States, ²Translational Imaging Lab, Children's Hospital of Michigan, Detroit, MI, United States, ³Neurology, Wayne State University, Detroit, MI, United States, ⁴Translational Neuroscience Program, Wayne State University, Detroit, MI, United States

Early surgery helps improve language function in pediatric epilepsy. We investigate if an advanced DWI approach combining deep convolution network-based tract classification with DWI connectome can help early surgery by providing preoperative imaging markers which indicate a high likelihood of postoperative language improvement. Our approach revealed two nodes in preoperative DWI data, including left middle temporal gyrus and left angular gyrus, of which preoperative local efficiency values are not significantly different in patients having postoperative improvement of receptive language, compared with age-matched healthy controls, which can be as effective imaging markers for prediction of the postoperative language improvement.

Fusheng Gao¹, Xiaoxia Shen¹, Hongxi Zhang¹, Yi Zhang², Xiaolu Ma¹, Jiangyang Zhang³, and Dan Wu^2
1Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China, ²Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China, ³Department of Radiology, New York University School of Medicine, New York, NY, United States

Despite the success of diffusion time (t_d) dependent diffusion MRI in simulation and preclinical studies, clinical applications of the technique are challenged by difficulties in accessing short t_d, limited primarily by the clinical gradient system. This study demonstrated the feasibility of t_d-dependent dMRI using oscillating and pulsed gradients on a 3T clinical system to investigate neonatal hypoxic-ischemic encephalopathy (HIE). Results demonstrated that the t_d-dependency (ΔMD) increased in the deep gray matter of infants during the first year. In HIE patients, ΔMD increased in the basal ganglia of the severe and moderate HIE, as well as in the penumbra of lesions.

Xuan Bu¹, Kaili Liang¹, Yingxue Gao¹, Lu Lu¹, Hailong Li¹, Lianqing Zhang¹, Shi Tang¹, Yanlin Wang¹, Xinyu Hu¹, Qiyong Gong¹, Bharat Biswal², and Xiaoqi Huang^1
1Huaxi MR Research Center (HMRRC), Functional and molecular imaging Key Laboratory of Sichuan Province, Department of Radiology, Sichuan University, Chengdu, China, ²Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States

In current study, we used a network growth charting method to map the normative maturational trajectories of major functional network activity in both grey matter and white matter. A quadratic maturation trajectory of functional activity was observed in DMN, SMN and FPN for both grey matter and white matter. The coherent maturational trajectory between these grey matter and white matter network suggests the corresponding refinements of brain network function plays an important role in improvements in higher-order cognitive abilities during normative adolescent development.

Adam J Shephard¹, Jan Novak¹, Cathy Catroppa², Vicki Anderson², and Amanda G Wood^1,3
1School of Life & Health Sciences & Aston Neuroscience Institute, Aston University, Birmingham, United Kingdom, ²Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia, ³School of Psychology, Deakin University, Geelong, Australia

Disconnectome-symptom mapping (DSM) was used to identify relationships between brain and behaviour, by assessing the effect of pathology-intersected white matter tracts on neuropsychological outcomes. This study used DSM to see how IQ, two years post-injury, related to disconnections in the brain, following paediatric traumatic brain injury. For this, two approaches were employed: the BCBtoolkit, designed for use in adults, and a child-analogue. This study found the BCBtoolkit to be less sensitive than the child-analogue, however, in both methods, disconnections in the superior longitudinal fasciculus and external capsule correlated with a reduced IQ when comparing disconnected patients to controls.

Filippo Arrigoni¹, Denis Peruzzo¹, Simone Mandelstam^2,3,4,5, Gabriele Amorosino¹, Daniela Redaelli¹, Romina Romaniello⁶, Richard Leventer^2,3,4, Renato Borgatti⁶, Marc Seal^2,4, and Joseph Yuan-Mou Yang^2,3,4
1Neuroimaging Lab, Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy, ²Murdoch Children’s Research Institute, Parkville, Australia, ³Royal Children’s Hospital, Parkville, Australia, ⁴The University of Melbourne, Parkville, Australia, ⁵The Florey Institute of Neuroscience and Mental Health, Parkville, Australia, ⁶Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy

White matter (WM) tracts organization in 42 polymicrogyria (PMG) and 8 lissencephaly (LIS) patients were characterized using the tissue-specific Constrained Spherical Deconvolution modelling technique. Structural appearance of 9 major WM tracts were judged using fiber orientation distribution based direction-encoded color maps and probabilistic algorithm based tractography reconstructions. More abnormal-appearing WM tracts were identified in LIS compared to PMG. Degrees of superior longitudinal fasciculus and cingulum abnormalities were associated with PMG distribution and severity. Thickened superior fronto-occipital fasciculus was demonstrated in three patients. Patterns of WM tracts involvement were related to PMG and LIS distribution and subgroups.