Clinical application of advanced MR methods in children: points to consider

Abstract

The application of both functional MRI and diffusion MR tractography prior to a neurosurgical operation is well established in adults, but less so in children, for several reasons. For this review, we have identified several aspects (task design, subject preparation, actual scanning session, data processing, interpretation of results, and decision‐making) where pediatric peculiarities should be taken into account. Further, we not only systematically identify common issues, but also provide solutions, based on our experience as well as a review of the pertinent literature. The aim is to provide the clinician as well as the imaging scientist with information that helps to plan, conduct, and interpret such a clinically‐indicated exam in a way that maximizes benefit for, and minimizes the burden on the individual child.

The Trajectory of Hemispheric Lateralization in the Core System of Face Processing: A Cross-Sectional Functional Magnetic Resonance Imaging Pilot Study

“…One of the biggest problems in fMRI of young children is therefore motion artifacts. A recent study from Wilke et al (2018) reported for instance a positive correlation between proceeding scanning time and the occurrence of motion artifacts in children. We therefore shortened the paradigm, compared to the standard task used in our lab in adults, and additionally split it into two parts with a break of 20 s in-between, in order to have the possibility to analyze only data of the first part, if motion artifacts would have increased with proceeding time in the second part.…”

Voxel Volume Overlap: Voxel‐Size Sensitive Indicators of Subject Motion in Functional MRI

“…This approach may be particularly relevant in clinical populations which may move more, but where every datapoint is precious (Wilke et al. 2018 ).…”

From Past to the Future of fMRI in Pediatrics: A Bibliometric Analysis

“…Complex acquisition and post-processing challenges, in particular, continue to necessitate significant local experience and background so that we not only properly acquire but also critically appraise fMRI results. Constant technical and theoretical advancement, on the other hand, will bring the ideal of a rigorous and regular examination of pediatric neurosurgery patients closer to reality (12). However, due to the large number of publications on this topic, it may be difficult and deceiving, particularly for researchers with less expertise in the field, to identify the proper study theme and stay up to date.…”