# Development of CT image-based cranial bone markers of intra-cranial hypertension

> **NIH NIH R21** · UNIVERSITY OF COLORADO DENVER · 2024 · $237,131

## Abstract

Project summary
The identification of intracranial hypertension (ICH) is essential during pediatric neurological and neurosurgical
evaluation. If untreated, it may lead to brain injury, developmental delay or even death. However, current non-
invasive evaluation of ICH is based on clinical symptoms that have poor correlation with it, and imaging
findings are highly variable and subjective. Hence, non-invasive evaluation of ICH is challenging and often
inconclusive. Additionally, invasive intracranial pressure monitors can help identify ICH but they are usually
avoided because they often offer inconclusive results and carry important risks of hemorrhage and infections.
Consequently, ICH remains underdiagnosed in the population. In this project, we aim to create non-invasive
methods to automatically identify the presence of ICH in pediatric patients using CT images of the head.
The main hypothesis of this project is that an elevated intracranial pressure results into a decrease of bone
mineralization, which can be quantified from CT images. This hypothesis is supported by clinical reports of
patients with elevated pressure or brain growth constraints showing thinner and less dense cranial bones, and
of patient with intracranial hypotension presenting an abnormally thick cranial bone.
During this project, we will: (1) create a sex- and age-specific normative statistical model of cranial bone
thickness and density between birth and 10 years using a large retrospective CT image dataset of subjects
without cranial pathology; (2) quantify bone abnormalities in patients with ICH and create machine learning
models to identify them using a retrospective dataset of patients who required surgical treatment for pressure
release; and (3) perform a pilot study to identify and quantify local signs of elevated pressure in patients with
cranial growth constraints caused by craniosynostosis. Upon completion of this project, we will have
established normative references of cranial bone mineralization, identified and quantified bone mineralization
changes associated with ICH, and created automatic tools to identify them. In addition, if our exploratory study
in patients with craniosynostosis succeeds, it will prompt a larger clinical study of the presence of ICH in these
patients that could translate in a substantial improvement of their clinical management through timely
interventions, especially in older children and relapsing patients.

## Key facts

- **NIH application ID:** 10892783
- **Project number:** 5R21DE031824-02
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** David V Conti
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $237,131
- **Award type:** 5
- **Project period:** 2023-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10892783

## Citation

> US National Institutes of Health, RePORTER application 10892783, Development of CT image-based cranial bone markers of intra-cranial hypertension (5R21DE031824-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10892783. Licensed CC0.

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