New imaging technique tracks babies brain growth

Researchers at University Medical Center Utrecht have advanced two imaging techniques — a powerful 7 Tesla Magnetic Resonance Imaging (MRI) scanner and 3D ultrasound — that make it possible to see the brain development of vulnerable babies in far greater detail. These are the findings of Inge van Ooijen's PhD research, which she defended on 25 June at UMC Utrecht.

Children born extremely prematurely or who experience complications during pregnancy sometimes start life with a developmental disadvantage. Van Ooijen investigated how doctors can identify such risks earlier and more precisely. She built on earlier work in which she showed that the 7 Tesla MRI scanner (7T-MRI) can be safely used on newborns.

Shining a light on babies' brain development

Using the 7T-MRI, Van Ooijen was able, for the first time, to measure myelin in the brains of newborn babies. Myelin is the insulating layer around nerve fibers that speeds up signal transmission. The brain produces large amounts of myelin precisely around the time premature birth occurs, but at that stage, the quantities are still so small that less powerful scanners can barely detect them. The 7T scanner, however, is sensitive enough to do so. Researchers will follow the participating children for several years to determine whether the amount of myelin at birth is linked to their later development — a finding that could eventually point toward targeted treatments, such as medication to support myelin formation.

Because 7T-MRI is not yet widely available, Van Ooijen also examined whether 3D ultrasound could offer an accessible alternative. While traditional ultrasound mainly allows doctors to measure brain dimensions, 3D ultrasound enables calculation of brain volumes — providing a more complete picture of brain development, even during pregnancy. The technique was applied for the first time in pregnancies between thirty and forty weeks, the period in which premature birth occurs, and the first abnormalities emerge, for example, in babies with a heart defect.

On the way to personalized care

Comparing the 3D ultrasound measurements with MRI scans of the same babies, taken on the same day, showed good agreement in the measured brain volume within the skull. According to Van Ooijen, this is a promising result: ultrasound is faster, cheaper, and far more widely available than an MRI scanner, meaning the technique could also be used outside large academic hospitals.

Researchers are now working on methods to use 3D ultrasound to visualize specific brain regions more precisely as well. Van Ooijen hopes the technique will continue to develop over the coming years to a quality comparable with MRI, so that the brain development of vulnerable babies can be monitored in an accessible way already during pregnancy.

The ultimate goal is personalized care: the better doctors can assess which babies are at risk and which are developing well, the more precisely care can be tailored to each child's needs — with the potential for better outcomes and fewer side effects.