Imaging Biomarkers of Severe Respiratory Infections in Premature Infants

ABSTRACTPrematurity is the largest single cause of death in children under five in the world and lower respiratory tract
infectionsLRTIare the top cause of hospitalization and mortality in premature infantsClinical tools to predict
and prevent severe LRTI in premature pediatric patients are critically needed to allow early interventions to
decrease the high morbidity and mortality in this patient groupAlthough imaging biomarkers of lung disease
from computed tomography have been successfully used in adultsthey entail heightened risks for children
due to cumulative radiation and the need for sedationOur goal is to address these gaps and improve clinical
practice by developing an objective imaging biomarker framework to assess the risk of severe respiratory
disease in premature babies using non invasive low radiation X ray imagingPrevious efforts lead by DrLinguraruPrincipal Investigatorat Childrenandapos s National Health SystemCNHShave focused on developing technical components to quantify lung structural data from chest X rayCXRin
childrenThe image processing pipeline developed at CNHS integrates three novel technical componentsaautomatic lung segmentationbobtrusive object removal in CXRand cseverity quantification of lung
pathologyThese innovations enabled the development of a quantitative imaging software technology to
quantify Lung Air trapping and Irregular opacities Radiological analyzerLungAIRThis Phase I project builds on the methodology developed in preliminary workWe will analyze a large
databasenof retrospective CXR images from premature infants with known clinical outcomesand
further develop and validate lung imaging biomarkersIn Specific Aimwe will design and implement a
prototype of the software technologyLungAIRfor the localization and quantification of heterogeneous
aeration patterns in each lung quadrant through quantitative imaging algorithmsA graphical user interface will
also be developed for the simple clinical use of the technologyIn Specific Aimwe will perform clinical
outcome analysis to correlate these biomarkers with the severity of lung diseaseWe will also combine our
new imaging biomarkers with clinical parameters to design and evaluate a predictive model of LRTI risk in the
first year of life to optimize the clinical management and improve the outcomes for premature babiesIn this projectCNHS partners with Kitware to translate our research into a clinical software application and
lay the groundwork for further developments and clinical studies in Phase IIIn summaryour approach will
enable better clinical management of diseases of prematurity leading to novel diagnostic strategies to improve
treatment and outcomes for the highly vulnerable population of premature infants PROJECT NARRATIVEPrematurity is the largest single cause of death in children under five in the world and lower respiratory tract
infectionsLRTIare the top cause of hospitalization and mortality in premature infantsClinical tools to predict
and prevent severe LRTI in premature pediatric patients are critically needed to allow early interventions to
decrease the high morbidity and mortality in this patient groupIn this projectwe will develop and evaluate a
quantitative imaging technology to assess the risk for severe respiratory disease in premature babies using
non invasive low radiation X ray imaging