# Understanding Skeletal Growth Using Diffusion Tensor Imaging of the Physis and Metaphysis

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2021 · $642,116

## Abstract

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; and 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.

## Key facts

- **NIH application ID:** 10183641
- **Project number:** 1R01HD104720-01
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** DIEGO JARAMILLO
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $642,116
- **Award type:** 1
- **Project period:** 2021-04-15 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10183641

## Citation

> US National Institutes of Health, RePORTER application 10183641, Understanding Skeletal Growth Using Diffusion Tensor Imaging of the Physis and Metaphysis (1R01HD104720-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10183641. Licensed CC0.

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