Point-of-Care Brain Magnetic Resonance Imaging in Children with Head Trauma (BRAINCHILD)

PROJECT SUMMARY/ABSTRACT Traumatic brain injury (TBI) is a predominant cause of disability and death among children, leading to over 800,000 emergency department (ED) visits and 6,000 deaths annually in the U.S. Over 30% of children presenting with head trauma are subjected to computed tomography (CT), the standard neuroimaging modality in acute evaluations, to detect clinically meaningful TBIs. While CT is efficient, it exposes the pediatric brain to ionizing radiation, thereby increasing potential for future cancer risk. Given the importance of identifying TBI while also minimizing potential hazards, there is a need for safer and equally effective neuroimaging alternatives. Magnetic resonance imaging (MRI) offers a radiation-free alternative to CT. Conventional MRI, although superior in identifying certain intracranial injuries, is not frequently employed in acute TBI scenarios due to constraints like scanner accessibility. However, recent advances have presented point-of-care, low-field brain MRI (POC LF-MRI) systems as a potential paradigm-shifting neuroimaging modality. These systems are cost-effective, portable, user-friendly, and have FDA clearance across all age groups. Notably, they enable bedside neuroimaging, which is immensely beneficial for critically injured patients who can't be safely moved. This project endeavors to bridge the existing knowledge gaps regarding the accuracy and feasibility of POC LF-MRI in emergency and critical care for pediatric head traumas through a prospective, single-center, observational cohort study of ED, hospitalized, and intensive care unit (ICU) children. Our research aims to (1) determine the accuracy of POC LF-MRI for TBI compared to current clinical standard of care initial neuroimaging, (2) determine the accuracy of POC LF-MRI for neuroradiographic injury progression on repeat neuroimaging, and (3) determine feasibility metrics and balancing measures of POC LF-MRI, including order to scan time, scan duration, incomplete scan proportion, and ED length-of-stay. In summary, our multidisciplinary team seeks to ascertain the diagnostic accuracy and operational feasibility of POC LF-MRI, potentially transforming the neuroimaging approach for pediatric trauma care. If successful, this could reduce radiation exposure risks, augment patient safety, cut healthcare costs, and broaden neuroimaging access in acute care.