White Matter Extension of the Melbourne Children’s Regional Infant Brain Atlas: M-CRIB-WM

BackgroundUnderstanding typically developing infant brain structure is crucial in investigating neurological disorders of early childhood. Brain atlases providing standardised identification of neonatal brain regions are key in such investigations. Our previously developed Melbourne Children’s Regional Infant Brain (M-CRIB) and M-CRIB 2.0 neonatal brain atlases provide standardised parcellation of 100 and 94 brain regions respectively, including cortical, subcortical, and cerebellar regions. The aim of this study was to extend the M-CRIB atlas coverage to include 54 white matter regions.MethodsParticipants were ten healthy term-born neonates who comprised the sample for the M-CRIB and M-CRIB 2.0 atlases. WM regions were manually segmented on T2 images and co-registered diffusion tensor imaging-based, direction-encoded colour maps. Our labelled regions are based on those in the JHU-neonate-SS atlas, but differ in the following ways: 1) we included five corpus callosum subdivisions instead of a left / right division; 2) we included a left / right division for the middle cerebellar peduncle; and 3) we excluded the three brainstem divisions. All segmentations were reviewed and approved by a paediatric radiologist and a neurosurgery research fellow for anatomical accuracy.ResultsThe resulting neonatal WM atlas comprises 54 WM regions: 24 paired regions, and six unpaired regions comprising five corpus callosum subdivisions and one pontine crossing tract. Detailed protocols for manual WM parcellations are provided, and the M-CRIB-WM atlas is presented together with the existing M-CRIB and M-CRIB 2.0 cortical, subcortical and cerebellar parcellations in ten individual neonatal MRI datasets.ConclusionThe updated M-CRIB atlas including the WM parcellations will be made publicly available. The atlas will be a valuable tool that will help facilitate neuroimaging research into neonatal WM development in both healthy and diseased states.

Subspecialty radiology consultation by interactive telemedicine

This investigation tested the hypothesis that interactive, low-resolution telemedicine is an effective method for radiologists' consultations. The case material consisted of radiographs and digital images from patients with 14 paediatric diseases readily diagnosed by imaging, and 10 matched controls. The original images were first evaluated by a general radiologist, who entered a diagnosis. He or she then discussed the case with a paediatric radiologist who had access to the same images via low-resolution interactive video. Following the consultation the general radiologist could change diagnosis. The experimental subjects were three teams of general and paediatric radiologists. Observer-performance and case-comparison methods were used for analysis. The results showed that the general radiologists' diagnostic accuracy improved after telemedicine consultation with the subspecialist, the area under the ROC curve improving from 0.648 to 0.709. The interactive consultation was judged valuable by all participants. We conclude that low-resolution interactive telemedicine is of value for consultation between generalists and subspecialists in radiology.