Imaging for babies and imagining the rest of their lives

26 February 2024

Dr Kerstin PannekWhen a baby is born prematurely it’s a worrying time for parents who are told about the higher risks for neurodiversity for preterm-born children but aren’t told what this may mean for the health of their child and what interventions they may need. 

Physicist Dr Kerstin Pannek is on a mission to change this by employing Artificial Intelligence (AI) and sophisticated Diffusion MRI to help parents access the care their baby may need as soon as possible.

Kerstin, who is a Principal Research Fellow at the University of Queensland’s Queensland Digital Health Centre (QDHeC) and a senior research scientist at the CSIRO Australian e-Health Research Centre, has been working on imaging of brain development of premature babies for more than a decade.

Her research has focused on early identification of those premature babies who may be at highest risk of developing conditions like cerebral palsy (CP) while still being cared for in neonatal intensive care units (NICU), or shortly after going home.

“Cerebral palsy is caused by abnormal brain development or injury to the developing brain. Very preterm babies are at a higher risk because they spend the last trimester outside the womb, having to breathe, digest milk, and be exposed to the world before they are ready for it. This can have severe impacts on their brain development,” Kerstin said.

She was working on her PhD in neuroimaging at UQ from 2011-2014, and it was at about this time that the Royal Brisbane and Women’s Hospital (RBWH) acquired its first MRI-compatible incubator. This made it possible to perform MRIs on tiny babies for the first time.

“It was a great opportunity for me to get into this field and make a difference to newborns and potentially in their lives and in their families’ lives, that’s a great motivator for me to do this work,” she said.

The goal of her research has been how to predict neurodevelopmental outcomes for premature babies using non-invasive Diffusion MRI.

“Diffusion MRI is really cool because it gives you beautiful, coloured pictures – and it allows you to look at the brain microstructure, to look at myelination quantitatively, and to look at the structural organisation of the brain, to see how the different areas of the brain are connected.

“When I started this research with my colleagues at CSIRO, UQ and the RBWH, the benchmark was 10% of very preterm babies will develop CP – now that has reduced, here in Australia and internationally, to less than 5%.

“It is now also possible to get a ‘high risk’ diagnosis of CP by 5 months age now, whereas it used to be 18 months age. This allows families to access interventions much earlier, and can result in improved outcomes for the children,” she said.

Her most recent research focuses on very early Diffusion MRI imaging (32 weeks – or 8 weeks before the babies due date) and its associations motor and cognitive performance at the age of two.

“Our next step will be to look at whether we can predict outcomes from this early imaging which could help with earlier interventions for at-risk babies.”

Kerstin's perspective is as a scientist but also as the mother of two premature babies.

“Being a premmie mum has changed my perspective on my research. I used to be very focussed on brain imaging, but there’s a whole baby attached to the brain. We won’t get a complete picture from just one measurement, we need to look at the baby as a whole, at their parents and family situation.”

“I'm much more interested in prediction and taking a whole of baby approach rather than focusing only on the imaging.

“We are looking at the small changes, the small details in the imaging that might differentiate vulnerable babies from the healthy babies. The small details can give us other clues that you might not see on conventional MRIs,” she said.

“My goal is to put the imaging information together with all the clinical information we have about the baby and train an AI model that can help give clinicians and parents the information that they need to provide the best care for the baby.”

In late-2023 Dr Kerstin Pannek won first prize for her presentation on her work at the ANZ Chapter of the International Society for Magnetic Resonance in Medicine.