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Quantification of Fluid Volume and Distribution in the Paediatric Colon via Magnetic Resonance Imaging
Jan Goelen1, Benoni Alexander2, Haren Eranga Wijesinghe3
1School of Pharmacy, Institute of Clinical Science, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Insights
This study used MRI to measure fluid in children's colons for the first time. The findings will help develop better colon-targeting medicines for pediatric drug development.
Area of Science:
- Pediatric Imaging
- Gastrointestinal Physiology
- Pharmacokinetics
Background:
- Previous research quantified gastrointestinal fluid using MRI in adults and children's upper GI tracts.
- Accurate quantification of fluid in the pediatric colon is lacking, hindering drug development.
Purpose of the Study:
- To quantify fluid volume and distribution in the pediatric colon using MRI.
- To establish baseline data for pediatric colonic fluid for drug formulation development.
Main Methods:
- Utilized magnetic resonance imaging (MRI) datasets from 28 fasted and 18 fluid-fed pediatric participants (aged 0-16 years).
- Employed 2D- and 3D-based software protocols for measuring colonic fluid volume and localization.
- Analyzed fluid pocket size and distribution within the pediatric colon.
Main Results:
- The pediatric colon contained a mean fluid volume of 22.5 mL ± 41.3 mL in 15.5 ± 17.5 fluid pockets.
- Larger fluid pockets (>1 mL) constituted 9.6% of pockets but 94.5% of total fluid volume.
- No significant correlations were found between colonic fluid volume and age, sex, or fed state.
Conclusions:
- This study provides the first quantitative MRI data on fluid volumes in the pediatric colon.
- These findings are crucial for developing biorelevant tools and advancing colon-targeting drug formulations for children.
- The data will accelerate pediatric drug development, particularly for formulations requiring precise colonic delivery.
Abstract:
Previous studies have used magnetic resonance imaging (MRI) to quantify the fluid in the stomach and small intestine of children, and the stomach, small intestine and colon of adults. This is the first study to quantify fluid volumes and distribution using MRI in the paediatric colon. MRI datasets from 28 fasted (aged 0-15 years) and 18 fluid-fed (aged 10-16 years) paediatric participants were acquired during routine clinical care. A series of 2D- and 3D-based software protocols were used to measure colonic fluid volume and localisation. The paediatric colon contained a mean volume of 22.5 mL ± 41.3 mL fluid, (range 0-167.5 mL, median volume 0.80 mL) in 15.5 ± 17.5 discreet fluid pockets (median 12). The proportion of the fluid pockets larger than 1 mL was 9.6%, which contributed to 94.5% of the total fluid volume observed. No correlation was detected between all-ages and colonic fluid volume, nor was a difference in colonic fluid volumes observed based on sex, fed state or age group based on ICH-classifications. This study quantified fluid volumes within the paediatric colon, and these data will aid and accelerate the development of biorelevant tools to progress paediatric drug development for colon-targeting formulations.
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