Clinical application of advanced MR methods in children: points to consider

Area of Science:

• Neuroimaging
• Pediatric Neurosurgery
• Medical Imaging Analysis

Background:

• Functional MRI (fMRI) and diffusion MR tractography are vital pre-surgical tools in adults.
• Their application in pediatric neurosurgery is less established due to unique challenges.
• Addressing these pediatric-specific issues is crucial for effective clinical use.

Purpose of the Study:

• To systematically review and address pediatric-specific challenges in pre-neurosurgical fMRI and diffusion MR tractography.
• To provide practical solutions for planning, conducting, and interpreting these neuroimaging exams in children.
• To enhance the benefit-to-burden ratio for pediatric patients undergoing neuroimaging.

Main Methods:

• Comprehensive literature review of pediatric neuroimaging for neurosurgery.
• Analysis of key aspects: task design, subject preparation, scanning, data processing, and interpretation.
• Incorporation of clinical experience to identify and solve common issues.

Main Results:

• Identified specific pediatric considerations across all stages of the neuroimaging process.
• Detailed common problems encountered in pediatric fMRI and tractography.
• Offered evidence-based and experience-driven solutions for each identified issue.

Conclusions:

• Tailoring neuroimaging protocols to pediatric needs is essential for successful pre-surgical planning.
• Standardized approaches for pediatric functional MRI and diffusion MR tractography can improve outcomes.
• This review provides a valuable resource for clinicians and imaging scientists working with pediatric neurosurgical patients.