Tandem 11: Imaging of Oxyhemoglobin and Deoxyhemoglobin Concentration to Detect Cerebral Ischemia in Preterm Infants

Short Summary:

Our tandem develops new, non-invasive, harmless optical imaging methods and applies them at the bedside to detect brain lesions in preterm neonates.

Scope:

Despite improved survival of extremely preterm infants within the last decades, long term cognitive, motor and behavioral impairment remain a significant burden for preterm born children and lead to significant health care costs (Fanaroff et al., 2007). Brain MRI is the best neuroimaging tool for detecting the most predominant brain lesions in preterm infants, i.e. diffuse white matter injury causing neurodevelopmental impairment. However, as transport of these critically ill infants is highly risky, currently diagnosis is only based on bedside instrumentation, such as ultrasound imaging. Ultrasound detects haemorrhagic brain lesions immediately, but ischaemic brain lesions, which lead to more severe impairments, can only be detected after weeks, once necrotic tissue has disintegrated, which delays therapeutic measures tremendously.

Specific Aims:

To develop optical imaging methods to immediately detect ischaemic in addition to haemorrhagic brain lesions at the bedside. To compare optical imaging in preterm infants with MRI at term equivalent age and to correlate these findings with neurodevelopmental outcome at two years of age.

Molecular imaging techniques used:

The near infrared imaging instrument will be based on a high resolution single-photon avalanche diode array sensor (Mata Pavia et al., 2011). Instrumentation will be developed to tomographically image the cerebral oxy- and deoxyhemoglobin (O2Hb and HHb) concentration of preterm infants in 3D with a spatial resolution of ~2 mm. Bleeding leads to high O2Hb and HHb concentration, while ischaemia is detected by low O2Hb and high HHb concentration and consequently both can be diagnosed at the same time.

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Non-invasive near infrared spectroscopy of a preterm infant for continuous observation of blood flow and blood oxygenation level. Currently tested at the University Hospital Zurich

Added value of KFSP for this specific tandem project:

The interdisciplinary collaboration leads to focused and efficient approach. The novel instrument and diagnostic capability will constitute a major progress in solving the principal problem in neonatology.

References