Large airway obstruction, subglottic stenosis, tracheal narrowing, and tracheomalacia are common morbidities associated with prematurity secondary to prolonged intubation. Laryngotracheoplasty is often required to alleviate subglottic stenosis and allow a patient to be decannulated from their tracheostomy. Patients will often have continued airway and voice issues despite being able to live without a tracheostomy. The clinical conundrum in treating this patient is whether vocal folds can be surgically moved closer together to improve vocalization without compromising the airway further and increasing resistance. Here we demonstrate how this clinical conundrum can be informed by CT-derived CFD modeling in a 15-year-old male former 31-week preterm infant with dysphonia and subglottic airway narrowing at the cervical trachea and narrow vocal cords. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Elma Alexander, Bates Alister, Xiao Qiwei, De Alarcon Alessandro, Fleck Robert

Keywords: compurtational fluid dynamics, airway modeling, subglottic stenosis

To develop an optimized AI model to automatically segment lung volumes from pulmonary magnetic resonance images (MRI) and generate tidal volume calculations for neonatal patients with chronic lung disease of prematurity (bronchopulmonary dysplasia, BPD). Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Mahalingam Neeraja, Bates Alister, Higano Nara, Gunatilaka Chamindu, Woods Jason, Somasundaram Elanchezhian

Keywords: Bronchopulmonary Dysplasia, MRI, Deep Learning

Tracheomalacia (TM) is a common morbidity associated with prematurity and manifests as dynamic collapse of the trachea lumen due to cyclic changes of intrathoracic pressure during breathing. Premature infants often have elevated work of breathing (WOB) related to their distal, small airway and lung abnormalities. The large airway contribution to WOB can be determined using computational fluid dynamics (CFD), which is a well-known technique to calculate the resistance and WOB in the human airway. However, previous studies are based on static airway geometry without motion. Using the novel technique of ultrashort echo time (UTE) magnetic resonance imaging (MRI), the tidal volume and airway motion can be used to create a dynamic model for use in CFD. Our aim is to calculate the estimated WOB in a dynamic trachea with neonatal TM compared with a stable, static trachea. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Gunatilaka Chamindu, Bates Alister, Higano Nara, Hahn Andrew, Fain Sean, Hysinger Erik, Fleck Robert, Woods Jason

Keywords: Bronchopulmonary Dysplasia, MRI, Prematurity

Qualitative scores of parenchymal disease severity from 3D lung MRI predict clinical outcomes such as duration of respiratory support in infants with BPD. However, current methods suffer from low signal-to-noise ratio (SNR) and motion-related blurring, reducing interpretability and diagnostic confidence. The inherently quiet zero echo time (ZTE) MRI with deep learning reconstruction (DLR) may improve diagnostic reliability but has not been evaluated in infants. This study assessed the feasibility of ZTE MRI and image quality improvements with DLR in infants with BPD. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Munidasa Samal, Bates Alister, Kingma Paul, Hysinger Erik, Woods Jason, Willmering Matthew, Muslu Yavuz, De Arcos Jose, Morin Cara, Kocaoglu Murat, Fleck Robert, Pednekar Amol, Tanimoto Aki, Higano Nara

Keywords: Neonatal, Deep Learning, Pulmonary