Awake pediatric brain-MRI: a fast multi-sequence scan augmented with motion compensated single-shot 2D acquisitions

Area of Science:

• Pediatric Radiology
• Neuroimaging
• Medical Imaging Technology

Background:

• Magnetic resonance imaging (MRI) in children is often compromised by motion artifacts, frequently necessitating sedation for diagnostic image acquisition.
• Existing external motion tracking and navigator techniques have limitations, posing persistent challenges in pediatric neuroimaging.

Purpose of the Study:

• To develop and validate a novel awake brain MRI examination protocol for children that yields diagnostic image quality.
• To establish a non-sedated MRI approach that is well-tolerated by pediatric patients.

Main Methods:

• A prospective study involving children undergoing brain MRI using an in-house developed multi-sequence protocol (NeuroMix) and a custom motion tracking device for prospective motion correction (PMC).
• NeuroMix acquired T1-weighted, T2-weighted, T2*-weighted, T2-FLAIR, and diffusion-weighted images in under 3 minutes.
• PMC was applied to 2D single-shot sequences for higher resolution imaging, with neuroradiologists assessing image artifacts.

Main Results:

• Out of 64 participants, 58 completed the examination. Head motion analysis during PMC sequences showed significant displacements and rotations.
• A high success rate of 93% for artifact-free series essential for MRI reports was achieved.
• 84% of participants received MRI reports with high radiologist confidence, indicating diagnostic quality was met.

Conclusions:

• The developed awake brain MRI protocol reliably produces diagnostic quality images and reports with high confidence in pediatric patients.
• This innovative approach has the potential to significantly reduce the requirement for procedural sedation in pediatric MRI examinations.