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Updated: Jul 2, 2025

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Published on: July 30, 2009

Improving advanced intraoperative MRI methods during pediatric neurosurgery.

Pien E J Jellema^1,2, Lilli M Mannsdörfer¹, Fredy Visser^2,3

¹Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.

NMR in Biomedicine

|February 25, 2024

Summary

Advanced intraoperative MRI protocols for pediatric brain tumor surgery show arterial spin labeling (ASL) cerebral blood flow (CBF) is valid in prone positions. Using four RF coils improves image quality and reduces artifacts compared to two coils.

Keywords:

arterial spin labeling diffusion MRI intraoperative neurosurgery pediatrics

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Published on: August 17, 2022

Area of Science:

Neuroimaging
Medical Physics
Neurosurgery

Background:

Advanced intraoperative MRI (ioMRI) can provide physiological data during pediatric brain tumor resections.
Optimizing ioMRI protocols for specific surgical positions and coil configurations is crucial for preserving healthy tissue.

Purpose of the Study:

To develop and evaluate an ioMRI protocol with enhanced sensitivity for ASL and dMRI in pediatric neurosurgery settings.
To assess the impact of patient positioning (prone vs. supine) on ASL cerebral blood flow (CBF) quantification.
To compare the image quality and performance of two vs. four RF coil setups for ioMRI.

Main Methods:

ASL and dMRI protocols were optimized for pediatric neurosurgery patient positioning.
ASL images were acquired in healthy adults in prone and supine positions to quantify CBF.
T1-weighted (T1w) signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were evaluated for two vs. four RF coil setups.
Qualitative assessment of T1w, T2w, ASL, and dMR images was performed for different coil configurations.

Main Results:

Mean ASL CBF did not significantly differ between prone and supine positions.
Four RF coils significantly increased T1w SNR (32-34%) and CNR compared to two RF coils.
Image quality was acceptable to good for both setups, but four RF coils reduced artifacts and improved precision of advanced ioMRI metrics.
Non-weighted diffusion images and corticospinal tract reconstructions showed higher quality with four RF coils.

Conclusions:

ASL CBF quantification is valid in the surgical prone position for pediatric neurosurgery.
Standard ASL and dMRI acquisition with two RF coils is adequate for clinical use.
Utilizing four RF coils enhances ioMRI image quality, increases SNR, and reduces susceptibility artifacts, leading to more precise advanced metrics.