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  • Journal article
    Arthurs OJ, Thayyil S, Addison S, Wade A, Jones R, Norman W, Scott R, Robertson NJ, Chitty LS, Taylor AM, Sebire NJ, Offiah ACet al., 2014,

    Diagnostic accuracy of postmortem MRI for musculoskeletal abnormalities in fetuses and children

    , PRENATAL DIAGNOSIS, Vol: 34, Pages: 1254-1261, ISSN: 0197-3851
  • Journal article
    Arthurs OJ, Thayyil S, Olsen OE, Addison S, Wade A, Jones R, Norman W, Scott RJ, Robertson NJ, Taylor AM, Chitty LS, Sebire NJ, Owens CMet al., 2014,

    Diagnostic accuracy of post-mortem MRI for thoracic abnormalities in fetuses and children

    , European Radiology, Vol: 24, Pages: 2876-2884, ISSN: 1432-1084

    Objectives To compare the diagnostic accuracy of postmortemmagnetic resonance imaging (PMMR) specificallyfor non-cardiac thoracic pathology in fetuses and children,compared with conventional autopsy.Methods Institutional ethics approval and parental consentwas obtained. A total of 400 unselected fetuses and childrenunderwent PMMR before conventional autopsy, reportedblinded to the other dataset.Results Of 400 non-cardiac thoracic abnormalities, 113(28 %) were found at autopsy. Overall sensitivity and specificity(95 % confidence interval) of PMMR for any thoracicpathology was poor at 39.6 % (31.0, 48.9) and 85.5 % (80.7,89.2) respectively, with positive predictive value (PPV)53.7 % (42.9, 64.0) and negative predictive value (NPV)77.0 % (71.8, 81.4). Overall agreement was 71.8 % (67.1,76.2). PMMR was most sensitive at detecting anatomicalabnormalities, including pleural effusions and lung or thoracichypoplasia, but particularly poor at detecting infection.Conclusions PMMR currently has relatively poor diagnosticdetection rates for the commonest intra-thoracic pathologiesidentified at autopsy in fetuses and children, including respiratorytract infection and diffuse alveolar haemorrhage. Thereasonable NPV suggests that normal thoracic appearancesat PMMR exclude the majority of important thoraciclesions at autopsy, and so could be useful in the contextof minimally invasive autopsy for detecting non-cardiacthoracic abnormalities.

  • Journal article
    Orasanu E, Melbourne A, Cardoso MJ, Modat M, Taylor AM, Thayyil S, Ourselin Set al., 2014,

    Brain volume estimation from post-mortem newborn and fetal MRI

    , NeuroImage: Clinical, Vol: 6, Pages: 438-444, ISSN: 2213-1582

    Objective:Minimally invasive autopsy using post-mortem magnetic resonance imaging (MRI) is a valid alternative to conventional autopsy in fetuses and infants. Estimation of brain weight is an integral part of autopsy, but manual segmentation of organ volumes on MRI is labor intensive and prone to errors, therefore unsuitable for routine clinical practice. In this paper we aim to show that volumetric measurements of the post-mortem fetal and neonatal brain can be accurately estimated using semi-automatic techniques and a high correlation can be found with the weights measured from conventional autopsy results.Methods:The brains of 17 newborn subjects, part of Magnetic Resonance Imaging Autopsy Study (MaRIAS), were segmented from post-mortem MR images into cerebrum, cerebellum and brainstem using a publicly available neonate brain atlas and semi-automatic segmentation algorithm. The results of the segmentation were averaged to create a new atlas, which was then used for the automated atlas-based segmentation of 17 MaRIAS fetus subjects. As validation, we manually segmented the MR images from 8 subjects of each cohort and compared them with the automatic ones. The semi-automatic estimation of cerebrum weight was compared with the results of the conventional autopsy.Results:The Dice overlaps between the manual and automatic segmentations are 0.991 and 0.992 for cerebrum, 0.873 and 0.888 for cerebellum and 0.819 and 0.815 for brainstem, for newborns and fetuses, respectively. Excellent agreement was obtained between the estimated MR weights and autopsy gold standard ones: mean absolute difference of 5 g and 2% maximum error for the fetus cohort and mean absolute difference of 20 g and 11% maximum error for the newborn one.Conclusions:The high correlation between the obtained segmentation and autopsy weights strengthens the idea of using post-mortem MRI as an alternative for conventional autopsy of the brain.

  • Journal article
    Pauliah S, Lally P, Price D, Bainbridge A, Kurien J, Sivaswami N, Cowan F, Balraj G, Swamy R, Madhavan V, Nair M, Krishnakumar P, Cady E, Shankaran S, Thayyil Set al., 2014,

    PC.106 Cerebral Injury and Early Childhood Neurodevelopmental Outcome following Neonatal Encephalopathy in a Middle-income Country.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1, Pages: A72-A73

    Although neonatal encephalopathy (NE), accounts for 1 million neonatal deaths annually in low-and middle-income countries (LMIC), underlying brain injury and long term outcomes are not well characterised in LMIC.

  • Journal article
    Pauliah S, Lally P, Bainbridge A, Price D, Addison S, Cowan F, Satodia P, Wayte S, Soe A, Pattnayak S, Harigopal S, Abernethy LJ, Turner M, Clarke P, Cheong J, Basheer S, Alavi A, Shankaran S, Cady E, Thayyil Set al., 2014,

    8.8 Neonatal Encephalopathy in the Cooling Therapy era - Preliminary Cerebral Magnetic Resonance results from the Marble Consortium.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1, Pages: A13-A14

    Although cerebral metabolic changes during neonatal encephalopathy (NE) have been well characterised using magnetic resonance spectroscopy (MRS) in single-centre studies, the widespread effect of therapeutic hypothermia is less clear.

  • Journal article
    Pauliah S, Narayanan E, Kumutha K, Vijaykumar M, Nair M, Shankaran S, Thayyil Set al., 2014,

    PC.110 Hypothermia for Encephalopathy in Low and Middle-Income Countries (HELIX): A Feasibility Study.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1

    Therapeutic hypothermia improves outcomes after neonatal encephalopathy in high-income countries, however the safety and efficacy of cooling in low- and middle-income countries (LMIC) is not known.

  • Journal article
    Lally P, Pauliah S, Price D, Bainbridge A, Addison S, Soe A, Pattnayak S, Satodia P, Wayte S, Ng'andwe E, Clarke P, Johnson G, Harigopal S, English P, Abernethy LJ, Turner M, Cheong J, Shankaran S, Cady E, Thayyil Set al., 2014,

    PC.45 Quantification of N-Acetylaspartate Concentration in the Neonatal Brain: Initial Results from the Multi-Centre Marble Study.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1

    Early cerebral proton magnetic resonance spectroscopy (MRS) predicts medium-term outcomes in neonatal encephalopathy (NE). Metabolite peak-area ratios are most commonly used for prognosis, but conflate pathological information from different metabolites. N-acetylaspartate (NAA) is predominantly neuronal and neuronal loss should result in reduced NAA absolute-concentration ([NAA]). Thus, thalamic [NAA] should offer significant prognostic value but is difficult to measure in a clinical setting. We have established a protocol for multi-centre [NAA] measurement with the aim to use it as a surrogate biomarker in phase II clinical trials.

  • Journal article
    Lally P, Price D, Bainbridge A, Pauliah S, Satodia P, Wayte S, Abernethy L, Turner M, Basheer A, Alavi A, Kirmi O, Jones B, Shankaran S, Cady E, Thayyil Set al., 2014,

    PC.26 Feasibility of Magnetic Resonance Spectroscopy in Examining Thalamic Metabolite Concentrations in a Multi-Centre Study of Neonatal Encephalopathy.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1, Pages: A44-A45

    Proton magnetic resonance spectroscopy (MRS) has high prognostic value in hypoxic ischaemic encephalopathy (HIE), however its multi-centre application is limited by inconsistencies between scanners and protocols. N-acetylaspartate (NAA) is predominantly neuronal: cerebral NAA concentration may be a more reliable HIE-severity biomarker than lactate/NAA.

  • Journal article
    Lally P, Zhang H, Pauliah S, Price D, Bainbridge A, Balraj G, Cady E, Shankaran S, Thayyil Set al., 2014,

    8.9 Microstructural Changes in Neonatal Encephalopathy Revealed with the Neurite Orientation Dispersion and Density Imaging (NODDI) Model.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1

    Although diffusion tensor imaging (DTI) fractional anisotropy (FA) is commonly used to quantify neural injury, it is non-specific and affected by a number of microstructural changes.

  • Journal article
    Lally P, Arthurs O, Addison S, Alavi A, Sebire NJ, Taylor A, Thayyil Set al., 2014,

    PFM.33 Estimating Maceration Severity Using Whole Body Magnetic Resonance T2 Relaxometry.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1, Pages: A92-A93

    Magnetic resonance (MR) imaging is an ideal modality to observe gross global changes in tissue structure, as is present with maceration. As tissue degrades, its MR transverse relaxation time (T2) should increase, with relaxometry methods enabling quantitative measurement of this.

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