# Bridging the gap: Translating fetal, infant, and toddler neuroimaging insights into clinical practice

## TL;DR

This paper reviews how fetal, infant, and toddler neuroimaging can improve pediatric care by identifying brain development issues early, while addressing challenges in translating these techniques into routine clinical use.

## Contribution

The paper proposes strategies and a framework to bridge the gap between FIT neuroimaging research and clinical practice, focusing on practical implementation in healthcare settings.

## Key findings

- FIT neuroimaging techniques like MRI and EEG are already used clinically to monitor brain development and injuries.
- Functional methods like fMRI and MEG offer insights into brain function but are not yet standard in clinical settings.
- Barriers such as cost, safety, and predictive utility hinder the widespread adoption of advanced neuroimaging in clinical practice.

## Abstract

Over the past decade, fetal, infant, and toddler (FIT) neuroimaging has become a rapidly expanding field, driven by advances in technology and computational methods. By providing non-invasive ways to explore the developing brain in both typical and pathological development, FIT neuroimaging holds promise for advancing pediatric medicine. Magnetic resonance imaging (MRI), ultrasonography, and electroencephalography (EEG) are regularly used in clinical practice to identify or rule out structural brain abnormalities; monitor the timing and evolution of brain injuries; assess brain growth and maturation; diagnose and monitor seizures, including infantile spasms; and facilitate pre-surgical planning. Other methods, including functional MRI, magnetoencephalography (MEG), and near-infrared spectroscopy (NIRS), provide information about brain function but have not yet been considered standard-of-care. As the field has rapidly advanced, numerous barriers (e.g., concerns regarding cost-effectiveness, safety, availability and portability, bedside applicability, suitability for serial imaging, and uncertain predictive utility) have hindered the routine use of neuroimaging techniques. This review focuses on how FIT neuroimaging research can be applied beyond academic settings to improve outcomes in clinical environments, such as high-risk follow-up programs and neonatal and pediatric intensive care units. Key topics include: (1) how FIT neuroimaging can advance pediatric medicine; (2) challenges and gaps in translating FIT neuroimaging to clinical practice; (3) proposed strategies for bridging these gaps; and (4) a framework for clinical translation and future directions to enhance pediatric healthcare and developmental outcomes.