Intracranial volume in craniosynostosis.
Research type
Research Study
Full title
Change in intracranial volume with growth in children with craniosynostosis.
IRAS ID
282523
Contact name
Fintan Sheerin
Contact email
Sponsor organisation
Joint Research Office, Oxford University Hospitals
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Summary of Research
Craniosynostosis is an abnormality of skull growth which affects up to one in 1,400 children. It is caused by early fusion of the skull sutures and can result in an abnormal head shape. There are several types of craniosynostosis, depending on the suture affected and the presence of an associated syndrome. Computed tomography (CT) scans are used to diagnose and characterise the type of craniosynostosis. Craniosynostosis can be treated by surgery to temporarily remove, and reshape affected parts of the skull.
The decision of whether and when to surgically treat craniosynostosis in an individual child depends on several factors. One of the most important problems associated with craniosynostosis is increased pressure on the brain (or intracranial pressure – ICP). Raised ICP can have serious consequences, such as delayed development, hence it must be detected and treated at an early stage. The most accurate method of monitoring ICP is using a pressure monitor inserted through the skull into the brain.
The aim of this study is twofold. Firstly, we aim to produce reference curves for the volume of the skull in normal unaffected children and each different type of craniosynostosis. In the future, this will enable like-for-like comparison and monitoring. Secondly, we aim to look for a relationship between features on brain scans and ICP. We hope to use this to develop a model to predict ICP using information from brain scans. If successful, this will be a non-invasive way to detect the presence of raised ICP. To fulfil these aims, we will use existing data from CT scans already performed for clinical indications at Oxford.
In the future, we believe this study can have several important benefits for children with craniosynostosis. In particular, we hope to improve the monitoring of this condition and support decision-making with respect to surgical treatment.Summary of Results
: Patients with craniosynostosis are at risk from intracranial space constriction, which can result in raised intracranial pressure. In this retrospective study, we developed and validated an automated approach to measure intracranial volume (ICV) from CT scans in children with craniosynostosis. Using 3D CTs from healthy children, we generated gender-specific nomograms. Then, we calculated ICV in children with craniosynostosis. Automatically calculated ICVs showed excellent agreement with ICVs segmented manually in a subset of patients. Children with craniosynostosis under the age of 1 had higher ICV values than controls.
The normative data generated in this study provide reference growth charts to interpret individual patient-derived ICV relative to patterns of typical childhood head growth. Combined with automated methods to calculate ICV, these data may help to address fundamental questions about head growth in subtypes of craniosynostosis, as well as tracking head volume and centile trends over time after cranial reconstruction surgery and in cases with proven raised pressure.REC name
North of Scotland Research Ethics Committee 2
REC reference
21/NS/0061
Date of REC Opinion
13 May 2021
REC opinion
Favourable Opinion