An International Collaboration to Create a Brain MRI Atlas for Infants with Congenital Heart Defects

Lay Summary: In 2012, the Saving Tiny Hearts Society funded Dr. Gee and myself, here at the Perelman School of Medicine and the Children’s Hospital of Philadelphia, to organize an international collaboration of researchers dedicated to understanding the factors which lead to brain injury in newborn infants with severe congenital heart defects. The initial phase of the collaboration, and the specific aim of this award, was to collect existing brain MRIs from all collaborators and from these 500 images, build brain atlases specific to gender, heart diagnosis and gestational age. These atlases would serve as population-based ground truth for prospective research for all investigators in the consortium, individually or as a group, and as the anchor to keep the consortium motivated to move forward towards multi-center collaboration.

 

The centers that contributed initial MRI data included 4 US centers, 3 European centers as well as centers in New Zealand and Australia. The consortium has since grown to over 20 centers across the globe. The hot topics currently under discussion are improved observational tools for rapid assessment of PVL lesion severity, automated methods for lesion detection and quantification and a glossary of terms such that the consortium speaks in the same vernacular when publishing data. The consortium is currently planning our 3rd annual meeting at the Pediatric Academic Society in San Diego this Spring. Among the projects proposed for the consortium is developing a core set of MRI sequences that yield standardized intensities and volumes regardless of the MRI platform (Philips, Siemens or GE). These core sequences will be maintained by the core (based at CHOP and the University of Pennsylvania) and optimized through the use of traveling, shared phantoms. Dr. Gee and I, with the help of Dr. Panigrahy at the Children’s Hospital of Pittsburgh, are planning a cloud-based data center for de-identified MRI images. This data center would serve both as a data repository for investigators, but also serve as a real-time quality control metric to make sure all scanners are functioning on par to expectations.

 

The challenges ahead include funding the infrastructure for this consortium. This may be accomplished through launching a multi-center prospective study of comparative effectiveness of the medical and surgical management of Transposition of the Great Arteries.