Quantitative Magnetic Resonance Imaging for Neurodevelopmental Outcome Prediction in Neonates Born Extremely Premature-An Exploratory Study

Victor U Schmidbauer; Mehmet S Yildirim; Gregor O Dovjak; Katharina Goeral; Julia Buchmayer; Michael Weber; Patric Kienast; Mariana C Diogo; Florian Prayer; Marlene Stuempflen; Jakob Kittinger; Jakob Malik; Nikolaus M Nowak; Katrin Klebermass-Schrehof; Renate Fuiko; Angelika Berger; Daniela Prayer; Gregor Kasprian; Vito Giordano

doi:10.1007/s00062-023-01378-9

Quantitative Magnetic Resonance Imaging for Neurodevelopmental Outcome Prediction in Neonates Born Extremely Premature-An Exploratory Study

Clin Neuroradiol. 2024 Jan 30. doi: 10.1007/s00062-023-01378-9. Online ahead of print.

Authors

Victor U Schmidbauer¹, Mehmet S Yildirim², Gregor O Dovjak², Katharina Goeral³, Julia Buchmayer³, Michael Weber², Patric Kienast², Mariana C Diogo⁴, Florian Prayer², Marlene Stuempflen², Jakob Kittinger², Jakob Malik², Nikolaus M Nowak², Katrin Klebermass-Schrehof³, Renate Fuiko³, Angelika Berger³, Daniela Prayer², Gregor Kasprian², Vito Giordano³

Affiliations

¹ Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. victor.schmidbauer@meduniwien.ac.at.
² Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
³ Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
⁴ Department of Neuroradiology, Hospital Garcia de Orta, Av. Torrado da Silva, 2805-267 Almada, Portugal.

PMID: 38289377
DOI: 10.1007/s00062-023-01378-9

Abstract

Purpose: Neonates born at < 28 weeks of gestation are at risk for neurodevelopmental delay. The aim of this study was to identify quantitative MR-based metrics for the prediction of neurodevelopmental outcomes in extremely preterm neonates.

Methods: T1-/T2-relaxation times (T1R/T2R), ADC, and fractional anisotropy (FA) of the left/right posterior limb of the internal capsule (PLIC) and the brainstem were determined at term-equivalent ages in a sample of extremely preterm infants (n = 33). Scores for cognitive, language, and motor outcomes were collected at one year corrected-age. Pearson's correlation analyses detected relationships between quantitative measures and outcome data. Stepwise regression procedures identified imaging metrics to estimate neurodevelopmental outcomes.

Results: Cognitive outcomes correlated significantly with T2R (r = 0.412; p = 0.017) and ADC (r = -0.401; p = 0.021) (medulla oblongata). Furthermore, there were significant correlations between motor outcomes and T1R (pontine tegmentum (r = 0.346; p = 0.049), midbrain (r = 0.415; p = 0.016), right PLIC (r = 0.513; p = 0.002), and left PLIC (r = 0.504; p = 0.003)); T2R (right PLIC (r = 0.405; p = 0.019)); ADC (medulla oblongata (r = -0.408; p = 0.018) and pontine tegmentum (r = -0.414; p = 0.017)); and FA (pontine tegmentum (r = -0.352; p = 0.045)). T2R/ADC (medulla oblongata) (cognitive outcomes (R² = 0.296; p = 0.037)) and T1R (right PLIC)/ADC (medulla oblongata) (motor outcomes (R² = 0.405; p = 0.009)) revealed predictive potential for neurodevelopmental outcomes.

Conclusion: There are relationships between relaxometry‑/DTI-based metrics determined by neuroimaging near term and neurodevelopmental outcomes collected at one year of age. Both modalities bear prognostic potential for the prediction of cognitive and motor outcomes. Thus, quantitative MRI at term-equivalent ages represents a promising approach with which to estimate neurologic development in extremely preterm infants.

Keywords: Brain Stem; Extremely Premature; Magnetic Resonance Imaging; Newborn; Prognosis.