Premature birth: detecting brain damage with MRI scans
This research was completed on 13 October 2012
Published on 23 October 2009
Around 50,000 babies are born prematurely each year in the UK, putting them at risk of death and disability.1,2,a MRI scans can reveal whether babies have any brain damage that is likely to cause problems as they grow and develop. However, the scans are difficult and time-consuming to read, meaning full information on brain damage cannot be extracted routinely. Researchers are developing a way to automate the analysis of these MRI scans, so many more babies can benefit.
What's the problem and who does it affect?
Brain damage in babies
Around 7% of births in the UK are premature.1,a Sadly, an early birth puts babies at risk of death and disability.
Many of the disabilities that premature babies develop result from brain damage. Damage to a tiny baby’s vulnerable brain can cause lifelong problems such as cerebral palsy, speech problems and learning disabilities.
The statistics make worrying reading: one in five babies born before 26 weeks of pregnancy – that’s about six months – develop severe disabilities and four in ten have learning difficulties at the age of six.2
It’s not easy to tell whether or not a baby has suffered brain damage, as their problems may not become apparent until months or even years later. MRI scans can help, but interpreting the scans is extremely time-consuming and complicated, and there is a lack of trained experts, meaning full information on brain damage cannot be extracted from scans routinely.
Without information from scans, parents can face an anxious wait to find out whether their baby is going to develop problems, and babies can miss out on getting the right sort of help as early as possible.
What is the project trying to achieve?
MRI scanning is a well-established technique that can provide detailed, three-dimensional pictures of inside the body. It can safely be used in babies, revealing valuable information about the way their brain has developed, including brain damage they may have suffered.
However, changes in babies’ brains are often very subtle, and it can be hard to spot them by eye on MRI scans. In fact, it is so difficult and time-consuming to interpret the scans they must be read by experts with many years’ training, meaning the technique cannot normally be made routinely available.
The researchers are developing a way to automate the interpretation of MRI scans of babies’ brains, to identify brain damage in newborns – whether they are born prematurely or born at the right time – and in babies who are up to one year old.
The technique involves developing a brain atlas showing, for example, the typical size and location of important structures within the brain, based on MRI scans of hundreds of babies. It draws on a similar technique that the researchers have already developed successfully for adults and two-year-olds, though it is much more difficult to set up, because babies’ brains differ much more from each other than do adults’.
What are the researchers' credentials?
|Project Leader||Dr D Rueckert PhD MSc and Professor David Edwards FMED Sci|
|Location||Division of Clincial Sciences, Faculty of Medicine, Hammersmith Hospital and Department of Computing, Imperial College London|
|Grant awarded||23 July 2009|
|Start date||14 October 2009|
|End date||13 October 2012|
|Grant code||AP1208, GN1748|
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Experts from many different fields are working together on this ambitious project, putting the team in a unique position to succeed. Professor David Edwards is a neonatologist – a doctor who specialises in caring for newborn babies – with a track record of innovation in developing new therapies for babies who are born prematurely. Professor Daniel Rueckert is a computer scientist with world-class expertise in developing the computer programs needed to analyse and interpret MRI scans of the brain automatically. Dr Alexander Hammers is a neurologist with a keen interest in the anatomy of the brain.
The project team also includes Dr Ioannis Gousias, who has recently completed a PhD on developing the type of brain atlas that will be used in this project and has in-depth expertise in interpreting MRI scans by eye.
With additional support from physicists who are specialised in MRI, the team is at the forefront of making brain atlasing techniques, like the one they are developing here, suitable for routine clinical use.
Who stands to benefit from this research and how?
Helping babies combat brain damage
The researchers hope to improve the detection and understanding of brain damage in babies, by finding a way to automate the interpretation of MRI scans of the brain. The new technique could help doctors to tell whether or not a baby has suffered brain damage, what sort of damage it is, whether they're likely to develop a disability as they grow and develop, and what kind of treatment might benefit them.
This information can be invaluable for parents, who generally want to know what sort of outlook their baby has for the future and make sure the baby gets the best sort of help as soon as possible. The new technique could also help researchers assess the pros and cons of possible new therapies.
If the technique is successful, the researchers hope to develop it for routine use.
Ultimately, the researchers think the new technique could mean premature babies, who are particularly at risk of brain damage, can all benefit fully from MRI scans, as a part of routine practice. Other babies could benefit too, as the technique should be suitable for use in all babies who are suspected of having a brain injury, whatever the cause.
1. The Information Centre, Community Health Statistics. NHS Maternity Statistics, England: 2003-04, 2004-05, 2005-06.
2. Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med 2005; 352:9-19.
a. Estimate assumes incidence of premature birth is the same for the UK overall as it is for England.