R01HD104720

Understanding Skeletal Growth Using Diffusion Tensor Imaging of the Physis and Metaphysis - Project Summary

Serial assessment of the main organ of longitudinal skeletal growth, the growth plate or physis, with a novel MR technique, Diffusion Tensor Imaging of the Physis and Metaphysis (DTI-P/M), can improve clinical decision making for conditions that lead to short stature in children. Treatment of short stature using growth hormone (GH) therapy leads to healthcare costs that can rise to $11 billion per year.

Assessing response to GH requires determination of height velocity, which currently relies on insensitive external measurements of length or stature and requires height measurements at least 1 year apart. Predicting growth potential, crucial to identifying who will benefit from growth-enhancing treatment, is currently estimated by assessing physeal changes on the hand that only indirectly reflect those of the knee, where most skeletal growth occurs.

This proposal addresses an unmet clinical need for a better tool to determine height velocity and predict growth potential. We have pioneered DTI-P/M of the knee, a technique that generates tracts based on anisotropic diffusion of water through the physeal and metaphyseal columns, to measure tract volume, tract length, and fractional anisotropy (FA), a marker of tissue organization.

Our proposal overcomes current gaps in knowledge regarding DTI-P/M measurements over time and in response to GH. Our specific aims will test the central hypothesis that DTI-P/M of the distal femur can be established as a diagnostic and predictive tool for height velocity, growth potential, and GH response:

Aim 1) Predict height velocity using DTI-P/M parameters during the adolescent growth spurt in 60 children;
Aim 2) Predict growth potential during cessation of adolescent growth in 40 children;
Aim 3) Assess response to GH therapy based on early changes in DTI-P/M parameters by analyzing tract volume and length and FA in 50 children prior to initiation of GH therapy and at 4, 8, and 12 month clinical follow-ups.

Achieving these aims will validate DTI-P/M as a tool for precision therapy with growth-enhancing medications and improved timing of orthopedic procedures.

The Trustees Of Columbia University In The City Of New York

TO CONDUCT AND SUPPORT LABORATORY RESEARCH, CLINICAL TRIALS, AND STUDIES WITH PEOPLE THAT EXPLORE HEALTH PROCESSES. NICHD RESEARCHERS EXAMINE GROWTH AND DEVELOPMENT, BIOLOGIC AND REPRODUCTIVE FUNCTIONS, BEHAVIOR PATTERNS, AND POPULATION DYNAMICS TO PROTECT AND MAINTAIN THE HEALTH OF ALL PEOPLE. TO EXAMINE THE IMPACT OF DISABILITIES, DISEASES, AND DEFECTS ON THE LIVES OF INDIVIDUALS. WITH THIS INFORMATION, THE NICHD HOPES TO RESTORE, INCREASE, AND MAXIMIZE THE CAPABILITIES OF PEOPLE AFFECTED BY DISEASE AND INJURY. TO SPONSOR TRAINING PROGRAMS FOR SCIENTISTS, DOCTORS, AND RESEARCHERS TO ENSURE THAT NICHD RESEARCH CAN CONTINUE. BY TRAINING THESE PROFESSIONALS IN THE LATEST RESEARCH METHODS AND TECHNOLOGIES, THE NICHD WILL BE ABLE TO CONDUCT ITS RESEARCH AND MAKE HEALTH RESEARCH PROGRESS UNTIL ALL CHILDREN, ADULTS, FAMILIES, AND POPULATIONS ENJOY GOOD HEALTH. THE MISSION OF THE NICHD IS TO ENSURE THAT EVERY PERSON IS BORN HEALTHY AND WANTED, THAT WOMEN SUFFER NO HARMFUL EFFECTS FROM REPRODUCTIVE PROCESSES, AND THAT ALL CHILDREN HAVE THE CHANCE TO ACHIEVE THEIR FULL POTENTIAL FOR HEALTHY AND PRODUCTIVE LIVES, FREE FROM DISEASE OR DISABILITY, AND TO ENSURE THE HEALTH, PRODUCTIVITY, INDEPENDENCE, AND WELL-BEING OF ALL PEOPLE THROUGH OPTIMAL REHABILITATION.

93.865 - Child Health and Human Development Extramural Research

National Institute of Child Health and Human Development (NICHD) [HHS - NIH]

New York, New York 100321559 United States

Single Zip Code

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the total obligations have increased 384% from $642,116 to $3,110,087.