Novel CT imaging method may identify premature skull fusion
A new imaging technology designed to predict whether a child’s skull bones are likely to grow back together too quickly after surgery is being developed by researchers in the Center for Pediatric Healthcare Technology Innovation at Georgia Institute of Technology in Atlanta. Also in the works are new technologies that may delay the premature fusion process.
Craniosyntosis affects nearly one in 2,500 babies in the U.S., causing bone plates in the skull to fuse too soon, typically requiring surgery after birth to remove portions of the fused bones. If untreated, the condition can cause a range of developmental problems, but even after a first treatment, studies indicate that 6 percent of patients need a second operation to separate the bones again, and some require a third.
“Following the first surgery, there’s a clinical need to be able to screen children on a regular basis to predict when their skull bones are going to fuse together again so that the surgeons can determine if additional intervention will be required,” Center Director Barbara D. Boyan, PhD, said in a statement.
Researchers have developed a noninvasive technique to monitor bone growth with CT images, according to findings recently presented at the 2011 Plastic Surgery Education Foundation conference.
“Using our snake algorithm to analyze computed tomography images of developing skulls in mice, we were able to monitor different types and speeds of bone growth on a daily basis for many weeks,” said Chris Hermann, MD, PhD candidate in the Coulter Department. “While one suture fused between 12 and 20 days and then significantly increased in mass for the next 20 days, another came close together and increased in mass but remained largely open.”
The technology was recently adapted for use in children and a clinical study is under way to determine its effectiveness in monitoring craniosyntosis. Researchers are also working to identify genes that influence suture fusion, and have designed a gel that can be injected into the gap after the first skull surgery to delay, but not prevent, bone growth.
“During the initial surgery, injecting the gel may reduce the operation's severity if it eliminates the need for plates and screws to hold the skull bones in place afterward,” said Boyan. “After the surgery, if the CT images tell us that the skull is closing too quickly, we may be able to inject the gel through the skin overlying the skull without surgery to further delay the bones from fusing.”
Craniosyntosis affects nearly one in 2,500 babies in the U.S., causing bone plates in the skull to fuse too soon, typically requiring surgery after birth to remove portions of the fused bones. If untreated, the condition can cause a range of developmental problems, but even after a first treatment, studies indicate that 6 percent of patients need a second operation to separate the bones again, and some require a third.
“Following the first surgery, there’s a clinical need to be able to screen children on a regular basis to predict when their skull bones are going to fuse together again so that the surgeons can determine if additional intervention will be required,” Center Director Barbara D. Boyan, PhD, said in a statement.
Researchers have developed a noninvasive technique to monitor bone growth with CT images, according to findings recently presented at the 2011 Plastic Surgery Education Foundation conference.
“Using our snake algorithm to analyze computed tomography images of developing skulls in mice, we were able to monitor different types and speeds of bone growth on a daily basis for many weeks,” said Chris Hermann, MD, PhD candidate in the Coulter Department. “While one suture fused between 12 and 20 days and then significantly increased in mass for the next 20 days, another came close together and increased in mass but remained largely open.”
The technology was recently adapted for use in children and a clinical study is under way to determine its effectiveness in monitoring craniosyntosis. Researchers are also working to identify genes that influence suture fusion, and have designed a gel that can be injected into the gap after the first skull surgery to delay, but not prevent, bone growth.
“During the initial surgery, injecting the gel may reduce the operation's severity if it eliminates the need for plates and screws to hold the skull bones in place afterward,” said Boyan. “After the surgery, if the CT images tell us that the skull is closing too quickly, we may be able to inject the gel through the skin overlying the skull without surgery to further delay the bones from fusing.”