Use of magnetic resonance imaging in severe pediatric traumatic brain injury

Assessment of current practice

Peter A. Ferrazzano, Bedda L. Rosario, Stephen R. Wisniewski, Nadeem I. Shaf, Heather M. Siefkes, Darryl K. Miles, Andrew L. Alexander, Michael J. Bell, Ajit Sarnaik, Shruti Agrawal, Sarah Mahoney, Deepak Gupta, John Beca, Laura Loftis, Kevin Morris, Lauren Piper, Anthony Slater, Karen Walson, Tellen Bennett, Todd Kilbaugh & 39 others A. M. Iqbal O'Meara, Nathan Dean, Ranjit S. Chima, Katherine Biagas, Enno Wildschut, Mark Peters, Kerri LaRovere, Joan Balcells, Courtney Robertson, Shira Gertz, Akash Deep, Sian Cooper, Mark Wainwright, Sarah Murphy, John Kuluz, Warwick Butt, Nicole O'Brien, Neal Thomas, Sandra Buttram, Simon Erickson, J. Mahil Samuel, Rachel Agbeko, Richard Edwards, Kesava Ananth Ramakrishnan, Margaret Winkler, Santiago Borasino, Joanne Natale, Christopher Giza, Mary Hilfiker, David Shellington, Anthony Figaji, Elizabeth Newell, Edward Truemper, Robert Clark, Kit Newth, Nadeem Shafi, Michelle Schober, Jerry Zimmerman, Jose Pineda

Research output: Contribution to journalArticle

Abstract

OBJECTIVE There is no consensus on the optimal timing and specific brain MRI sequences in the evaluation and management of severe pediatric traumatic brain injury (TBI), and information on current practices is lacking. The authors performed a survey of MRI practices among sites participating in a multicenter study of severe pediatric TBI to provide information for designing future clinical trials using MRI to assess brain injury after severe pediatric TBI. METHODS Information on current imaging practices and resources was collected from 27 institutions participating in the Approaches and Decisions after Pediatric TBI Trial. Multiple-choice questions addressed the percentage of patients with TBI who have MRI studies, timing of MRI, MRI sequences used to investigate TBI, as well as the magnetic feld strength of MR scanners used at the participating institutions and use of standardized MRI protocols for imaging after severe pediatric TBI. RESULTS Overall, the reported use of MRI in pediatric patients with severe TBI at participating sites was high, with 40% of sites indicating that they obtain MRI studies in > 95% of this patient population. Differences were observed in the frequency of MRI use between US and international sites, with the US sites obtaining MRI in a higher proportion of their pediatric patients with severe TBI (94% of US vs 44% of international sites reported MRI in at least 70% of patients with severe TBI). The reported timing and composition of MRI studies was highly variable across sites. Sixty percent of sites reported typically obtaining an MRI study within the first 7 days postinjury, with the remainder of responses distributed throughout the first 30-day postinjury period. Responses indicated that MRI sequences sensitive for diffuse axonal injury and ischemia are frequently obtained in patients with TBI, whereas perfusion imaging and spectroscopy techniques are less common. CONCLUSIONS Results from this survey suggest that despite the lack of consensus or guidelines, MRI is commonly obtained during the acute clinical setting after severe pediatric TBI. The variation in MRI practices highlights the need for additional studies to determine the utility, optimal timing, and composition of clinical MRI studies after TBI. The information in this survey describes current clinical MRI practices in children with severe TBI and identifies important challenges and objectives that should be considered when designing future studies.

Original languageEnglish (US)
Pages (from-to)471-479
Number of pages9
JournalJournal of Neurosurgery: Pediatrics
Volume23
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Magnetic Resonance Imaging
Pediatrics
Traumatic Brain Injury
Diffuse Axonal Injury
Perfusion Imaging
Brain Injuries
Multicenter Studies
Spectrum Analysis
Ischemia
Clinical Trials
Guidelines
Brain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Ferrazzano, P. A., Rosario, B. L., Wisniewski, S. R., Shaf, N. I., Siefkes, H. M., Miles, D. K., ... Pineda, J. (2019). Use of magnetic resonance imaging in severe pediatric traumatic brain injury: Assessment of current practice. Journal of Neurosurgery: Pediatrics, 23(4), 471-479. https://doi.org/10.3171/2018.10.PEDS18374
Ferrazzano, Peter A. ; Rosario, Bedda L. ; Wisniewski, Stephen R. ; Shaf, Nadeem I. ; Siefkes, Heather M. ; Miles, Darryl K. ; Alexander, Andrew L. ; Bell, Michael J. ; Sarnaik, Ajit ; Agrawal, Shruti ; Mahoney, Sarah ; Gupta, Deepak ; Beca, John ; Loftis, Laura ; Morris, Kevin ; Piper, Lauren ; Slater, Anthony ; Walson, Karen ; Bennett, Tellen ; Kilbaugh, Todd ; Iqbal O'Meara, A. M. ; Dean, Nathan ; Chima, Ranjit S. ; Biagas, Katherine ; Wildschut, Enno ; Peters, Mark ; LaRovere, Kerri ; Balcells, Joan ; Robertson, Courtney ; Gertz, Shira ; Deep, Akash ; Cooper, Sian ; Wainwright, Mark ; Murphy, Sarah ; Kuluz, John ; Butt, Warwick ; O'Brien, Nicole ; Thomas, Neal ; Buttram, Sandra ; Erickson, Simon ; Mahil Samuel, J. ; Agbeko, Rachel ; Edwards, Richard ; Ramakrishnan, Kesava Ananth ; Winkler, Margaret ; Borasino, Santiago ; Natale, Joanne ; Giza, Christopher ; Hilfiker, Mary ; Shellington, David ; Figaji, Anthony ; Newell, Elizabeth ; Truemper, Edward ; Clark, Robert ; Newth, Kit ; Shafi, Nadeem ; Schober, Michelle ; Zimmerman, Jerry ; Pineda, Jose. / Use of magnetic resonance imaging in severe pediatric traumatic brain injury : Assessment of current practice. In: Journal of Neurosurgery: Pediatrics. 2019 ; Vol. 23, No. 4. pp. 471-479.
@article{2a28dad99c94470ba98526b720c9d8ac,
title = "Use of magnetic resonance imaging in severe pediatric traumatic brain injury: Assessment of current practice",
abstract = "OBJECTIVE There is no consensus on the optimal timing and specific brain MRI sequences in the evaluation and management of severe pediatric traumatic brain injury (TBI), and information on current practices is lacking. The authors performed a survey of MRI practices among sites participating in a multicenter study of severe pediatric TBI to provide information for designing future clinical trials using MRI to assess brain injury after severe pediatric TBI. METHODS Information on current imaging practices and resources was collected from 27 institutions participating in the Approaches and Decisions after Pediatric TBI Trial. Multiple-choice questions addressed the percentage of patients with TBI who have MRI studies, timing of MRI, MRI sequences used to investigate TBI, as well as the magnetic feld strength of MR scanners used at the participating institutions and use of standardized MRI protocols for imaging after severe pediatric TBI. RESULTS Overall, the reported use of MRI in pediatric patients with severe TBI at participating sites was high, with 40{\%} of sites indicating that they obtain MRI studies in > 95{\%} of this patient population. Differences were observed in the frequency of MRI use between US and international sites, with the US sites obtaining MRI in a higher proportion of their pediatric patients with severe TBI (94{\%} of US vs 44{\%} of international sites reported MRI in at least 70{\%} of patients with severe TBI). The reported timing and composition of MRI studies was highly variable across sites. Sixty percent of sites reported typically obtaining an MRI study within the first 7 days postinjury, with the remainder of responses distributed throughout the first 30-day postinjury period. Responses indicated that MRI sequences sensitive for diffuse axonal injury and ischemia are frequently obtained in patients with TBI, whereas perfusion imaging and spectroscopy techniques are less common. CONCLUSIONS Results from this survey suggest that despite the lack of consensus or guidelines, MRI is commonly obtained during the acute clinical setting after severe pediatric TBI. The variation in MRI practices highlights the need for additional studies to determine the utility, optimal timing, and composition of clinical MRI studies after TBI. The information in this survey describes current clinical MRI practices in children with severe TBI and identifies important challenges and objectives that should be considered when designing future studies.",
author = "Ferrazzano, {Peter A.} and Rosario, {Bedda L.} and Wisniewski, {Stephen R.} and Shaf, {Nadeem I.} and Siefkes, {Heather M.} and Miles, {Darryl K.} and Alexander, {Andrew L.} and Bell, {Michael J.} and Ajit Sarnaik and Shruti Agrawal and Sarah Mahoney and Deepak Gupta and John Beca and Laura Loftis and Kevin Morris and Lauren Piper and Anthony Slater and Karen Walson and Tellen Bennett and Todd Kilbaugh and {Iqbal O'Meara}, {A. M.} and Nathan Dean and Chima, {Ranjit S.} and Katherine Biagas and Enno Wildschut and Mark Peters and Kerri LaRovere and Joan Balcells and Courtney Robertson and Shira Gertz and Akash Deep and Sian Cooper and Mark Wainwright and Sarah Murphy and John Kuluz and Warwick Butt and Nicole O'Brien and Neal Thomas and Sandra Buttram and Simon Erickson and {Mahil Samuel}, J. and Rachel Agbeko and Richard Edwards and Ramakrishnan, {Kesava Ananth} and Margaret Winkler and Santiago Borasino and Joanne Natale and Christopher Giza and Mary Hilfiker and David Shellington and Anthony Figaji and Elizabeth Newell and Edward Truemper and Robert Clark and Kit Newth and Nadeem Shafi and Michelle Schober and Jerry Zimmerman and Jose Pineda",
year = "2019",
month = "4",
day = "1",
doi = "10.3171/2018.10.PEDS18374",
language = "English (US)",
volume = "23",
pages = "471--479",
journal = "Journal of Neurosurgery: Pediatrics",
issn = "1933-0707",
publisher = "American Association of Neurological Surgeons",
number = "4",

}

Ferrazzano, PA, Rosario, BL, Wisniewski, SR, Shaf, NI, Siefkes, HM, Miles, DK, Alexander, AL, Bell, MJ, Sarnaik, A, Agrawal, S, Mahoney, S, Gupta, D, Beca, J, Loftis, L, Morris, K, Piper, L, Slater, A, Walson, K, Bennett, T, Kilbaugh, T, Iqbal O'Meara, AM, Dean, N, Chima, RS, Biagas, K, Wildschut, E, Peters, M, LaRovere, K, Balcells, J, Robertson, C, Gertz, S, Deep, A, Cooper, S, Wainwright, M, Murphy, S, Kuluz, J, Butt, W, O'Brien, N, Thomas, N, Buttram, S, Erickson, S, Mahil Samuel, J, Agbeko, R, Edwards, R, Ramakrishnan, KA, Winkler, M, Borasino, S, Natale, J, Giza, C, Hilfiker, M, Shellington, D, Figaji, A, Newell, E, Truemper, E, Clark, R, Newth, K, Shafi, N, Schober, M, Zimmerman, J & Pineda, J 2019, 'Use of magnetic resonance imaging in severe pediatric traumatic brain injury: Assessment of current practice', Journal of Neurosurgery: Pediatrics, vol. 23, no. 4, pp. 471-479. https://doi.org/10.3171/2018.10.PEDS18374

Use of magnetic resonance imaging in severe pediatric traumatic brain injury : Assessment of current practice. / Ferrazzano, Peter A.; Rosario, Bedda L.; Wisniewski, Stephen R.; Shaf, Nadeem I.; Siefkes, Heather M.; Miles, Darryl K.; Alexander, Andrew L.; Bell, Michael J.; Sarnaik, Ajit; Agrawal, Shruti; Mahoney, Sarah; Gupta, Deepak; Beca, John; Loftis, Laura; Morris, Kevin; Piper, Lauren; Slater, Anthony; Walson, Karen; Bennett, Tellen; Kilbaugh, Todd; Iqbal O'Meara, A. M.; Dean, Nathan; Chima, Ranjit S.; Biagas, Katherine; Wildschut, Enno; Peters, Mark; LaRovere, Kerri; Balcells, Joan; Robertson, Courtney; Gertz, Shira; Deep, Akash; Cooper, Sian; Wainwright, Mark; Murphy, Sarah; Kuluz, John; Butt, Warwick; O'Brien, Nicole; Thomas, Neal; Buttram, Sandra; Erickson, Simon; Mahil Samuel, J.; Agbeko, Rachel; Edwards, Richard; Ramakrishnan, Kesava Ananth; Winkler, Margaret; Borasino, Santiago; Natale, Joanne; Giza, Christopher; Hilfiker, Mary; Shellington, David; Figaji, Anthony; Newell, Elizabeth; Truemper, Edward; Clark, Robert; Newth, Kit; Shafi, Nadeem; Schober, Michelle; Zimmerman, Jerry; Pineda, Jose.

In: Journal of Neurosurgery: Pediatrics, Vol. 23, No. 4, 01.04.2019, p. 471-479.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Use of magnetic resonance imaging in severe pediatric traumatic brain injury

T2 - Assessment of current practice

AU - Ferrazzano, Peter A.

AU - Rosario, Bedda L.

AU - Wisniewski, Stephen R.

AU - Shaf, Nadeem I.

AU - Siefkes, Heather M.

AU - Miles, Darryl K.

AU - Alexander, Andrew L.

AU - Bell, Michael J.

AU - Sarnaik, Ajit

AU - Agrawal, Shruti

AU - Mahoney, Sarah

AU - Gupta, Deepak

AU - Beca, John

AU - Loftis, Laura

AU - Morris, Kevin

AU - Piper, Lauren

AU - Slater, Anthony

AU - Walson, Karen

AU - Bennett, Tellen

AU - Kilbaugh, Todd

AU - Iqbal O'Meara, A. M.

AU - Dean, Nathan

AU - Chima, Ranjit S.

AU - Biagas, Katherine

AU - Wildschut, Enno

AU - Peters, Mark

AU - LaRovere, Kerri

AU - Balcells, Joan

AU - Robertson, Courtney

AU - Gertz, Shira

AU - Deep, Akash

AU - Cooper, Sian

AU - Wainwright, Mark

AU - Murphy, Sarah

AU - Kuluz, John

AU - Butt, Warwick

AU - O'Brien, Nicole

AU - Thomas, Neal

AU - Buttram, Sandra

AU - Erickson, Simon

AU - Mahil Samuel, J.

AU - Agbeko, Rachel

AU - Edwards, Richard

AU - Ramakrishnan, Kesava Ananth

AU - Winkler, Margaret

AU - Borasino, Santiago

AU - Natale, Joanne

AU - Giza, Christopher

AU - Hilfiker, Mary

AU - Shellington, David

AU - Figaji, Anthony

AU - Newell, Elizabeth

AU - Truemper, Edward

AU - Clark, Robert

AU - Newth, Kit

AU - Shafi, Nadeem

AU - Schober, Michelle

AU - Zimmerman, Jerry

AU - Pineda, Jose

PY - 2019/4/1

Y1 - 2019/4/1

N2 - OBJECTIVE There is no consensus on the optimal timing and specific brain MRI sequences in the evaluation and management of severe pediatric traumatic brain injury (TBI), and information on current practices is lacking. The authors performed a survey of MRI practices among sites participating in a multicenter study of severe pediatric TBI to provide information for designing future clinical trials using MRI to assess brain injury after severe pediatric TBI. METHODS Information on current imaging practices and resources was collected from 27 institutions participating in the Approaches and Decisions after Pediatric TBI Trial. Multiple-choice questions addressed the percentage of patients with TBI who have MRI studies, timing of MRI, MRI sequences used to investigate TBI, as well as the magnetic feld strength of MR scanners used at the participating institutions and use of standardized MRI protocols for imaging after severe pediatric TBI. RESULTS Overall, the reported use of MRI in pediatric patients with severe TBI at participating sites was high, with 40% of sites indicating that they obtain MRI studies in > 95% of this patient population. Differences were observed in the frequency of MRI use between US and international sites, with the US sites obtaining MRI in a higher proportion of their pediatric patients with severe TBI (94% of US vs 44% of international sites reported MRI in at least 70% of patients with severe TBI). The reported timing and composition of MRI studies was highly variable across sites. Sixty percent of sites reported typically obtaining an MRI study within the first 7 days postinjury, with the remainder of responses distributed throughout the first 30-day postinjury period. Responses indicated that MRI sequences sensitive for diffuse axonal injury and ischemia are frequently obtained in patients with TBI, whereas perfusion imaging and spectroscopy techniques are less common. CONCLUSIONS Results from this survey suggest that despite the lack of consensus or guidelines, MRI is commonly obtained during the acute clinical setting after severe pediatric TBI. The variation in MRI practices highlights the need for additional studies to determine the utility, optimal timing, and composition of clinical MRI studies after TBI. The information in this survey describes current clinical MRI practices in children with severe TBI and identifies important challenges and objectives that should be considered when designing future studies.

AB - OBJECTIVE There is no consensus on the optimal timing and specific brain MRI sequences in the evaluation and management of severe pediatric traumatic brain injury (TBI), and information on current practices is lacking. The authors performed a survey of MRI practices among sites participating in a multicenter study of severe pediatric TBI to provide information for designing future clinical trials using MRI to assess brain injury after severe pediatric TBI. METHODS Information on current imaging practices and resources was collected from 27 institutions participating in the Approaches and Decisions after Pediatric TBI Trial. Multiple-choice questions addressed the percentage of patients with TBI who have MRI studies, timing of MRI, MRI sequences used to investigate TBI, as well as the magnetic feld strength of MR scanners used at the participating institutions and use of standardized MRI protocols for imaging after severe pediatric TBI. RESULTS Overall, the reported use of MRI in pediatric patients with severe TBI at participating sites was high, with 40% of sites indicating that they obtain MRI studies in > 95% of this patient population. Differences were observed in the frequency of MRI use between US and international sites, with the US sites obtaining MRI in a higher proportion of their pediatric patients with severe TBI (94% of US vs 44% of international sites reported MRI in at least 70% of patients with severe TBI). The reported timing and composition of MRI studies was highly variable across sites. Sixty percent of sites reported typically obtaining an MRI study within the first 7 days postinjury, with the remainder of responses distributed throughout the first 30-day postinjury period. Responses indicated that MRI sequences sensitive for diffuse axonal injury and ischemia are frequently obtained in patients with TBI, whereas perfusion imaging and spectroscopy techniques are less common. CONCLUSIONS Results from this survey suggest that despite the lack of consensus or guidelines, MRI is commonly obtained during the acute clinical setting after severe pediatric TBI. The variation in MRI practices highlights the need for additional studies to determine the utility, optimal timing, and composition of clinical MRI studies after TBI. The information in this survey describes current clinical MRI practices in children with severe TBI and identifies important challenges and objectives that should be considered when designing future studies.

UR - http://www.scopus.com/inward/record.url?scp=85065258570&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065258570&partnerID=8YFLogxK

U2 - 10.3171/2018.10.PEDS18374

DO - 10.3171/2018.10.PEDS18374

M3 - Article

VL - 23

SP - 471

EP - 479

JO - Journal of Neurosurgery: Pediatrics

JF - Journal of Neurosurgery: Pediatrics

SN - 1933-0707

IS - 4

ER -