NNUH’s world-first in baby safety research
Neonatologists at the Norfolk and Norwich University Hospital are the first in the world to publish research showing the thermal safety of scanning newborn babies with high powered 3T magnetic resonance imaging (MRI) scanners.
This research was done when the NNUH took part in the national MARBLE study which investigated the benefits of using the more detailed 3T MRI scans for babies.
Newborn babies who have suffered from oxygen starvation at birth receive “cooling” treatment to minimise the risk of brain damage, followed by a standard MRI scan to check the brain health. But the MARBLE study needed to use high powered 3T scanners. The 3T scanners allow specialist scanning techniques that can measure brain chemistry and provide more detailed images of any areas of damage. However, they have magnetic fields twice as strong as those commonly used for babies and nowhere in the world had so far published data to show that it was safe to scan babies using the higher magnetic fields.
When taking part in the MARBLE study, the Norfolk and Norwich University Hospital team decided to do their own additional research and safety monitoring to be sure that using a stronger magnetic field did not lead to dangerous overheating in babies during scanning.
The NNUH team, which included an MRI physics expert from the UEA, therefore carried out thermal safety research to record the core body temperature of all babies undergoing a 3T MRI brain scan. To enable this monitoring, the team had to purchase specialist fibre optic equipment to record the core body temperature of babies continuously throughout the scans.
The results of the thermal safety research showed that no babies had any overheating during their scans. The team concluded that it is safe to use the more powerful 3T MRI scanners for brain scans in newborn babies. The findings have now been published in the The Journal of Pediatrics.
Dr Clarke, who led the research, said: “We are delighted that our research has provided the first data to be published internationally that show the thermal safety of 3T MRI scanner use in babies. Our findings will provide reassurance to other doctors across the world who may be looking to introduce 3T MR scanning for babies. We were only able to monitor the core temperature of babies taking part in this research thanks to the specialist equipment we purchased using clinical trials funds.”
Dr Clarke added: “Taking part in research is crucial to ensure that the Norfolk and Norwich University Hospital and all the babies we care for benefit from the latest advances in neonatal care, technology and treatment. We are always extremely grateful for donations to our Neonatal Intensive Care Unit because all donations really do help to improve the care we provide for our babies and their families. We also hope that some organisations and individuals may be interested to support our unit’s research at a local level. Therefore we invite those interested in furthering neonatal research to donate specifically to our unit’s ‘NICU Research fund’. Donations to this fund will help us to carry out further important research for babies which may help us make exciting discoveries that improve the outcomes of the babies we care for.”
The NNUH is now taking part in the follow up phase of the MARBLE study. Data are being collected on the babies’ development through special neurological assessments at 1 and 2 years of age.
Rachael Cherry’s son, Theo, was born in August 2014 and took part in the MARBLE study. Rachael had a difficult labour resulting in an emergency caesarian section. Theo did not breathe for 8 minutes so needed the cooling treatment straight after birth. Rachael said: “Theo was cooled and we were told about the MARBLE study the next day. We were happy for Theo to take part in the research because we knew it could help future babies. It was also reassuring for us because we wanted to know what was happening and if anything would be picked up by the more detailed MRI scan.”
She added: “Theo spent around two weeks in NICU in total. I didn’t really have any concerns about him taking part in the research. The staff were incredible; they were very understanding and explained everything to us so we could understand what was happening. Theo’s just like any other toddler now. Our last review with Dr Clarke was very encouraging so we are really pleased. We are so grateful.”
Notes to Editors:
The Magnetic Resonance Biomarkers in Neonatal Encephalopathy (MARBLE) is being run by Imperial College London. 180 babies are taking part in the national MARBLE study. 26 babies were recruited for the study at NNUH during 2013-2015. Further details of the MARBLE study are available at http://bmjopen.bmj.com/content/5/9/e008912.full.pdf+html