Radial Structure in the Preterm Cortex; Persistence of the Preterm Phenotype at Term Equivalent Age? Andrew Melbourne 1 , Giles S. Kendall 2 , M. Jorge Cardoso 1 , Roxanna Gunney 3 , Nicola J. Robertson 2 , Neil Marlow 2 , and Sebastien Ourselin 1 1 Centre for Medical Image Computing, University College London, UK 2 Academic Neonatology, EGA UCL Institute for Women’s Health, London, UK 3 Neuroradiology, Great Ormond Street Hospital for Children NHS Trust, London, UK Abstract. Preterm birth increases the risk of perinatal brain injury and is believed to initiate a cascade of processes causing white matter damage resulting in subsequent neurological deficit; neonatal magnetic resonance imaging provides a number of potential biomarkers of this deficit. In this work we unify measures of the cortical folding pattern and of white mat- ter integrity to establish correlation between grey and white matter de- rived properties. Diffusion weighted MRI has revealed that the cortical grey matter in the extremely preterm period exhibits a strong transient radial organisation suggesting neuronal axons are orientated towards the underlying white matter. This effect is lost during cortical maturation and is considered no longer visible on MRI at term equivalent age. Here we show that, in a group of 19 infants, radial organisation in the cor- tical grey matter remains detectable at term-equivalent age and that there is a strong anterior-posterior asymmetry. A group of three infants with moderate or severe abnormal white matter abnormality have signif- icantly higher cortical grey matter radial organisation (p< 0.02), higher grey matter FA (p< 0.01) and a lower measure of cortical complexity (p< 0.03) than infants with normal or mild abnormal white matter ab- normality; all measures associated with the preterm phenotype before term equivalent age. The novel combination of state-of-the-art imaging techniques, analysing grey-matter based spatial characteristics, may pro- vide insight into the mechanism of neurodevelopmental deficits seen in infants with abnormal MR imaging at term equivalent age. 1 Introduction Preterm brain injury is increasingly recognised to be an amalgamation of specific brain injury and abnormal brain development [1]. Advances in MR techniques including volumetric and cortical surface analysis [2] have begun to define dif- ferences in the brains of preterm infants imaged at term compared to term born controls and thus can help define biomarkers for prediction of subsequent neurodevelopment outcome. This preterm brain phenotype extends beyond re- duction in volume and anisotropy of the cortical white matter to encompass decreased volume in the cortical grey matter, basal ganglia and cerebellum. N. Ayache et al. (Eds.): MICCAI 2012, Part III, LNCS 7512, pp. 256–263, 2012. c  Springer-Verlag Berlin Heidelberg 2012