New imaging techniques make it possible to visualize brain development in vulnerable babies in greater detail. That is the finding of Inge van Ooijen’s PhD research. Using a 7 Tesla MRI scanner, she was able to measure important processes in the brains of newborns that were previously invisible. She also shows that 3D ultrasound is a promising and accessible way to monitor brain development during pregnancy. Van Ooijen earned her PhD on this topic on 25 June.
Some children begin life already at a disadvantage, for instance because they are born extremely prematurely, or because complications arise during pregnancy. Inge van Ooijen, PhD candidate at UMC Utrecht, investigated new imaging techniques that can help doctors identify vulnerable children more effectively. With this, she built on previous research in which she demonstrated that the 7 Tesla MRI scanner (7T-MRI) is safe for newborn babies.
With the 7T-MRI, Van Ooijen was able to measure myelin in the brains of newborns for the first time. Myelin forms an insulating layer around nerve fibres and helps nerves transmit signals more quickly. “Preterm birth occurs precisely during the period when the brain is producing large amounts of myelin,” Van Ooijen explains. “Those amounts are still so small that a less powerful scanner can barely make them visible.” The 7T-MRI is sensitive enough to do so for the first time.
Doctors will continue to follow the children from the study in the coming years to see how they develop physically and cognitively. “Only then can we say whether the amount of myelin at birth is also linked to how a child develops later on,” says Van Ooijen. “And if it is, we can start focusing on possible treatments, such as medication that supports myelin formation.”
Although the 7T-MRI yields many new insights, the technique is not widely available. Van Ooijen therefore also investigated whether ultrasound could serve as a good alternative. With conventional ultrasound, doctors were until now mainly able to measure brain dimensions. With 3D ultrasound, it becomes possible to calculate brain volumes, giving a more complete picture of brain development, already during pregnancy.
“We applied this technique for the first time in pregnancies between thirty and forty weeks,” says Van Ooijen. “This is the period when preterm birth occurs and when the first abnormalities in brain development appear in babies with, for example, a heart condition.”
The researchers compared the volumetric measurements from the 3D ultrasound with MRI scans taken on the same day from the same babies. The intracranial volume corresponded well. “That is a very encouraging result,” says Van Ooijen. “An ultrasound is faster, cheaper, and far more widely available than an MRI scanner. This means doctors can use it outside of major academic hospitals as well.”
Researchers are now working on methods to use 3D ultrasound to image specific brain regions with greater precision. “If this technique continues to develop the way it has over the past five years, I hope that 3D ultrasound will soon reach the same quality as MRI,” says Van Ooijen. “That would allow us to monitor the brain development of vulnerable children during pregnancy in an accessible way.”
For Van Ooijen, that is ultimately what it is all about. “The better we understand which babies are at risk and which are developing well, the better we can tailor care to what a child needs — and which form of imaging adds real value.” This personalised approach to care in young children often leads to better outcomes, fewer side effects, and greater chances of healthy development.
