Bridging the gap: Translating fetal, infant, and toddler neuroimaging insights into clinical practice

Over the past decade, fetal, infant, and toddler (FIT) neuroimaging has become a rapidly expanding field, driven by advances in technology and computational methods. By providing non-invasive ways to explore the developing brain in both typical and pathological development, FIT neuroimaging holds promise for advancing pediatric medicine. Magnetic resonance imaging (MRI), ultrasonography, and electroencephalography (EEG) are regularly used in clinical practice to identify or rule out structural brain abnormalities; monitor the timing and evolution of brain injuries; assess brain growth and maturation; diagnose and monitor seizures, including infantile spasms; and facilitate pre-surgical planning. Other methods, including functional MRI, magnetoencephalography (MEG), and near-infrared spectroscopy (NIRS), provide information about brain function but have not yet been considered standard-of-care. As the field has rapidly advanced, numerous barriers (e.g., concerns regarding cost-effectiveness, safety, availability and portability, bedside applicability, suitability for serial imaging, and uncertain predictive utility) have hindered the routine use of neuroimaging techniques. This review focuses on how FIT neuroimaging research can be applied beyond academic settings to improve outcomes in clinical environments, such as high-risk follow-up programs and neonatal and pediatric intensive care units. Key topics include: (1) how FIT neuroimaging can advance pediatric medicine; (2) challenges and gaps in translating FIT neuroimaging to clinical practice; (3) proposed strategies for bridging these gaps; and (4) a framework for clinical translation and future directions to enhance pediatric healthcare and developmental outcomes.