Each child deserves the best-possible care to address their unique healthcare needs. Phoenix Children’s is working to discover new technologies and techniques that can fulfill that mission. Our researchers are working on more effective methods to diagnose and treat the conditions that are of greatest concern for children today.
Obesity is one of the most significant health challenges in America. It’s particularly concerning for children and teenagers, who may have long-term health consequences and lower quality of life. Phoenix Children’s collaborated with Arizona State University to evaluate the effects and benefits of early health and lifestyle interventions for adolescents who are obese. Magnetic resonance imaging (MRI) and ultrasound allow specialists to see the benefits of these interventions on liver and heart health.
This work was supported by a National Institutes of Health grant awarded to Dr. Gabe Shaibi at Arizona State University and an Arizona Biomedical Research Consortium grant awarded to Dr. Smita Bailey at Phoenix Children’s.
Think Ultrasound First
Ultrasound is often used in the care of expectant mothers and developing babies. It’s also used in diagnostic imaging, particularly for children. Ultrasound is radiation free, noninvasive and can be portable. This makes it an ideal method of diagnosing, monitoring and treating a number of conditions.
Our clinicians understand the value of “Think Ultrasound First,” and we are working with Philips Healthcare — one of the major ultrasound vendors — to evaluate new and emerging ultrasound technologies.
Since ultrasound is low-cost and doesn’t expose patients to ionizing radiation, one of our primary research goals is to replace exams normally done in X-ray, CT, or MRI with ultrasound. We have already replaced several exams with ultrasound imaging and developed new exams for slipping rib syndrome and retinoblastoma:
One important question for some unborn babies is whether the fetal brain is developing at a normal rate. Improved ultrasound technology, along with new MRI methods, now allow physicians to visualize the anatomy of an entire fetus in exquisite detail.
Researchers at Phoenix Children’s are studying additional noninvasive methods to evaluate the volume and structure of the fetal brain. This will give clinicians and families more information about the well-being of the unborn child.
Phoenix Children’s is also testing new methods for imaging the fetal heart to answer important questions about the prenatal diagnosis of congenital heart disease and the evaluation of cardiac growth and function in the fetus. Echocardiography, which uses ultrasound technology, is well-established for this purpose. Our preliminary results show that fetal MRI adds valuable information when ultrasound images don’t answer the whole question. This can happen when an unborn baby’s heart needs to be imaged and the baby’s ribs, spine or other bones produce shadows that obscure the heart.
With ultrasound, our partnership with Philips has allowed us to pioneer the use of ultra-high frequency probes that produce superb, high-resolution images of the fetal anatomy. These images can be as clear as those obtained after the baby is born.
MRI provides important insights into a large number of conditions, without exposing the patient to radiation. However, MRIs can be challenging for children who have a hard time holding still for the length of the procedure. Our researchers are investigating new technologies and techniques such as spiral MRI, radial MRI and compressed sensing. These may shorten the time required for an MRI or minimize the effects of the patient’s motion.
These efforts, in conjunction with Philips Healthcare and researchers at the Mayo Clinic, promise to enhance the quality of MRI images while also improving patient care by reducing examination times.
Pediatric Applications of Dual-Energy CT
Computed tomography— CT scanning— is a valuable tool to diagnose many diseases and injuries in children. Routine CT scans produce highly detailed images by using normal X-rays. With dual-energy CT, a normal X-ray is combined with less powerful X-rays. Since substances absorb X-rays at different rates, contrast agents such as iodine may be individually identified. This allows technologists to manipulate these substances, which gives dual-energy CT scanning advantages such as:
- Making some abnormalities clearer than routine CT scans. Technologists can intensify iodine in the image, which improves the evaluation of the heart and blood vessels. Areas of inflammation, traumatic injury, poor blood supply or active bleeding can also be better identified.
- Reducing radiation exposure. This happens because technologists can use dual-energy CT scans to construct virtual images of the body before the contrast agent was used. As a result, fewer scans are needed.
Phoenix Children’s is also investigating the ability of dual-energy CT to identify kidney stones, as well as how it may improve our diagnosis of traumatic injuries in children. Our researchers are also looking into the quantitative biomarkers of cognitive development, which are only obtainable with dual-energy CT.
Additional areas of radiology research include:
- Enteral Tube Care Program
- Fetal Cardiac MRI: Accurate Cardiac Gating, Motion Correction, and 3D Reconstruction of the Fetal Heart
- Liver Fat Quantification Study, in partnership with Philips
- Venous Map Development