Project ID BE-MI2024_18


Co Supervisor 1A Faculty of Life Sciences & Medicine, School of Life Course & Population Sciences, Department of Women & Children’s HealthWebsite

Co Supervisor 1B Faculty of Life Sciences & Medicine, School of Biomedical Engineering & Imaging Sciences, Department of Biomedical EngineeringWebsite

Additional Supervisor Dr Jana Hutter, Dr Lisa Story

Do advanced fetal MRI protocols provide enhanced assessment of the fetal bowel: an MRI pilot study

Fetal MRI is an exciting, rapidly evolving field due to the use of advanced motion correction protocols and the advent of functional imaging. These have enabled assessment of not only fetal anatomy but also tissue function.

Necrotising Enterocolitis (NEC) is a devastating condition which can affect premature and low birthweight infants. Gut tissue becomes inflamed and can die, causing significant morbidity and even mortality for neonates. Currently it is difficult to predict which fetuses may subsequently develop NEC. The ability to do this may enable different feeding protocols to be initiated after birth thereby reducing the incidence of NEC.

We propose that advanced MRI and post processing protocols applied to the fetal bowel such as:
– T2* imaging, which harness the fact oxygenated and deoxygenated haemoglobin have different paramagnetic properties thereby providing an indirect assessment of perfusion
– diffusion imaging which can assess tissue microstructure
– combined T2*diffusion protocols which may give insight into tissue inflammation
– motion correction and alignment of diffusion and T2* data to anatomical images allowing quantification of functional data from selected regions of the bowel
may prove to be a more effective way to predict subsequent NEC in fetuses known to have growth restriction or are at high risk of preterm delivery.

We have experience of using these techniques for assessment of the placenta, fetal lungs, thymus and brain. Using>300 existing datasets as well as prospective data from uncomplicated pregnancies, and those at high risk of NEC, this project will assess the fetal bowel using advanced MRI techniques and correlate findings with neonatal outcomes.

Year 1-2: analysis of existing datasets, optimisation of data acquisition and post processing
Year 3: data analysis and correlation with neonatal outcomes
Dr Story is a Clinical Academic and Prof Hajnal an Engineer and will provide supervision in the above areas.

Representative Publications

1. ‘Assessment of normal pulmonary development using functional magnetic resonance imaging techniques. Avena-Zampieri CL, Hutter J, Deprez M, Payette K, Hall M, Uus A, Nanda S, Milan A, Seed PT, Rutherford M, Greenough A, Story L. Am J Obstet Gynecol MFM. 2023 Jun;5(6):100935. doi: 10.1016/j.ajogmf.2023.100935. Epub 2023 Mar 17.

2. The use of functional placental magnetic resonance imaging for assessment of the placenta after prolonged preterm rupture of the membranes in vivo: A pilot study. Hutter J, Jackson L, Ho A, Avena Zampieri C, Hajnal JV, Al- Adnani M, Nanda S, Shennan AH, Tribe RM, Gibbons D, Rutherford MA, Story L. Acta Obstet Gynecol Scand. 2021 Dec;100(12):2244-2252. doi: 10.1111/aogs.14267. Epub 2021 Sep 21.

3. Brain volumetry in fetuses that deliver very preterm: An MRI pilot study. Story L, Davidson A, Patkee P, Fleiss B, Kyriakopoulou V, Colford K, Sankaran S, Seed P, Jones A, Hutter J, Shennan A, Rutherford M. Neuroimage Clin. 2021;30:102650. doi: 10.1016/j.nicl.2021.102650. Epub 2021 Mar 29

1. Automated processing pipeline for neonatal diffusion MRI in the developing Human Connectome Project. Bastiani M, Andersson JLR, Cordero-Grande L, Murgasova M, Hutter J, Price AN, Makropoulos A, Fitzgibbon SP, Hughes E, Rueckert D, Victor S, Rutherford M, Edwards AD, Smith SM, Tournier JD, Hajnal JV, Jbabdi S, Sotiropoulos SN. Neuroimage. 2019 Jan 15;185:750-763. doi: 10.1016/j.neuroimage.2018.05.064. Epub 2018 May 28.

2. Data-driven motion-corrected brain MRI incorporating pose-dependent B0 fields. Brackenier Y, Cordero-Grande L, Tomi-Tricot R, Wilkinson T, Bridgen P, Price A, Malik SJ, De Vita E, Hajnal JV. Magn Reson Med. 2022 Aug;88(2):817-831. doi: 10.1002/mrm.29255. Epub 2022 May 8.

3. Integrated and efficient diffusion-relaxometry using ZEBRA. Hutter J, Slator PJ, Christiaens D, Teixeira RPAG, Roberts T, Jackson L, Price AN, Malik S, Hajnal JV.Sci Rep. 2018 Oct 11;8(1):15138. doi: 10.1038/s41598-018-33463-2.