Brain Scan Technology for Critical Newborns

By providing crucial data about brain function at the bedside, the scanner avoids the necessity to move critically ill babies to traditional scanning facilities, which may involve sedating them and involves some risk. The information produced by the new scanner can be used to diagnose and evaluate problems including brain hemorrhages and brain damage, and to make decisions on effective treatment alternatives.

A prototype of the scanner, called MONSTIR, has been developed by researchers at University College London (UCL, UK), with funding from the Engineering and Physical Sciences Research Council (EPSRC) and the Wellcome Trust. The scientists are now trying to reduce the size of the scanner and improve its speed of operation.

Currently, there are two major ways to perform brain scans on small babies. Magnetic resonance imaging (MRI) can provide data on brain function, but MRI scanners are large and static, and the infant may require sedation and have to be moved to the scanner for the procedure to be done. The other option, ultrasound, can be performed at the bedside and is effective at showing brain anatomy, but cannot reveal how the brain is actually functioning, in terms of oxygen supply and blood flow.

Combining the benefits of MRI and ultrasound but avoiding their disadvantages, MONSTIR, the first scanner of its kind in the world, uses a ground-breaking technique called optical tomography to generate images that demonstrate how the brain is functioning. In optical tomography, light passes through body tissue and is then assessed by computer to provide information about the tissue.

A helmet incorporating 32 light detectors and 32 sources of safe, low-intensity laser light is positioned on the infant's head. The sources produce short flashes and the detectors measure the amount of light that reaches them through the brain and the time the light takes to travel. A software package also developed with EPSRC funding uses this information to construct a three-dimensional (3D) image. This can show which areas of the brain are receiving oxygen, where blood is situated, and also evidence of brain damage.

MONSTIR is the size of a refrigerator's freezer and takes approximately eight minutes to produce an image. The goal is to produce a version that is half this size, five times faster, even more accurate and can be used in clinical situations. Another possible use of the technology in breast imaging to help in cancer prevention and treatment is also being evaluated.

Dr. Adam Gibson is a key member of the multi-disciplinary MONSTIR group at UCL that includes medics, physiologists, and mathematicians. "The technology we're developing has the potential to produce high-quality images at the cot side and is also cheaper than MRI. It could make an important contribution to the care and treatment of critically ill babies. Scanners could be available commercially within a few years,” he stated.



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