title: Magnetic Resonance-Guided Nasogastric Feeding Tube Placement for Neonates: A Preclinical Study.
abstract: Establishing postnatal nutrition delivery is challenging in neonates with immature sucking and swallowing ability. Enteral feeding is the gold standard for such patients, but their small size and fragility present challenges in nasogastric (NG) feeding tube placement. Feeding tubes are typically placed with x-ray guidance, which provides minimal soft tissue contrast and exposes the baby to ionizing radiation. This research investigates magnetic resonance (MR) guidance of NG feeding tube placement in neonates to provide improved soft tissue visualization without ionizing radiation.
  
  
  
  A novel feeding tube incorporating 3 solenoid coils for real-time tracking and guidance in the MR environment was developed. The feeding tube was placed 5 times in a rabbit with conventional x-ray guidance to assess mechanical stability and function. After x-ray procedures, the rabbit was transferred to a neonatal MR system, and the tube was placed 5 more times.
  
  
  
  In procedures guided by x-ray and MR, the feeding tube provided sufficient mechanical strength and functionality to access the esophagus and stomach of the rabbit. MR imaging provided significantly improved soft tissue contrast versus x-ray, which aided in proper tube guidance. Moreover, MR guidance allowed for real-time placement of the tube without the use of ionizing radiation.
  
  
  
  The feasibility and benefits offered by an MR-guided approach to NG feeding tube placement were demonstrated. The ability to acquire high-quality MR images of soft tissue without ionizing radiation and a contrast agent, coupled with accurate 3-dimensional device tracking, promises to have a powerful impact on future neonatal feeding tube placements.
authors: 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors: Barret
authors: B
authors: Daniels
authors: 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.|2 Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA.
authors: Christopher
authors: C
authors: Ireland
authors: 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors: Steven
authors: S
authors: Kraus
authors: 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors: John
authors: J
authors: Racadio
authors: 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors: Nicole
authors: N
authors: Hilvert
authors: 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors: Richard
authors: R
authors: Dunn
authors: 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.|2 Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA.
authors: Charles
authors: C
authors: Dumoulin
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D004195:Disease Models, Animal; D004750:Enteral Nutrition; D004947:Esophagus / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D011817:Rabbits; D013270:Stomach / Q000000981:diagnostic imaging
keywords: MR tracking; active device tracking; enteral feeding; feeding tube; interventional MRI; nasogastric; neonate