The Royal Children’s Hospital (RCH) in Melbourne is internationally renowned for the care and management of paediatric neurological conditions, supporting hundreds of children every year. The team work together to improve health outcomes of infants, children and adolescents with disorders of the brain, nerves and muscles.
Money raised by Boating for Brains will fund the position of a specialised neuroscientist for the management of brain scans in children with epilepsy, brain tumours, stroke and malformations.
Medical imaging allows neurologists to identify subtle lesions causing a child's seizures and provides the ability for neurosurgeons to operate safely on tumours and seizures while avoiding normal functioning brain structures.
Medical imaging is an integral component to the success of the RCH Neurology Department, and plays a vital role in supporting the diagnosis, treatment and surgical outcomes of Victoria’s sickest children. Through your support, Neurology can ensure the world class treatment and management of paediatric neurological conditions can continue.
Statistics and facts about Epilepsy treatment at The Royal Children’s Hospital
- Hundreds of children are managed at RCH with various forms of uncontrolled epilepsy each year
- Over 150 children with uncontrolled epilepsy are evaluated for surgery each year at the RCH
- Up to 10 patients each week require brain image processing as part of assessments for epilepsy, tumour and stroke related surgery
- 40-50 children undergo surgery at RCH for the management of epilepsy each year
- 1/3 of children presented at the RCH with epilepsy are referred from interstate
Brain scanning is frequently used in the diagnosis, treatment and follow-up of children with neurological disorders including brain tumours, brain malformations, epilepsy and stroke. For children undergoing neurosurgery, brain scanning is vital for resecting lesions and avoiding normal structures.
There are several types of brain scanning employed in the care of children with neurological disorders, utilising either x-ray technology (CT scans), magnetic resonance technology (MRI scans) or nuclear medicine technology (PET and SPECT scans). Major hospitals in Australia have such scanners in their medical imaging (radiology) departments, scanning hundreds of patients every day. However, the quality of scanning equipment and the expertise of imaging staff vary widely between hospitals, and not all hospitals provide the services necessary to manage children with complex neurological problems.
The Royal Children's Hospital, Melbourne has state-of-the-art MRI, PET, SPECT and CT scanners that are utilised by their nationally and internationally renowned epilepsy, tumour, malformation and stroke programs. For example, the four onsite MRI scanners at RCH provide, in addition to conventional MRI scanning, the capability for high-field (3T) structural and functional brain imaging, intraoperative scanning, and combined MRI-PET scanning. As a result, children are referred from all over Victoria and from interstate to undergo brain imaging which is not possible elsewhere, sometimes with potentially life-changing ramifications for their treatment.
However, advanced brain imaging necessary for neurological diagnosis and neurosurgical planning requires more than just expensive scanners and skilled imaging technologists and radiologists. The generation of high-resolution, three-dimensional images of a child's brain structure and function requires hours of expert neuroscientist and high-end computer time. With this so-called "post-processing" of MRI, PET, SPECT and CT imaging data, neurologists can identify subtle lesions causing a child's seizures, neuropsychologists and speech pathologists can understand a child's learning and language difficulties, and neurosurgeons can operate safely on tumours and seizure foci while avoiding normal functioning brain structures.
This advanced brain scan processing is vital to the patient care and brain research undertaken in the clinical neuroscience departments of the Royal Children's Hospital and neuroscience research groups of the Murdoch Children's Research Institute.
BRAIN IMAGING TECHNOLOGIES
Magnetic Resonance Imaging (MRI)
Conventional MRI generates pictures of the brain's structure and is used to detect malformations, injuries, tumours, inflammation etc. that may cause a child to suffer seizures, headaches or neurological difficulties. Advanced image processing of MRI can help detect and localise subtle lesions not obvious to the radiologist.
Positron Emission Tomography (PET)
PET yields images of glucose metabolism in different regions of the brain. In children with epilepsy, brain regions causing focal seizures usually have reduced metabolic activity. Advanced image processing of PET can help detect tiny lesions causing drug-resistant epileptic seizures and identify brain regions with normal and abnormal function.
Functional Magnetic Resonance Imaging (fMRI)
Functional MRI employs advanced image processing to produce images of regions which subserve normal functions such as finger movement and sensation, language and vision while the child is in the MRI scanner performing supervised tasks. With this information, neurosurgeons can determine approaches that will minimise risk to a child's normal functions during surgery.
MRI tractography employs advanced image processing of diffusion MRI data to produce images of the nerve fibre pathways that connect brain regions subserving normal functions such as movement, sensation, language, memory and vision. With this information, neurosurgeons can determine approaches that will minimise risk to a child's normal functions during surgery.
Magnetic Resonance Angiography (MRA) and Perfusion Imaging
MRI angiography and perfusion imaging are specialised MRI processing techniques that allow generation of images of blood vessels and blood supply in the brain, useful in children affected by stroke and disorders of the brain's blood vessels. With this information, neurological deficits are better understood and urgent stroke treatments can be implemented where necessary.
Single Photon Emission Computed Tomography (SPECT)
SPECT reveals images of blood flow in the brain and is used in some children with epilepsy and stroke. Advanced image processing of SPECT scans performed in specific settings can highlight brain areas where blood supply is precarious (in stroke) or where seizures arise (in epilepsy).
Coregistered Multi-Modal Imaging
Advanced image processing allows structural, functional and vascular information from MRI, PET and SPECT scans to be "co-registered" into a single 3D computerised image that can highlight important relationships between lesions and normal structures, and allow computerised simulation of neurosurgery. This imaging data can then be loaded onto neuro-navigation equipment used in the neurosurgical operating theatre to assist in resection of tumours and seizure foci, while minimising risk to normal functions.