Respiratory Motion Analysis in Children With MRI

Cardiac magnetic resonance imaging (MRI) is used heavily in the research setting but its use
is limited in clinical practice, the main reason being artifact (noise) from respiratory and
cardiac motion. To counteract these sources of motion, many different applications have
been applied. For cardiac motion, ECG (electrocardiogram) gating is widely used, while
respiratory motion reduction uses methods of breath holding or respiratory gating
techniques.

Patients will be recruited based on whether they are a normal healthy volunteer or a patient
already receiving a routine cardiac MRI.

Normal Healthy Volunteers Patients will be recruited via a flyer posted in various locations
at Emory University. The contents of this flyer will adhere strictly to Emory IRB
Advertisement guidelines. Subjects will register by contacting Marijn Brunner, PhD, by
email or telephone.

Patients already scheduled for a routine cardiac MRI The MRI technical specialist will
review the laboratory schedule daily. Those who are already scheduled for a routine cardiac
MRI will be approached by a study staff member in the Children's MRI Department. The
patient will be asked if he/she would wish to enroll in this study. The patient will be
requested to sign a consent prior to any study procedures being performed.

MRI image data will be collected by the prescribed protocol for respiratory monitoring. All
MRI data will be acquired by standard FDA approved imaging methods. The image data will be
transferred by network to the Pediatrics Imaging Research Laboratory where they will be
stored on a password-protected computer and analyzed.

Inclusion Criteria:

- We will recruit two groups of patients - 35 healthy volunteers (21 years or older)
and 25 cardiac MRI patients of different age groups.

We wish to recruit cardiac patients from Children's Healthcare of Atlanta into five (5)
different categories defined by the overall characteristics of breathing motion. The
categories are:

1. neonates/infants (shallow belly breathing)

2. young children (unable to do controlled breathing or breath-holding on command, up to
approximately 7 years of age)

3. older children capable of controlled breathing/breath-holding on command
(approximately 8-12 years of age)

4. teenagers/adolescents/young adults (ages 13 through 17)

5. adults (18 and older) These categories may be adjusted or modified during the project
as deemed appropriate based on the analysis results.

We will recruit 10 - 35 healthy volunteer subjects for scans to define the MRI imaging
protocol for respiratory motion monitoring. Healthy subjects are defined as those
individuals who do not have a prior history of heart or lung disease nor are currently
diagnosed with heart or lung disease. This information will be obtained verbally during
the subject screening process.

Exclusion Criteria:

- No exclusion criteria will be placed on any sub-population based on age, gender or
race other than the patient not freely giving written informed consent or having a
history or current diagnosis of heart or lung disease. However, the normal exclusion
criteria for MRI exams will still be adhered to:

1. subjects with pacemakers, medical implants, aneurysm clips, or imbedded metal
fragments will be excluded because of potential effects of the magnetic field

2. women who are pregnant or who may be pregnant will be excluded because of the
potential of a high level of RF power deposition on the fetus

3. subjects who may experience claustrophobia will be excluded because of their
inability to remain in the magnet for the time required to complete the exam