Major advance for detecting brain conditions in babies

Experts at Evelina London Children's Hospital and King's College London have made major advances in detecting brain conditions in babies using portable MRI scanners.

Thanks to their pioneering research published in The Lancet's eClinicalMedicine journal, testing newborn babies with suspected brain abnormalities could become more accessible and more affordable for healthcare settings around the world.

The expert researchers conducted more than 100 paired scans at Evelina Newborn Imaging Centre, part of Guy's and St Thomas' NHS Foundation Trust, comparing brain images from the new portable MRI with those from a traditional fixed MRI scanner.

The state-of-the-art Evelina Newborn Imaging Centre has become the first site in Europe to perform newborn brain imaging using a portable MRI scanner. Evelina London Children's Hospital is one of only two purpose-built, dedicated, children's hospitals in London, and has 24/7 access to imaging.

Results found that the portable MRI scanner could effectively detect both normal brain anatomy, as well as a wide range of clinically important abnormalities with sufficient contrast, signal, and detail.

Researchers have adapted the technology so it can scan using a weakened magnetic field, instead of the stronger one needed for traditional MRI machines. This means it is safe to use on small babies, and in portable machines at their cot-side or in intensive care units, without having to move them for conventional imaging when critically sick.

Before this, portable MRI scanners had been mostly restricted to bedside adult brain imaging. Adult imaging protocols had led to poor results in babies who had been scanned due to significant differences in infant brain composition.

For this study, researchers developed new imaging protocols which can now be used and tested around the world, with sites already starting in Germany and South Africa.

Dr Paul Cawley, lead author for the study and consultant neonatologist at Evelina London Children's Hospital and King's College London, said:

"This study is a much needed first step in establishing the potential of portable MRI scans for newborn babies. MRI is critical for diagnosing and deciding the best course of treatment for infants with suspected brain abnormalities.

"However, over half the world’s population have severely limited or no access to MRI facilities. Even within highly resourced healthcare settings, transporting vulnerable infants needing intensive care to radiology departments for their scans can be challenging. Portable scanners could democratise access to brain imaging and offer many novel solutions to these challenges.

"Portable MRI scanners are much less expensive to produce and are deployable directly within ward or clinical settings, which could enable more healthcare providers to scan babies and children – especially those that have no access or very limited access to static MRI scanners."

MRI scans are complex, expensive and often not available outside advanced medical facilities. As a result, access to MRI is 140 times less in low-income countries compared with high-income countries, and there are countries who have no access to MRI at all.

This research is part of the UNITY Project - a Bill & Melinda Gates Foundation funded global initiative, which is a consortium of world leading researchers collaborating to enhance the study of environmental factors and potential therapeutic interventions affecting early brain development.

Professor Steve Williams, professor of neuroimaging at King's College London and principal investigator for the UNITY Project said:

"This pioneering study is very important for our Bill & Melinda Gates Foundation UNITY project. We have shown that our portable Hyperfine MRI can visualise brain health and pathology in the baby. These results will inform our planned studies and new treatments of malnutrition, infection and birth complications across sub-Saharan Africa and south east Asia."