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Bolar DS, Barnes RA, Chen C, Han F, Pfeuffer J, Liu TT, Wong EC. Reduced B 0/B 1 + sensitivity in velocity-selective inversion arterial spin labeling using adiabatic refocusing pulses. Magn Reson Med 2024. [PMID: 39011598 DOI: 10.1002/mrm.30210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE To mitigate the B0/B1 + sensitivity of velocity-selective inversion (VSI) pulse trains for velocity-selective arterial spin labeling (VSASL) by implementing adiabatic refocusing. This approach aims to achieve artifact-free VSI-based perfusion imaging through single-pair label-control subtractions, reducing the need for the currently required four-pair dynamic phase-cycling (DPC) technique when using a velocity-insensitive control. METHODS We introduce a Fourier-transform VSI (FT-VSI) train that incorporates sinc-modulated hard excitation pulses with MLEV-8-modulated adiabatic hyperbolic secant refocusing pairs. We compare performance between this train and the standard composite refocusing train, including with and without DPC, for dual-module VSI VSASL. We evaluate (1) simulated velocity-selective profiles and subtraction fidelity across a broad B0/B1 + range, (2) subtraction fidelity in phantoms, and (3) image quality, artifact presence, and gray-matter perfusion heterogeneity (as measured by the spatial coefficient of variation) in healthy human subjects. RESULTS Adiabatic refocusing significantly improves FT-VSI robustness to B0/B1 + inhomogeneity for a single label-control subtraction. Subtraction fidelity is dramatically improved in both simulation and phantoms compared with composite refocusing without DPC, and is similar compared with DPC methods. In humans, marked artifacts seen with the non-DPC composite refocusing approach are eliminated, corroborated by significantly reduced gray-matter heterogeneity (via lower spatial coefficient of variation values). CONCLUSION A novel VSASL labeling train using adiabatic refocusing pulses for VSI was found to reduce artifacts related to B0/B1 + inhomogeneity, thereby providing an alternative to DPC and its associated limitations, which include increased vulnerability to physiological noise and motion, reduced functional MRI applicability, and suboptimal data censoring.
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Affiliation(s)
- Divya S Bolar
- Center for Functional MRI, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Ryan A Barnes
- Center for Functional MRI, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Conan Chen
- Center for Functional MRI, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
- Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, California, USA
| | - Fei Han
- Siemens Medical Solutions, Malvern, Pennsylvania, USA
| | - Josef Pfeuffer
- Application Development, Siemens Healthineers AG, Erlangen, Germany
| | - Thomas T Liu
- Center for Functional MRI, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Eric C Wong
- Center for Functional MRI, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
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Zhang K, Triphan SMF, Wielpütz MO, Ziener CH, Ladd ME, Schlemmer HP, Kauczor HU, Sedlaczek O, Kurz FT. Non-contrast free-breathing liver perfusion imaging using velocity selective ASL combined with prospective motion compensation. Z Med Phys 2024:S0939-3889(24)00051-5. [PMID: 38960810 DOI: 10.1016/j.zemedi.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/28/2024] [Accepted: 06/11/2024] [Indexed: 07/05/2024]
Abstract
PURPOSE To apply velocity selective arterial spin labeling (VSASL) combined with a navigator-based (NAV) prospective motion compensation method for a free-breathing liver perfusion measurement without contrast agent. METHODS Sinc-modulated Velocity Selective Inversion (sinc-VSI) pulses were applied as labeling and control pulses. In order to account for respiratory motion, a navigator was employed in the form of a single gradient-echo projection readout, located at the diaphragm along the inferior-superior direction. Prior to each transverse imaging slice of the spin-echo EPI based readouts, navigator and fat suppression were incorporated. Motion data was obtained from the navigator and transmitted back to the sequence, allowing real-time adjustments to slice positioning. The sinc-VSI without velocity-selective gradients during the control condition but with velocity-selective gradients along all three directions during labeling was chosen for the VSASL. The VSASL was compared with pseudo-continuous ASL (pCASL) methods, which selectively tagged the moving spins using a tagging plane placed at the portal vein and hepatic artery. RESULTS The motion caused by respiratory activity was effectively computed using the navigator signal. The coefficients of variation (CoV) of average liver voxel in NAV were significantly decreased when compared to breath-hold (BH), with an average reduction of 29.4 ± 18.44% for control images, and 29.89 ± 20.83% for label images (p < 0.001). The resulting maps of normalized ASL signal (normalized to M0) showed significantly higher perfusion weightings in the NAV-compensated VSASL, when compared to the NAV-compensated pCASL techniques. CONCLUSIONS This study demonstrates the feasibility of using a navigator-based prospective motion compensation technique in conjunction with VSASL for the measurement of liver perfusion without the use of contrast agents while allowing for free-breathing.
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Affiliation(s)
- Ke Zhang
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany; Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Divison of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Simon M F Triphan
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany; Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Mark O Wielpütz
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany; Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Christian H Ziener
- Divison of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Mark E Ladd
- Divison of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany; Faculty of Physics and Astronomy, Heidelberg University, Heidelberg, Germany; Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | | | - Hans-Ulrich Kauczor
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany; Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Oliver Sedlaczek
- Department of Diagnostic & Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany; Department of Diagnostic & Interventional Radiology with Nuclear Medicine, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Divison of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Felix T Kurz
- Divison of Radiology, German Cancer Research Center, Heidelberg, Germany; Division of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland.
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Hu Y, Zhang K, Liu R. The effect of post-labeling delay on cerebral blood flow is influenced by age and sex: a study based on arterial spin-labeling magnetic resonance imaging. Quant Imaging Med Surg 2024; 14:4388-4402. [PMID: 39022245 PMCID: PMC11250344 DOI: 10.21037/qims-23-1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/22/2024] [Indexed: 07/20/2024]
Abstract
Background Whether the effect of post-labeling delay (PLD) on cerebral blood flow (CBF) is influenced by age and sex in adults is unknown. In this study, we mainly aimed to explore the potential influence of age and sex on the effect of PLD on CBF. Methods This prospective study enrolled 90 healthy adult volunteers (49.47±15.63 years of age; age range, 20-77 years; 47 female; 43 male). All participants underwent 3-dimensional (3D) pseudo-continuous arterial spin labeling (ASL) imaging with 3 different PLDs (1,525, 2,025, and 2,525 ms). The CBF values for each PLD, the arterial transit time (ATT), and the spatial coefficient of variation (spatial CoV) were computed for 21 regions of interest (ROIs) in every participant. Multivariate regression analysis was conducted to assess the potential influence of age and sex on the effect of PLD on CBF and the relationships among CBF, ATT, PLD, age, sex, and spatial CoV. Results The CBF increased for 7.32 to 9.87 mL/100 g/min as the PLD increased per 1 second in the global gray matter, bilateral frontal, temporal lobes, the vascular territories of bilateral anterior and middle carotid artery. When the age increased per 1 year, the speed of the changes for CBF decreased for 0.26 to 0.3 mL/100 g/min/s in these regions. However, the CBF decreased for 12 to 17 mL/100 g/min as the PLD increased per 1 second in the bilateral limbic lobes, insula, and deep gray matter. In these regions, the speed of the changes for CBF increased for 0.2 to 0.28 mL/100 g/min/s as the age increased per 1 year. Furthermore, compared to the female, the speed of the changes for CBF decreased for 3.58 to 4.6 mL/100 g/min/s for the male in global gray matter, bilateral frontal, limbic lobes, and the vascular territories of bilateral anterior carotid artery, and the speed increased 4.49 to 5.09 mL/100 g/min/s for the male in the limbic lobes. In addition, the CBF decreased with aging and the CBF tended to be higher in females compared to males. At the same time, we found that the ATT of all ROIs increased with age and manifested higher in males than females. Moreover, we found that CBF decreased with the increase of ATT, and the effect of ATT on CBF was less influenced by PLD. Finally, we found that the spatial CoV of ASL in certain regions increased with the increase of ATT and age, and was greater in males. Conclusions The effect of PLD on CBF can be influenced by age and sex. The relationships among CBF, ATT, PLD, age, sex, and spatial CoV found in this study may have certain significance for the study of ASL imaging in the future.
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Affiliation(s)
- Ying Hu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kai Zhang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Rongbo Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Seiter D, Chen R, Ludwig KD, Zhu A, Shah D, Wieben O, Johnson KM. Velocity-selective arterial spin labeling perfusion measurements in 2nd trimester human placenta with varying BMI. Placenta 2024; 150:72-79. [PMID: 38615536 PMCID: PMC11065564 DOI: 10.1016/j.placenta.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Proper placental development is crucial to fetal health but is challenging to functionally assess non-invasively and is thus poorly characterized in populations. Body mass index (BMI) has been linked with adverse outcomes, but the causative mechanism is uncertain. Velocity-selective arterial spin labeling (VS-ASL) MRI provides a method to non-invasively measure placental perfusion with robustness to confounding transit time delays. In this study, we report on the measurement of perfusion in the human placenta in early pregnancy using velocity-selective arterial spin labeling (VS-ASL) MRI, comparing non-obese and obese participants. METHODS Participants (N = 97) undergoing routine prenatal care were recruited and imaged with structural and VS-ASL perfusion MRI at 15 and 21 weeks gestation. Resulting perfusion images were analyzed with respect to obesity based on BMI, gestational age, and the presence of adverse outcomes. RESULTS At 15 weeks gestation BMI was not associated with placental perfusion or perfusion heterogeneity. However, at 21 weeks gestation BMI was associated with higher placental perfusion (p < 0.01) and a decrease in perfusion heterogeneity (p < 0.05). In alignment with past studies, perfusion values were also higher at 21 weeks compared to 15 weeks gestation. In a small cohort of participants with adverse outcomes, at 21 weeks lower perfusion was observed compared to participants with uncomplicated pregnancies. DISCUSSION These results suggest low placental perfusion in the early second trimester may not be the culpable factor driving associations of obesity with adverse outcomes.
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Affiliation(s)
- Daniel Seiter
- Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Ruiming Chen
- Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Kai D Ludwig
- Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Ante Zhu
- Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States; Radiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Dinesh Shah
- Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, United States
| | - Oliver Wieben
- Medical Physics, University of Wisconsin-Madison, Madison, WI, United States; Radiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Kevin M Johnson
- Medical Physics, University of Wisconsin-Madison, Madison, WI, United States; Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States; Radiology, University of Wisconsin-Madison, Madison, WI, United States.
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Lambrecht S, Liu D, Dzaye O, Kamson DO, Reis J, Liebig T, Holdhoff M, Van Zijl P, Qin Q, Lin DDM. Velocity-Selective Arterial Spin Labeling Perfusion in Monitoring High Grade Gliomas Following Therapy: Clinical Feasibility at 1.5T and Comparison with Dynamic Susceptibility Contrast Perfusion. Brain Sci 2024; 14:126. [PMID: 38391701 PMCID: PMC10886779 DOI: 10.3390/brainsci14020126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/24/2024] Open
Abstract
MR perfusion imaging is important in the clinical evaluation of primary brain tumors, particularly in differentiating between true progression and treatment-induced change. The utility of velocity-selective ASL (VSASL) compared to the more commonly utilized DSC perfusion technique was assessed in routine clinical surveillance MR exams of 28 patients with high-grade gliomas at 1.5T. Using RANO criteria, patients were assigned to two groups, one with detectable residual/recurrent tumor ("RT", n = 9), and the other with no detectable residual/recurrent tumor ("NRT", n = 19). An ROI was drawn to encompass the largest dimension of the lesion with measures normalized against normal gray matter to yield rCBF and tSNR from VSASL, as well as rCBF and leakage-corrected relative CBV (lc-rCBV) from DSC. VSASL (rCBF and tSNR) and DSC (rCBF and lc-rCBV) metrics were significantly higher in the RT group than the NRT group allowing adequate discrimination (p < 0.05, Mann-Whitney test). Lin's concordance analyses showed moderate to excellent concordance between the two methods, with a stronger, moderate correlation between VSASL rCBF and DSC lc-rCBV (r = 0.57, p = 0.002; Pearson's correlation). These results suggest that VSASL is clinically feasible at 1.5T and has the potential to offer a noninvasive alternative to DSC perfusion in monitoring high-grade gliomas following therapy.
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Affiliation(s)
- Sebastian Lambrecht
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Institute of Neuroradiology, University Hospital LMU Munich, 81377 Munich, Germany
| | - Dapeng Liu
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA
| | - Omar Dzaye
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - David O Kamson
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jonas Reis
- Institute of Neuroradiology, University Hospital LMU Munich, 81377 Munich, Germany
| | - Thomas Liebig
- Institute of Neuroradiology, University Hospital LMU Munich, 81377 Munich, Germany
| | - Matthias Holdhoff
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Peter Van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA
| | - Qin Qin
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA
| | - Doris D M Lin
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Xu H, Han H, Liu Y, Huo R, Lang N, Yuan H, Wang T, Zhao X. Perioperative cerebral blood flow measured by arterial spin labeling with different postlabeling delay in patients undergoing carotid endarterectomy: a comparison study with CT perfusion. Front Neurosci 2023; 17:1200273. [PMID: 37781254 PMCID: PMC10536277 DOI: 10.3389/fnins.2023.1200273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Background Arterial spin labeling (ASL) is a non-invasive technique for measuring cerebral perfusion. Its accuracy is affected by the arterial transit time. This study aimed to (1) evaluate the accuracy of ASL in measuring the cerebral perfusion of patients who underwent carotid endarterectomy (CEA) and (2) determine a better postlabeling delay (PLD) for pre- and postoperative perfusion imaging between 1.5 and 2.0 s. Methods A total of 24 patients scheduled for CEA due to severe carotid stenosis were included in this study. All patients underwent ASL with two PLDs (1.5 and 2.0 s) and computed tomography perfusion (CTP) before and after surgery. Cerebral blood flow (CBF) values were measured on the registered CBF images of ASL and CTP. The correlation in measuring perioperative relative CBF (rCBF) and difference ratio of CBF (DRCBF) between ASL with PLD of 1.5 s (ASL1.5) or 2.0 s (ASL2.0) and CTP were also determined. Results There were no significant statistical differences in preoperative rCBF measurements between ASL1.5 and CTP (p = 0.17) and between ASL2.0 and CTP (p = 0.42). Similarly, no significant differences were found in rCBF between ASL1.5 and CTP (p = 0.59) and between ASL2.0 and CTP (p = 0.93) after CEA. The DRCBF measured by CTP was found to be marginally lower than that measured by ASL2.0_1.5 (p = 0.06) and significantly lower than that measured by ASL1.5_1.5 (p = 0.01), ASL2.0_2.0 (p = 0.03), and ASL1.5_2.0 (p = 0.007). There was a strong correlation in measuring perioperative rCBF and DRCBF between ASL and CTP (r = 0.67-0.85, p < 0.001). Using CTP as the reference standard, smaller bias can be achieved in measuring rCBF by ASL2.0 (-0.02) than ASL1.5 (-0.07) before CEA. In addition, the same bias (0.03) was obtained by ASL2.0 and ASL1.5 after CEA. The bias of ASL2.0_2.0 (0.31) and ASL2.0_1.5 (0.32) on DRCBF measurement was similar, and both were smaller than that of ASL1.5_1.5 (0.60) and ASL1.5_2.0 (0.60). Conclusion Strong correlation can be found in assessing perioperative cerebral perfusion between ASL and CTP. During perioperative ASL imaging, the PLD of 2.0 s is better than 1.5 s for preoperative scan, and both 1.5 and 2.0 s are suitable for postoperative scan.
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Affiliation(s)
- Huimin Xu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Hualu Han
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China
| | - Ying Liu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Ran Huo
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Ning Lang
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Tao Wang
- Department of Neurosurgery, Peking University Third Hospital, Beijing, China
| | - Xihai Zhao
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China
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Lee S, Meyer BP, Hernandez-Garcia L, Kurpad SN, Schmit BD, Budde MD. Comparison and optimization of pCASL and VSASL for rat thoracolumbar spinal cord MRI at 9.4 T. Magn Reson Med 2023; 89:2305-2317. [PMID: 36744728 PMCID: PMC10050093 DOI: 10.1002/mrm.29603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate pseudo-continuous arterial spin labeling (pCASL) and velocity-selective arterial spin labeling (VSASL) for quantification of spinal cord blood flow (SCBF) in the rat thoracolumbar spinal cord. METHODS Labeling efficiency (LE) was compared between pCASL and three VSASL variants in simulations and both phantom and in vivo experiments at 9.4 T. For pCASL, the effects of label plane position and shimming were systematically evaluated. For VSASL, the effects of composite pulses and phase cycling were evaluated to reduce artifacts. Additionally, vessel suppression, respiratory, and cardiac gating were evaluated to reduce motion artifacts. pCASL and VSASL maps of spinal cord blood flow were acquired with the optimized protocols. RESULTS LE of the descending aorta was larger in pCASL compared to VSASL variants. In pCASL, LE off-isocenter was improved by local shimming positioned at the label plane and the anatomical level of labeling for the thoracic cord was only viable at the level of the T10 vertebra. Cardiac gating was essential to reduce motion artifacts. Both pCASL and VSASL successfully demonstrated comparable SCBF values in the thoracolumbar cord. CONCLUSION pCASL demonstrated high and consistent LE in the thoracic aorta, and VSASL was also feasible, but with reduced efficiency. A combination of cardiac gating and recording of actual post-label delays was important for accurate SCBF quantification. These results highlight the challenges and solutions to achieve sufficient ASL labeling and contrast at high field in organs prone to motion.
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Affiliation(s)
- Seongtaek Lee
- Joint Department of Biomedical Engineering, Marquette University & Medical College of Wisconsin, Milwaukee, WI
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI
| | - Briana P Meyer
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI
| | - Luis Hernandez-Garcia
- FMRI Laboratory, Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Shekar N Kurpad
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI
- Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
| | - Brian D Schmit
- Joint Department of Biomedical Engineering, Marquette University & Medical College of Wisconsin, Milwaukee, WI
| | - Matthew D Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI
- Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
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Lindner T, Bolar DS, Achten E, Barkhof F, Bastos-Leite AJ, Detre JA, Golay X, Günther M, Wang DJJ, Haller S, Ingala S, Jäger HR, Jahng GH, Juttukonda MR, Keil VC, Kimura H, Ho ML, Lequin M, Lou X, Petr J, Pinter N, Pizzini FB, Smits M, Sokolska M, Zaharchuk G, Mutsaerts HJMM. Current state and guidance on arterial spin labeling perfusion MRI in clinical neuroimaging. Magn Reson Med 2023; 89:2024-2047. [PMID: 36695294 PMCID: PMC10914350 DOI: 10.1002/mrm.29572] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 01/26/2023]
Abstract
This article focuses on clinical applications of arterial spin labeling (ASL) and is part of a wider effort from the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group to update and expand on the recommendations provided in the 2015 ASL consensus paper. Although the 2015 consensus paper provided general guidelines for clinical applications of ASL MRI, there was a lack of guidance on disease-specific parameters. Since that time, the clinical availability and clinical demand for ASL MRI has increased. This position paper provides guidance on using ASL in specific clinical scenarios, including acute ischemic stroke and steno-occlusive disease, arteriovenous malformations and fistulas, brain tumors, neurodegenerative disease, seizures/epilepsy, and pediatric neuroradiology applications, focusing on disease-specific considerations for sequence optimization and interpretation. We present several neuroradiological applications in which ASL provides unique information essential for making the diagnosis. This guidance is intended for anyone interested in using ASL in a routine clinical setting (i.e., on a single-subject basis rather than in cohort studies) building on the previous ASL consensus review.
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Affiliation(s)
- Thomas Lindner
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Divya S. Bolar
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Eric Achten
- Department of Radiology and Nuclear Medicine, Ghent University, Ghent, Belgium
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, UK
| | | | - John A. Detre
- Department of Neurology, University of Pennsylvania, Philadelphia PA USA
| | - Xavier Golay
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Matthias Günther
- (1) University Bremen, Germany; (2) Fraunhofer MEVIS, Bremen, Germany; (3) mediri GmbH, Heidelberg, Germany
| | - Danny JJ Wang
- Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles CA USA
| | - Sven Haller
- (1) CIMC - Centre d’Imagerie Médicale de Cornavin, Place de Cornavin 18, 1201 Genève 1201 Genève (2) Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (3) Faculty of Medicine of the University of Geneva, Switzerland. Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, P. R. China
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Hans R Jäger
- UCL Queen Square Institute of Neuroradiology, University College London, London, UK
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Meher R. Juttukonda
- (1) Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown MA USA (2) Department of Radiology, Harvard Medical School, Boston MA USA
| | - Vera C. Keil
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical sciences, University of Fukui, Fukui, JAPAN
| | - Mai-Lan Ho
- Nationwide Children’s Hospital and The Ohio State University, Columbus, OH, USA
| | - Maarten Lequin
- Division Imaging & Oncology, Department of Radiology & Nuclear Medicine | University Medical Center Utrecht & Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Xin Lou
- Department of Radiology, Chinese PLA General Hospital, Beijing, China
| | - Jan Petr
- (1) Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany (2) Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Nandor Pinter
- Dent Neurologic Institute, Buffalo, NY, USA. University at Buffalo Neurosurgery, Buffalo, NY, USA
| | - Francesca B. Pizzini
- Radiology Institute, Dept. of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Marion Smits
- (1) Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands (2) The Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Magdalena Sokolska
- Department of Medical Physics and Biomedical Engineering University College London Hospitals NHS Foundation Trust, UK
| | | | - Henk JMM Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
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9
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Zun Z, Shin T. Velocity-selective excitation: Principles and applications. NMR IN BIOMEDICINE 2023; 36:e4820. [PMID: 35994473 PMCID: PMC9845137 DOI: 10.1002/nbm.4820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/12/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Velocity-selective (VS) excitation is a relatively new type of excitation that can be useful for generating image contrast based on spin's motion. This review aims to explain the principles of VS excitation and their utilization for clinical applications. We first review the generalized excitation k-space formalism, which reveals a Fourier relationship between sequence parameters and excitation profiles for spins with arbitrary spatial location, off-resonance, and velocity. Based on the k-space framework, we analyze practical VS excitation pulse sequences that yield sinusoidal or sinc-shaped velocity profiles. Then we demonstrate how these two types of VS excitation can be used as magnetization preparation for clinical applications, including saturation- or inversion-based arterial spin labeling and black- or bright-blood angiography. We also discuss practical considerations and issues for each application, including the determination of design parameters and the effects of MR system errors, such as magnetic field offsets and eddy currents.
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Affiliation(s)
- Zungho Zun
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Taehoon Shin
- Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul, South Korea
- Graduate Program in Smart Factory, Ewha Womans University, Seoul, South Korea
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
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10
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Qin Q, Alsop DC, Bolar DS, Hernandez‐Garcia L, Meakin J, Liu D, Nayak KS, Schmid S, van Osch MJP, Wong EC, Woods JG, Zaharchuk G, Zhao MY, Zun Z, Guo J. Velocity-selective arterial spin labeling perfusion MRI: A review of the state of the art and recommendations for clinical implementation. Magn Reson Med 2022; 88:1528-1547. [PMID: 35819184 PMCID: PMC9543181 DOI: 10.1002/mrm.29371] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/16/2022] [Accepted: 06/08/2022] [Indexed: 12/11/2022]
Abstract
This review article provides an overview of the current status of velocity-selective arterial spin labeling (VSASL) perfusion MRI and is part of a wider effort arising from the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group. Since publication of the 2015 consensus paper on arterial spin labeling (ASL) for cerebral perfusion imaging, important advancements have been made in the field. The ASL community has, therefore, decided to provide an extended perspective on various aspects of technical development and application. Because VSASL has the potential to become a principal ASL method because of its unique advantages over traditional approaches, an in-depth discussion was warranted. VSASL labels blood based on its velocity and creates a magnetic bolus immediately proximal to the microvasculature within the imaging volume. VSASL is, therefore, insensitive to transit delay effects, in contrast to spatially selective pulsed and (pseudo-) continuous ASL approaches. Recent technical developments have improved the robustness and the labeling efficiency of VSASL, making it a potentially more favorable ASL approach in a wide range of applications where transit delay effects are of concern. In this review article, we (1) describe the concepts and theoretical basis of VSASL; (2) describe different variants of VSASL and their implementation; (3) provide recommended parameters and practices for clinical adoption; (4) describe challenges in developing and implementing VSASL; and (5) describe its current applications. As VSASL continues to undergo rapid development, the focus of this review is to summarize the fundamental concepts of VSASL, describe existing VSASL techniques and applications, and provide recommendations to help the clinical community adopt VSASL.
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Affiliation(s)
- Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - David C. Alsop
- Department of RadiologyBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMassachusettsUSA
| | - Divya S. Bolar
- Center for Functional Magnetic Resonance Imaging, Department of RadiologyUniversity of CaliforniaSan Diego La JollaCaliforniaUSA
| | | | - James Meakin
- Department of Radiology, Nuclear Medicine and AnatomyRadboud University Medical CenterNijmegenThe Netherlands
| | - Dapeng Liu
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Krishna S. Nayak
- Magnetic Resonance Engineering Laboratory, Ming Hsieh Department of Electrical EngineeringUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Sophie Schmid
- C.J. Gorter Center for high field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Matthias J. P. van Osch
- C.J. Gorter Center for high field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Eric C. Wong
- Center for Functional Magnetic Resonance Imaging, Department of RadiologyUniversity of CaliforniaSan Diego La JollaCaliforniaUSA
| | - Joseph G. Woods
- Center for Functional Magnetic Resonance Imaging, Department of RadiologyUniversity of CaliforniaSan Diego La JollaCaliforniaUSA
| | - Greg Zaharchuk
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Moss Y. Zhao
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Zungho Zun
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Jia Guo
- Department of BioengineeringUniversity of California RiversideRiversideCaliforniaUSA
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11
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Hu Y, Wei Q, Zhou Z, Hu J, Xie J, Xu J. Customized whole brain-covering 3D GRASE in multi-delay pseudo-continuous arterial spin labeling for duplex distinct hemodynamic mapping contrasts of brain tissues and circulation pathways. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac8591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/29/2022] [Indexed: 11/11/2022]
Abstract
Abstract
Gradient and spin echo (GRASE) is widely employed in arterial spin labeling (ASL) as an efficient readout sequence. Hemodynamic parameter mappings of perfusion, such as cerebral blood flow (CBF) and arterial transit time (ATT), can be derived via multi-delay ASL acquisitions. Multi-delay ASL perfusion imaging inevitably suffers limited signal-to-noise ratio (SNR) since a motion-sensitized vessel suppressing module has to be employed to highlight perfusion signals. The present work reveals that in multi-delay ASL, manipulation of GRASE sequence on either planar imaging echo echo train for adjusted spatial resolutions or FSE echo train for modulated extent of T
2-blurring can significantly alter the mapping contrasts among tissues and among cerebral lobes under different pathways of blood circulation, and meanwhile regulates SNR. Four separate multi-delay ASL scans with different echo train designs in 3D whole brain covering GRASE were carried out for healthy subjects to evaluate the variations in regard to the parameter quantifications and SNR. Based on the quantification mappings, the GRASE acquisition with moderate spatial resolution (3.5 × 3.5 × 4 mm3) and segmented k
z scheme was recognized for the first time to be recommended for more unambiguous CBF and ATT contrasts between GM and WM in conjunction with more enhanced ATT contrast between anterior and posterior cerebral circulations, with reasonably good SNR. The technical proposal is of great value for the cutting-edge research of a variety of neurological diseases of global concerns.
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12
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Zhang H, Lu M, Liu S, Liu D, Shen X, Sheng F, Han C, Cai J. The value of 3D pseudo-continuousarterial spin labeling perfusion imaging in moyamoya disease—Comparison with dynamic susceptibility contrast perfusion imaging. Front Neurosci 2022; 16:944246. [PMID: 35992916 PMCID: PMC9389231 DOI: 10.3389/fnins.2022.944246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022] Open
Abstract
Background and purpose 3D pseudo-continuous arterial spin labeling (3D pCASL) is commonly used to measure arterial cerebral blood flow (CBF). The aim of this study was to assess the clinical feasibility and accuracy of 3D pCASL in comparison with dynamic susceptibility contrast (DSC) perfusion imaging in moyamoya disease (MMD). Materials and methods A total of 174 MMD patients underwent 3D pCASL and DSC-MRI for evaluating cerebral blood perfusion. 3D-pCASL with two single post-labeling delay (PLD) times (1,500 and 2,500 ms) was used to measure CBF. The values of DSC-CBF and ASL-CBF were calculated for major arterial territories including the anterior, middle, and posterior cerebral arteries as well as the areas based on the Alberta Stroke Program Early CT Score (ASPECTS) template. The correlation between DSC-CBF and ASL-CBF was analyzed. The consistency and accuracy between the two methods in assessing the cerebral ischemic state before and after surgery were analyzed. Results The correlation between ASL (2,500 ms) and DSC-MRI was slightly better than the correlation between ASL (1,500 ms) and DSC-MRI in major vascular territories before revascularization. Significant correlations were observed between ASL (2,500 ms) and DSC-MRI and between ASL (1,500 ms) and DSC-MRI in major vascular territories after revascularization. For 44 surgically treated patients, the scores of ASPECTS for CBF on the operated side were significantly different before and after revascularization (p < 0.05) and showed good consistency on all the examination methods. A comparison of the scores of ASPECTS of the three parameters before and after revascularization showed that there was no statistical difference between them (p > 0.05). Conclusion Compared to DSC-MRI, 3D pCASL can assess the cerebral blood perfusion in MMD before and after revascularization effectively. 3D pCASL showed the feasibility and clinical utility value in patients with MMD.
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Affiliation(s)
- Hongtao Zhang
- Department of Radiology, The Fifth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Mingming Lu
- Department of Radiology, Pingjin Hospital, Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin, China
| | - Shitong Liu
- Department of Radiology, The Fifth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Dongqing Liu
- Department of Radiology, The Fifth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Xuxuan Shen
- Department of Neurosurgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Fugeng Sheng
- Department of Radiology, The Fifth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Fugeng Sheng,
| | - Cong Han
- Department of Neurosurgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- Cong Han,
| | - Jianming Cai
- Department of Radiology, The Fifth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- Jianming Cai,
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13
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Cerebral blood vessels and perfusion in the pediatric brain death: five cases studied by neuroimaging. Neuroradiology 2022; 64:1661-1669. [PMID: 35511244 DOI: 10.1007/s00234-022-02955-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/11/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To detect the cerebral blood vessels and perfusion using neuroimaging modalities including computed tomography angiography (CTA), computed tomography perfusion (CTP), and arterial spin labeling (ASL) in children with brain death (BD). METHODS According to the current children's BD criteria, 5 children (3 males, 2 females, mean age of 5.65 years) with BD were enrolled from January 2019 to December 2020. The imaging features of CTA, CTP, and ASL were evaluated to analyze the visualization of important intracranial blood vessels and the states of the cerebral blood flow (CBF) and cerebral blood volume (CBV) related to the region of interest (ROI) brain tissue during the two clinical assessments for BD. RESULTS The "4-point scale" scoring system of CTA was applied to evaluate BD and no negative results were detected. The CTP results of the 5 children suggested the cessation of cerebral circulation with 100% positive results. The ranges of CBF and CBV were 0.00-9.52 ml/100 g/min (mean value 4.95 ± 1.69 ml/100 g/min) and 0.00-1.34 ml/100 g (mean value 0.36 ± 0.20 ml/100 g), respectively. One patient also underwent ASL examination, which demonstrated a significant reduction in whole brain perfusion, indicating the absence of cerebral circulation. The CBF values of the brainstem, basal ganglia, and prefrontal lobe were 11.61 ± 1.49 ml/100 g/min, 7.81 ± 2.42 ml/100 g/min, and 9.94 ± 2.01 ml/100 g/min, respectively. CONCLUSION Neuroimaging examinations particularly CTA and CTP reveal well the hemodynamic and cerebral blood vessels changes of BD, which can be used as supplementary supportive evidence for the declaration of brain death in children.
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14
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Golay X, Ho ML. Multidelay ASL of the pediatric brain. Br J Radiol 2022; 95:20220034. [PMID: 35451851 PMCID: PMC10996417 DOI: 10.1259/bjr.20220034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/22/2022] [Indexed: 11/05/2022] Open
Abstract
Arterial spin labeling (ASL) is a powerful noncontrast MRI technique for evaluation of cerebral blood flow (CBF). A key parameter in single-delay ASL is the choice of postlabel delay (PLD), which refers to the timing between the labeling of arterial free water and measurement of flow into the brain. Multidelay ASL (MDASL) utilizes several PLDs to improve the accuracy of CBF calculations using arterial transit time (ATT) correction. This approach is particularly helpful in situations where ATT is unknown, including young subjects and slow-flow conditions. In this article, we discuss the technical considerations for MDASL, including labeling techniques, quantitative metrics, and technical artefacts. We then provide a practical summary of key clinical applications with real-life imaging examples in the pediatric brain, including stroke, vasculopathy, hypoxic-ischemic injury, epilepsy, migraine, tumor, infection, and metabolic disease.
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Affiliation(s)
- Xavier Golay
- MR Neurophysics and Translational Neuroscience, UCL Queen
Square Institute of Neurology London, London,
England, UK
| | - Mai-Lan Ho
- Radiology, Nationwide Children’s Hospital and The Ohio
State University, Columbus, OH,
USA
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15
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Solozhentseva K, Batalov A, Zakharova N, Goryaynov S, Pogosbekyan E, Pronin I. The Role of 3D-pCASL MRI in the Differential Diagnosis of Glioblastoma and Brain Metastases. Front Oncol 2022; 12:874924. [PMID: 35558515 PMCID: PMC9086561 DOI: 10.3389/fonc.2022.874924] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/21/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose The first aim of this study was to compare the intratumoral and peritumoral blood flow parameters in glioblastomas and brain metastases measured by pseudocontinuous arterial spin labeling MRI (3D pCASL). The second aim of this study was to determine whether pCASL could aid in identifying the source of brain metastases. Materials and Methods This study included 173 patients aged 12 to 83 years (median age—61 years), who were observed at the National Medical Research Center for Neurosurgery. All patients underwent preoperative MRI with pCASL perfusion. Thereafter patients were operated on and received histological diagnosis. No patients received preoperative chemo or radiotherapy. Results The values of maximum and normalized intratumoral blood flow were significantly higher in the group with gliblastoma than in the group with brain metastases: 168.98 + −91.96 versus 152.1 + −173.32 and 7.6 + −8.4 versus 9.3 + −5.33 respectively (p <0.01). However, ROC analysis showed low AUC specificity and sensitivity (0.64, 70%, 60% for mTBF and 0.66, 77%, 62% for nTBF). Peritumoral blood flow parameters were also higher in the glioblastoma group (29.61 + −22.89 versus 16.58 + −6.46 for mTBF and 1.63 + −1.14 versus 0.88 + −0.38 for nTBF, respectively; p <0.01). ROC analysis showed the following measurements of AUC, specificity, and sensitivity (0.75, 68%, 73% for mTBF and 0.77, 58%, 91% for nTBF). Regarding pCASL and various histological subsets of brain metastases, the study found statistically significant differences between the lung and melanoma metastases and the lung and kidney metastases. ROC analysis gave the following values for lung and melanoma metastases: AUC—0.76, specificity—75%, and sensitivity—73% for mTBF; 0.83, 67%, and 93% respectively, for nTBF. For lung and kidney metastases: AUC—0.74, specificity—70%, and sensitivity—93% for mTBF; 0.75, 70%, and 93% respectively, for nTBF. Conclusions pCASL could aid in differential diagnosis between glioblastoma and brain metastases. Measurement of peritumoral blood flow demonstrates higher specificity and sensitivity than with intratumoral blood flow. Moreover, pCASL provides the ability to distinguish lung metastases from kidney and melanoma metastases.
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Affiliation(s)
- Kristina Solozhentseva
- N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Artem Batalov
- N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Natalia Zakharova
- N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Sergey Goryaynov
- N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Eduard Pogosbekyan
- N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Igor Pronin
- N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia
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16
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Kitajima M, Uetani H. Arterial Spin Labeling for Pediatric Central Nervous System Diseases: Techniques and Clinical Applications. Magn Reson Med Sci 2022; 22:27-43. [PMID: 35321984 PMCID: PMC9849418 DOI: 10.2463/mrms.rev.2021-0118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL) are techniques used to evaluate brain perfusion using MRI. DSC requires dynamic image acquisition with a rapid administration of gadolinium-based contrast agent. In contrast, ASL obtains brain perfusion information using magnetically labeled blood water as an endogenous tracer. For the evaluation of brain perfusion in pediatric neurological diseases, ASL has a significant advantage compared to DSC, CT, and single-photon emission CT/positron emission tomography because of the lack of radiation exposure and contrast agent administration. However, in ASL, optimization of several parameters, including the type of labeling, image acquisition, background suppression, and postlabeling delay, is required, because they have a significant effect on the quantification of cerebral blood flow (CBF).In this article, we first review recent technical developments of ASL and age-dependent physiological characteristics in pediatric brain perfusion. We then review the clinical implementation of ASL in pediatric neurological diseases, including vascular diseases, brain tumors, acute encephalopathy with biphasic seizure and late reduced diffusion (AESD), and migraine. In moyamoya disease, ASL can be used for brain perfusion and vessel assessment in pre- and post-treatment. In arteriovenous malformations, ASL is sensitive to detect small degrees of shunt. Furthermore, in vascular diseases, the implementation of ASL-based time-resolved MR angiography is described. In neoplasms, ASL-derived CBF has a high diagnostic accuracy for differentiation between low- and high-grade pediatric brain tumors. In AESD and migraine, ASL may allow for accurate early diagnosis and provide pathophysiological information.
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Affiliation(s)
- Mika Kitajima
- Department of Medical Imaging Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan,Corresponding author: 4-24-1, Kuhonji, Chuo-ku, Kumamoto, Kumamoto 862-0976, Japan. Phone: +81-373-5483, Fax: +81-373-5519, E-mail:
| | - Hiroyuki Uetani
- Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
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17
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Batalov AI, Afandiev RM, Zakharova NE, Pogosbekyan EL, Shulgina AA, Kobyakov GL, Potapov AA, Pronin IN. 3D pseudo-continuous arterial spin labeling-MRI (3D PCASL-MRI) in the differential diagnosis between glioblastomas and primary central nervous system lymphomas. Neuroradiology 2022; 64:1539-1545. [PMID: 35112216 DOI: 10.1007/s00234-021-02888-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the study was to compare the parameters of blood flow in glioblastomas and primary central nervous system lymphomas (PCNSLs), measured by pseudo-continuous arterial spin labeling MRI (3D PCASL), and to determine the informativeness of this method in the differential diagnosis between these lesions. METHODS The study included MRI data of 139 patients with PCNSL (n = 21) and glioblastomas (n = 118), performed in the Burdenko Neurosurgical Center. No patients received chemotherapy, hormone therapy, or radiation therapy prior to MRI. On the 3D PCASL perfusion map, the absolute and normalized values of tumor blood flow were calculated in the glioblastoma and PCNSL groups (maxTBFmean and nTBF). RESULTS MaxTBFmean and nTBF in the glioblastoma group were significantly higher than those in the PCNSL group: 168.9 ml/100 g/min versus 65.6 and 9.3 versus 3.7, respectively (p < 0.001). Arterial spin labeling perfusion had high sensitivity (86% for maxTBFmean, 95% for nTBF) and specificity (77% for maxTBFmean, 73% for nTBF) in the differential diagnosis between PCNSL and glioblastomas. Blood flow thresholds were 98.9 ml/100 g/min using absolute blood flow values and 6.1 using normalized values, AUC > 0.88. CONCLUSION The inclusion of 3D PCASL in the standard MRI protocol can increase the specificity of the differential diagnosis between glioblastomas and PCNSL.
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Affiliation(s)
- A I Batalov
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - R M Afandiev
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
| | - N E Zakharova
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - E L Pogosbekyan
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - A A Shulgina
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - G L Kobyakov
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - A A Potapov
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - I N Pronin
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
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18
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Woods JG, Wong EC, Boyd EC, Bolar DS. VESPA ASL: VElocity and SPAtially Selective Arterial Spin Labeling. Magn Reson Med 2022; 87:2667-2684. [PMID: 35061920 DOI: 10.1002/mrm.29159] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/25/2021] [Accepted: 12/22/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE Spatially selective arterial spin labeling (ASL) perfusion MRI is sensitive to arterial transit times (ATT) that can result in inaccurate perfusion quantification when ATTs are long. Velocity-selective ASL is robust to this effect because blood is labeled within the imaging region, allowing immediate label delivery. However, velocity-selective ASL cannot characterize ATTs, which can provide important clinical information. Here, we introduce a novel pulse sequence, called VESPA ASL, that combines velocity-selective and pseudo-continuous ASL to simultaneously label different pools of arterial blood for robust cerebral blood flow (CBF) and ATT measurement. METHODS The VESPA ASL sequence is similar to velocity-selective ASL, but the velocity-selective labeling is made spatially selective, and pseudo-continuous ASL is added to fill the inflow time. The choice of inflow time and other sequence settings were explored. VESPA ASL was compared to multi-delay pseudo-continuous ASL and velocity-selective ASL through simulations and test-retest experiments in healthy volunteers. RESULTS VESPA ASL is shown to accurately measure CBF in the presence of long ATTs, and ATTs < TI can also be measured. Measurements were similar to established ASL techniques when ATT was short. When ATT was long, VESPA ASL measured CBF more accurately than multi-delay pseudo-continuous ASL, which tended to underestimate CBF. CONCLUSION VESPA ASL is a novel and robust approach to simultaneously measure CBF and ATT and offers important advantages over existing methods. It fills an important clinical need for noninvasive perfusion and transit time imaging in vascular diseases with delayed arterial transit.
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Affiliation(s)
- Joseph G Woods
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Eric C Wong
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Emma C Boyd
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA.,Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Divya S Bolar
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA
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19
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Wang DJJ, Le Bihan D, Krishnamurthy R, Smith M, Ho ML. Noncontrast Pediatric Brain Perfusion: Arterial Spin Labeling and Intravoxel Incoherent Motion. Magn Reson Imaging Clin N Am 2021; 29:493-513. [PMID: 34717841 DOI: 10.1016/j.mric.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Noncontrast magnetic resonance imaging techniques for measuring brain perfusion include arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM). These techniques provide noninvasive and repeatable assessment of cerebral blood flow or cerebral blood volume without the need for intravenous contrast. This article discusses the technical aspects of ASL and IVIM with a focus on normal physiologic variations, technical parameters, and artifacts. Multiple pediatric clinical applications are presented, including tumors, stroke, vasculopathy, vascular malformations, epilepsy, migraine, trauma, and inflammation.
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Affiliation(s)
- Danny J J Wang
- USC Institute for Neuroimaging and Informatics, SHN, 2025 Zonal Avenue, Health Sciences Campus, Los Angeles, CA 90033, USA
| | - Denis Le Bihan
- NeuroSpin, Centre d'études de Saclay, Bâtiment 145, Gif-sur-Yvette 91191, France
| | - Ram Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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Evaluation of Arterial Spin Labeling MRI-Comparison with 15O-Water PET on an Integrated PET/MR Scanner. Diagnostics (Basel) 2021; 11:diagnostics11050821. [PMID: 34062847 PMCID: PMC8147295 DOI: 10.3390/diagnostics11050821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 11/16/2022] Open
Abstract
Cerebral blood flow (CBF) measurements are of high clinical value and can be acquired non-invasively with no radiation exposure using pseudo-continuous arterial spin labeling (ASL). The aim of this study was to evaluate accordance in resting state CBF between ASL (CBFASL) and 15O-water positron emission tomography (PET) (CBFPET) acquired simultaneously on an integrated 3T PET/MR system. The data comprised ASL and dynamic 15O-water PET data with arterial blood sampling of eighteen subjects (eight patients with focal epilepsy and ten healthy controls, age 21 to 61 years). 15O-water PET parametric CBF images were generated using a basis function implementation of the single tissue compartment model. Cortical and subcortical regions were automatically segmented using Freesurfer. Average CBFASL and CBFPET in grey matter were 60 ± 20 and 75 ± 22 mL/100 g/min respectively, with a relatively high correlation (r = 0.78, p < 0.001). Bland-Altman analysis revealed poor agreement (bias = −15 mL/100 g/min, lower and upper limits of agreements = −16 and 45 mL/100 g/min, respectively) with a negative relationship. Accounting for the negative relationship, the width of the limits of agreement could be narrowed from 61 mL/100 g/min to 35 mL/100 g/min using regression-based limits of agreements. Although a high correlation between CBFASL and CBFPET was found, the agreement in absolute CBF values was not sufficient for ASL to be used interchangeably with 15O-water PET.
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Liu D, Li W, Xu F, Zhu D, Shin T, Qin Q. Ensuring both velocity and spatial responses robust to B0/B1+ field inhomogeneities for velocity-selective arterial spin labeling through dynamic phase-cycling. Magn Reson Med 2021; 85:2723-2734. [PMID: 33349968 PMCID: PMC7962600 DOI: 10.1002/mrm.28622] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/15/2020] [Accepted: 11/09/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE To evaluate both velocity and spatial responses of velocity-selective arterial spin labeling (VS-ASL), using velocity-insensitive and velocity-compensated waveforms for control modules, as well as a novel dynamic phase-cycling approach, at different B0 / B 1 + field inhomogeneities. METHODS In the presence of imperfect refocusing, the mechanism of phase-cycling the refocusing pulses through four dynamics was first theoretically analyzed with the conventional velocity-selective saturation (VSS) pulse train. Numerical simulations were then deployed to compare the performance of the Fourier-transform based velocity-selective inversion (FT-VSI) with these three different schemes in terms of both velocity and spatial responses under various B0 / B 1 + conditions. Phantom and human brain scans were performed to evaluate the three methods at B 1 + scales of 0.8, 1.0, and 1.2. RESULTS The simulations of FT-VSI showed that, under nonuniform B0 / B 1 + conditions, the scheme with velocity-insensitive control was susceptible to DC bias of the static spins as systematic error, while the scheme with velocity-compensated control had deteriorated velocity-selective labeling profiles and, thus, reduced labeling efficiency. Through numerical simulation, phantom scans, and brain perfusion measurements, the dynamic phase-cycling method demonstrated considerable improvements over these issues. CONCLUSION The proposed dynamic phase-cycling approach was demonstrated for the velocity-selective label and control modules with both velocity and spatial responses robust to a wide range of B0 and B 1 + field inhomogeneities.
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Affiliation(s)
- Dapeng Liu
- Department of Radiology; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Wenbo Li
- Department of Radiology; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Feng Xu
- Department of Radiology; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Dan Zhu
- Department of Biomedical Engineering; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Taehoon Shin
- Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul, South Korea
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Qin Qin
- Department of Radiology; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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22
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Holmes JH, Jen ML, Eisenmenger LB, Schubert T, Turski PA, Johnson KM. Spatial dependency and the role of local susceptibility for velocity selective arterial spin labeling (VS-ASL) relative tagging efficiency using accelerated 3D radial sampling with a BIR-8 preparation. Magn Reson Med 2021; 86:293-307. [PMID: 33615527 DOI: 10.1002/mrm.28726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 01/31/2023]
Abstract
PURPOSE Velocity selective arterial spin labeling (VS-ASL) is a promising approach for non-contrast perfusion imaging that provides robustness to vascular geometry and transit times; however, VS-ASL assumes spatially uniform tagging efficiency. This work presents a mapping approach to investigate VS-ASL relative tagging efficiency including the impact of local susceptibility effects on a BIR-8 preparation. METHODS Numerical simulations of tagging efficiency were performed to evaluate sensitivity to regionally varying local susceptibility gradients and blood velocity. Tagging efficiency mapping was performed in susceptibility phantoms and healthy human subjects (N = 7) using a VS-ASL preparation module followed by a short, high spatial resolution 3D radial-based image acquisition. Tagging efficiency maps were compared to 4D-flow, B1 , and B0 maps acquired in the same imaging session for six of the seven subjects. RESULTS Numerical simulations were found to predict reduced tagging efficiency with the combination of high blood velocity and local gradient fields. Phantom experiments corroborated numerical results. Relative efficiency mapping in normal volunteers showed unique efficiency patterns depending on individual subject anatomy and physiology. Uniform tagging efficiency was generally observed in vivo, but reduced efficiency was noted in regions of high blood velocity and local susceptibility gradients. CONCLUSION We demonstrate an approach to map the relative tagging efficiency and show application of this methodology to a novel BIR-8 preparation recently proposed in the literature. We present results showing rapid flow in the presence of local susceptibility gradients can lead to complicated signal modulations in both tag and control images and reduced tagging efficiency.
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Affiliation(s)
- James H Holmes
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Mu-Lan Jen
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Laura B Eisenmenger
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Tilman Schubert
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick A Turski
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kevin M Johnson
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
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23
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Franklin SL, Bones IK, Harteveld AA, Hirschler L, van Stralen M, Qin Q, de Boer A, Hoogduin JM, Bos C, van Osch MJP, Schmid S. Multi-organ comparison of flow-based arterial spin labeling techniques: Spatially non-selective labeling for cerebral and renal perfusion imaging. Magn Reson Med 2020; 85:2580-2594. [PMID: 33251644 PMCID: PMC7898485 DOI: 10.1002/mrm.28603] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/21/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022]
Abstract
Purpose Flow‐based arterial spin labeling (ASL) techniques provide a transit‐time insensitive alternative to the more conventional spatially selective ASL techniques. However, it is not clear which flow‐based ASL technique performs best and also, how these techniques perform outside the brain (taking into account eg, flow‐dynamics, field‐inhomogeneity, and organ motion). In the current study we aimed to compare 4 flow‐based ASL techniques (ie, velocity selective ASL, acceleration selective ASL, multiple velocity selective saturation ASL, and velocity selective inversion prepared ASL [VSI‐ASL]) to the current spatially selective reference techniques in brain (ie, pseudo‐continuous ASL [pCASL]) and kidney (ie, pCASL and flow alternating inversion recovery [FAIR]). Methods Brain (n = 5) and kidney (n = 6) scans were performed in healthy subjects at 3T. Perfusion‐weighted signal (PWS) maps were generated and ASL techniques were compared based on temporal SNR (tSNR), sensitivity to perfusion changes using a visual stimulus (brain) and robustness to respiratory motion by comparing scans acquired in paced‐breathing and free‐breathing (kidney). Results In brain, all flow‐based ASL techniques showed similar tSNR as pCASL, but only VSI‐ASL showed similar sensitivity to perfusion changes. In kidney, all flow‐based ASL techniques had comparable tSNR, although all lower than FAIR. In addition, VSI‐ASL showed a sensitivity to B1‐inhomogeneity. All ASL techniques were relatively robust to respiratory motion. Conclusion In both brain and kidney, flow‐based ASL techniques provide a planning‐free and transit‐time insensitive alternative to spatially selective ASL techniques. VSI‐ASL shows the most potential overall, showing similar performance as the golden standard pCASL in brain. However, in kidney, a reduction of B1‐sensitivity of VSI‐ASL is necessary to match the performance of FAIR.
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Affiliation(s)
- Suzanne L Franklin
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Isabell K Bones
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anita A Harteveld
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lydiane Hirschler
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Marijn van Stralen
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anneloes de Boer
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes M Hoogduin
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Clemens Bos
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Sophie Schmid
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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24
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Nanjappa M, Troalen T, Pfeuffer J, Maréchal B, Hilbert T, Kober T, Schneider FC, Croisille P, Viallon M. Comparison of 2D simultaneous multi-slice and 3D GRASE readout schemes for pseudo-continuous arterial spin labeling of cerebral perfusion at 3 T. MAGMA (NEW YORK, N.Y.) 2020; 34:437-450. [PMID: 33048262 DOI: 10.1007/s10334-020-00888-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In this perfusion magnetic resonance imaging study, the performances of different pseudo-continuous arterial spin labeling (PCASL) sequences were compared: two-dimensional (2D) single-shot readout with simultaneous multislice (SMS), 2D single-shot echo-planar imaging (EPI) and multishot three-dimensional (3D) gradient and spin echo (GRASE) sequences combined with a background-suppression (BS) module. MATERIALS AND METHODS Whole-brain PCASL images were acquired from seven healthy volunteers. The performance of each protocol was evaluated by extracting regional cerebral blood flow (rCBF) measures using an inline morphometric segmentation prototype. Image data postprocessing and subsequent statistical analyses enabled comparisons at the regional and sub-regional levels. RESULTS The main findings were as follows: (i) Mean global CBF obtained across methods was were highly correlated, and these correlations were significantly higher among the same readout sequences. (ii) Temporal signal-to-noise ratio and gray-matter-to-white-matter CBF ratio were found to be equivalent for all 2D variants but lower than those of 3D-GRASE. DISCUSSION Our study demonstrates that the accelerated SMS readout can provide increased acquisition efficiency and/or a higher temporal resolution than conventional 2D and 3D readout sequences. Among all of the methods, 3D-GRASE showed the lowest variability in CBF measurements and thus highest robustness against noise.
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Affiliation(s)
- Manjunathan Nanjappa
- Univ Lyon, UJM-Saint-Etienne, INSA, CNRS, UMR 5520, INSERM U1206, CREATIS, 42023, Saint-Etienne, France.
- Siemens Healthcare SAS, Saint-Denis, France.
| | | | - Josef Pfeuffer
- Siemens Healthcare GmbH, Application Development, Erlangen, Germany
| | - Bénédicte Maréchal
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Signal Processing Laboratory (LTS 5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Tom Hilbert
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Signal Processing Laboratory (LTS 5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Signal Processing Laboratory (LTS 5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Fabien C Schneider
- Department of Radiology, University Hospital of Saint Etienne, 42055, Saint-Etienne, France
- University of Lyon, UJM-Saint-Etienne, TAPE EA7423, Saint-Etienne, France
| | - Pierre Croisille
- Univ Lyon, UJM-Saint-Etienne, INSA, CNRS, UMR 5520, INSERM U1206, CREATIS, 42023, Saint-Etienne, France
- Department of Radiology, University Hospital of Saint Etienne, 42055, Saint-Etienne, France
| | - Magalie Viallon
- Univ Lyon, UJM-Saint-Etienne, INSA, CNRS, UMR 5520, INSERM U1206, CREATIS, 42023, Saint-Etienne, France
- Department of Radiology, University Hospital of Saint Etienne, 42055, Saint-Etienne, France
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Ji Y, Lu D, Jiang Y, Wang X, Meng Y, Sun PZ. Development of fast multi-slice apparent T 1 mapping for improved arterial spin labeling MRI measurement of cerebral blood flow. Magn Reson Med 2020; 85:1571-1580. [PMID: 32970848 DOI: 10.1002/mrm.28510] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/12/2020] [Accepted: 08/18/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE To develop fast multi-slice apparent T1 (T1app ) mapping for accurate cerebral blood flow (CBF) quantification with arterial spin labeling (ASL) MRI. METHODS Fast multi-slice T1app was measured using a modified inversion recovery echo planar imaging (EPI) sequence with simultaneous application of ASL tagging radiofrequency (RF) and gradient pulses. The fast multi-slice T1app measurement was compared with the single-slice T1app imaging approach, repeated per slice. CBF was assessed in healthy adult Wistar rats (N = 5) and rats with acute stroke 24 hours after a transient middle cerebral artery occlusion (N = 5). RESULTS The fast multi-slice T1app measurement was in good agreement with that of a single-slice T1app imaging approach (Lin's concordance correlation coefficient = 0.92). CBF calculated using T1app reasonably accounted for the finite labeling RF duration, whereas the routine T1 -normalized ASL MRI underestimated the CBF, particularly at short labeling durations. In acute stroke rats, the labeling time and the CBF difference (ΔCBF) between the contralateral normal area and the ischemic lesion were significantly correlated when using T1 -normalized perfusion calculation (R = 0.844, P = .035). In comparison, T1app -normalized ΔCBF had little labeling time dependence based on the linear regression equation of ΔCBF = -0.0247*τ + 1.579 mL/g/min (R = -0.352, P = .494). CONCLUSIONS Our study found fast multi-slice T1app imaging improves the accuracy and reproducibility of CBF measurement.
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Affiliation(s)
- Yang Ji
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
| | - Dongshuang Lu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
| | - Yinghua Jiang
- Clinical Neuroscience Research Center, Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Xiaoying Wang
- Clinical Neuroscience Research Center, Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Yuguang Meng
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Phillip Zhe Sun
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA.,Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
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26
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Liu D, Xu F, Li W, van Zijl PC, Lin DD, Qin Q. Improved velocity-selective-inversion arterial spin labeling for cerebral blood flow mapping with 3D acquisition. Magn Reson Med 2020; 84:2512-2522. [PMID: 32406137 DOI: 10.1002/mrm.28310] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/17/2020] [Accepted: 04/15/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE To further optimize the velocity-selective arterial spin labeling (VSASL) sequence utilizing a Fourier-transform based velocity-selective inversion (FT-VSI) pulse train, and to evaluate its utility for 3D mapping of cerebral blood flow (CBF) with a gradient- and spin-echo (GRASE) readout. METHODS First, numerical simulations and phantom experiments were done to test the susceptibility to eddy currents and B1 field inhomogeneities for FT-VSI pulse trains with block and composite refocusing pulses. Second, the choices of the post-labeling delay (PLD) for FT-VSI prepared 3D VSASL were evaluated for the sensitivity to perfusion signal. The study was conducted among a young-age and a middle-age group at 3T. Both signal-to-noise ratio (SNR) and CBF were quantitatively compared with pseudo-continuous ASL (PCASL). The optimized 3D VSI-ASL was also qualitatively compared with PCASL in a whole-brain coverage among two healthy volunteers and a brain tumor patient. RESULTS The simulations and phantom test showed that composite refocusing pulses are more robust to both eddy-currents and B1 field inhomogeneities than block pulses. 3D VSASL images with FT-VSI preparation were acquired over a range of PLDs and PLD = 1.2 s was selected for its higher perfusion signal. FT-VSI labeling produced quantitative CBF maps with 27% higher SNR in gray matter compared to PCASL. 3D whole-brain CBF mapping using VSI-ASL were comparable to the corresponding PCASL results. CONCLUSION FT-VSI with 3D-GRASE readout was successfully implemented and showed higher sensitivity to perfusion signal than PCASL for both young and middle-aged healthy volunteers.
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Affiliation(s)
- Dapeng Liu
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Feng Xu
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Wenbo Li
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Peter C van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Doris D Lin
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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Zhang B, Wang C, Wang H, Kong H, Gao F, Yang M, Zhang J. Feasibility of MRI based oxygenation imaging for the assessment of acute limb ischemia. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:315. [PMID: 32355759 PMCID: PMC7186751 DOI: 10.21037/atm.2020.02.139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Acute limb ischemia (ALI) can lead to death and amputation. Evaluating the severity of ischemia is important but difficult, through current methods of examination. The purpose of this research was to demonstrate the feasibility of magnetic resonance imaging (MRI) susceptibility-based imaging techniques for use in assessing muscle oxygenation alterations in ALI. Methods ALI animal models were established in 11 rabbits. Their left iliac arteries were embolized by microspheres. MRI scans were conducted 24 hours before (Pre) and 1 hour (Post 1) and 3 hours (Post 2) after the procedure. A susceptibility model was used to calculate skeletal muscle oxygenation extraction fraction (SMOEF) and relaxation rate (R2’). T2 weighted (T2w) imaging and diffusion-weighted (DW) imaging were performed. Results The average calf muscle SMOEF in the embolized hindlimbs increased from 0.43±0.02 (Pre) to 0.48±0.02 (Post 1) and 0.50±0.02 (Post 2), both P<0.05. The R2’ value increased from 13.01±2.31 s−1 (Pre) to 16.78±2.28 s−1 (Post 1) and 17.90±3.29 s−1 (Post 2), both P<0.05. No significant changes of SMOEF and R2’ were found after embolization in the contralateral hindlimbs. Apparent diffusion coefficient (ADC) values derived from DW imaging remained unchanged at different stages compared to before the procedures (all P>0.05). No abnormal signals were observed in the anatomical T2w images at Post 1 and Post 2. Conclusions This study demonstrates the feasibility of using SMOEF for the assessment of oxygenation alterations in ALI models. SMOEF is more sensitive than T2w and DW imaging in detecting acute muscle ischemia at an early stage.
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Affiliation(s)
- Bihui Zhang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing 100034, China
| | - Chengyan Wang
- Human Phenome Institute, Fudan University, Shanghai 201203, China.,Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Haochen Wang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing 100034, China
| | - Hanjing Kong
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Fei Gao
- College of Engineering, Peking University, Beijing 100871, China
| | - Min Yang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing 100034, China
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.,College of Engineering, Peking University, Beijing 100871, China
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28
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Bones IK, Franklin SL, Harteveld AA, van Osch MJP, Hendrikse J, Moonen C, van Stralen M, Bos C. Influence of labeling parameters and respiratory motion on velocity-selective arterial spin labeling for renal perfusion imaging. Magn Reson Med 2020; 84:1919-1932. [PMID: 32180263 PMCID: PMC7384062 DOI: 10.1002/mrm.28252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/15/2020] [Accepted: 02/19/2020] [Indexed: 12/12/2022]
Abstract
Purpose Arterial transit time uncertainties and challenges during planning are potential issues for renal perfusion measurement using spatially selective arterial spin labeling techniques. To mitigate these potential issues, a spatially non‐selective technique, such as velocity‐selective arterial spin labeling (VSASL), could be an alternative. This article explores the influence of VSASL sequence parameters and respiratory induced motion on VS‐label generation. Methods VSASL data were acquired in human subjects (n = 15), with both single and dual labeling, during paced‐breathing, while essential sequence parameters were systematically varied; (1) cutoff velocity, (2) labeling gradient orientation and (3) post‐labeling delay (PLD). Pseudo‐continuous ASL was acquired as a spatially selective reference. In an additional free‐breathing single VSASL experiment (n = 9) we investigated respiratory motion influence on VS‐labeling. Absolute renal blood flow (RBF), perfusion weighted signal (PWS), and temporal signal‐to‐noise ratio (tSNR) were determined. Results (1) With decreasing cutoff velocity, tSNR and PWS increased. However, undesired tissue labeling occurred at low cutoff velocities (≤ 5.4 cm/s). (2) Labeling gradient orientation had little effect on tSNR and PWS. (3) For single VSASL high signal appeared in the kidney pedicle at PLD < 800 ms, and tSNR and PWS decreased with increasing PLD. For dual VSASL, maximum tSNR occurred at PLD = 1200 ms. Average cortical RBF measured with dual VSASL (264 ± 34 mL/min/100 g) at a cutoff velocity of 5.4 cm/s, and feet‐head labeling was slightly lower than with pseudo‐continuous ASL (283 ± 55 mL/min/100 g). Conclusion With well‐chosen sequence parameters, tissue labeling induced by respiratory motion can be minimized, allowing to obtain good quality RBF maps using planning‐free labeling with dual VSASL.
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Affiliation(s)
- Isabell K Bones
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Suzanne L Franklin
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands.,C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Anita A Harteveld
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Chrit Moonen
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marijn van Stralen
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Clemens Bos
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
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Hara S, Tanaka Y, Ueda Y, Abe D, Hayashi S, Inaji M, Maehara T, Ishii K, Nariai T. Detection of hemodynamic impairment on 15O gas PET using visual assessment of arterial spin-labeling MR imaging in patients with moyamoya disease. J Clin Neurosci 2019; 72:258-263. [PMID: 31843438 DOI: 10.1016/j.jocn.2019.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/25/2018] [Accepted: 11/19/2019] [Indexed: 12/24/2022]
Abstract
It is unclear whether the visual assessment of noninvasive arterial spin labeling magnetic resonance imaging (ASL) can identify instances of hemodynamic compromise including an elevated oxygen extraction fraction (OEF) measured by 15O-gas positron emission tomography (PET). Here we evaluated the relationship between a four-point visual assessment system referred to as 'ASL scores' using ASL with two postlabeling delays (PLDs; 1525 ms and 2525 ms) and some quantitative hemodynamic parameters measured by PET. We retrospectively evaluated the cases of 18 Japanese patients with moyamoya disease who underwent ASL and PET. We compared the patients' regional ASL scores on two ASL images to the regional values of PET parameters, and we observed a significant trend in accord with the presumed clinical severity among all PET parameters and ASL scores (p < .003). The ASL score of the long PLD (2525 ms) showed the highest specificity (98.5%) for elevated OEF. Our results suggest that hemodynamic impairment (including elevated OEF) in patients with moyamoya disease may be grossly assessed by a visual assessment of noninvasive ASL images, which can be easily obtained in clinical settings.
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Affiliation(s)
- Shoko Hara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoji Tanaka
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yasuhiro Ueda
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisu Abe
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shihori Hayashi
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan; Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Motoki Inaji
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan; Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenji Ishii
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tadashi Nariai
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan; Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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30
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Bolar DS, Gagoski B, Orbach DB, Smith E, Adalsteinsson E, Rosen BR, Grant PE, Robertson RL. Comparison of CBF Measured with Combined Velocity-Selective Arterial Spin-Labeling and Pulsed Arterial Spin-Labeling to Blood Flow Patterns Assessed by Conventional Angiography in Pediatric Moyamoya. AJNR Am J Neuroradiol 2019; 40:1842-1849. [PMID: 31694821 PMCID: PMC6975103 DOI: 10.3174/ajnr.a6262] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/21/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Imaging CBF is important for managing pediatric moyamoya. Traditional arterial spin-labeling MR imaging detects delayed transit thorough diseased arteries but is inaccurate for measuring perfusion because of these delays. Velocity-selective arterial spin-labeling is insensitive to transit delay and well-suited for imaging Moyamoya perfusion. This study assesses the accuracy of a combined velocity-selective arterial spin-labeling and traditional pulsed arterial spin-labeling CBF approach in pediatric moyamoya, with comparison to blood flow patterns on conventional angiography. MATERIALS AND METHODS Twenty-two neurologically stable pediatric patients with moyamoya and 5 asymptomatic siblings without frank moyamoya were imaged with velocity-selective arterial spin-labeling, pulsed arterial spin-labeling, and DSA (patients). Qualitative comparison was performed, followed by a systematic comparison using ASPECTS-based scoring. Quantitative pulsed arterial spin-labeling CBF and velocity-selective arterial spin-labeling CBF for the middle cerebral artery, anterior cerebral artery, and posterior cerebral artery territories were also compared. RESULTS Qualitatively, velocity-selective arterial spin-labeling perfusion maps reflect the DSA parenchymal phase, regardless of postinjection timing. Conversely, pulsed arterial spin-labeling maps reflect the DSA appearance at postinjection times closer to the arterial spin-labeling postlabeling delay, regardless of vascular phase. ASPECTS comparison showed excellent agreement (88%, κ = 0.77, P < .001) between arterial spin-labeling and DSA, suggesting velocity-selective arterial spin-labeling and pulsed arterial spin-labeling capture key perfusion and transit delay information, respectively. CBF coefficient of variation, a marker of perfusion variability, was similar for velocity-selective arterial spin-labeling in patient regions of delayed-but-preserved perfusion compared to healthy asymptomatic sibling regions (coefficient of variation = 0.30 versus 0.26, respectively, Δcoefficient of variation = 0.04), but it was significantly different for pulsed arterial spin-labeling (coefficient of variation = 0.64 versus 0.34, Δcoefficient of variation = 0.30, P < .001). CONCLUSIONS Velocity-selective arterial spin-labeling offers a powerful approach to image perfusion in pediatric moyamoya due to transit delay insensitivity. Coupled with pulsed arterial spin-labeling for transit delay information, a volumetric MR imaging approach capturing key DSA information is introduced.
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Affiliation(s)
- D S Bolar
- From the Department of Radiology (D.S.B.)
- Center for Functional Magnetic Resonance Imaging (D.S.B.), UC San Diego, La Jolla, California
| | - B Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science Center (B.G., P.E.G.)
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
| | - D B Orbach
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
- Division of Neurointerventional Radiology (D.B.O.)
| | - E Smith
- Department of Neurosurgery (E.S.)
| | - E Adalsteinsson
- Department of Electrical Engineering & Computer Science (E.A.), Massachusetts Institute of Technology, Cambridge, Massachusetts
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging (E.A., B.R.R.), Charlestown, Massachusetts
| | - B R Rosen
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging (E.A., B.R.R.), Charlestown, Massachusetts
| | - P E Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center (B.G., P.E.G.)
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
- Division of Newborn Medicine (P.E.G.), Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - R L Robertson
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
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Tong Y, Hocke LM, Frederick BB. Low Frequency Systemic Hemodynamic "Noise" in Resting State BOLD fMRI: Characteristics, Causes, Implications, Mitigation Strategies, and Applications. Front Neurosci 2019; 13:787. [PMID: 31474815 PMCID: PMC6702789 DOI: 10.3389/fnins.2019.00787] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 07/15/2019] [Indexed: 01/06/2023] Open
Abstract
Advances in functional magnetic resonance imaging (fMRI) acquisition have improved signal to noise to the point where the physiology of the subject is the dominant noise source in resting state fMRI data (rsfMRI). Among these systemic, non-neuronal physiological signals, respiration and to some degree cardiac fluctuations can be removed through modeling, or in the case of newer, faster acquisitions such as simultaneous multislice acquisition, simple spectral filtering. However, significant low frequency physiological oscillation (∼0.01-0.15 Hz) remains in the signal. This is problematic, as it is the precise frequency band occupied by the neuronally modulated hemodynamic responses used to study brain connectivity, precluding its removal by spectral filtering. The source of this signal, and its method of production and propagation in the body, have not been conclusively determined. Here, we summarize the defining characteristics of the systemic low frequency noise signal, and review some current theories about the signal source and the evidence supporting them. The strength and distribution of the systemic LFO signal make characterizing and removing it essential for accurate quantification, especially for resting state connectivity, when no stimulation can be compared with the signal. Widespread correlated non-neuronal signals obscure and distort the more localized patterns of neuronal correlations between interacting brain regions; they may even cause apparent connectivity between regions with no neuronal interaction. Here, we discuss a simple method we have developed to parse the global, moving, blood-borne signal from the stationary, neuronal connectivity signals, substantially reducing the negative correlations that result from global signal regression. Finally, we will discuss some of the uses to which the moving systemic low frequency oscillation can be put if we consider it a "signal" carrying information, rather than simply "noise" complicating the interpretation of resting state connectivity. Properly utilizing this signal may offer insights into subtle hemodynamic alterations that can be used as early indicators of circulatory dysfunction in a number of neuropsychiatric conditions, such as prodromal stroke, moyamoya, and Alzheimer's disease.
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Affiliation(s)
- Yunjie Tong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Lia M. Hocke
- McLean Imaging Center, McLean Hospital, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Blaise B. Frederick
- McLean Imaging Center, McLean Hospital, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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32
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Sheng H, Zhao B, Ge Y. Blood Perfusion and Cellular Microstructural Changes Associated With Iron Deposition in Multiple Sclerosis Lesions. Front Neurol 2019; 10:747. [PMID: 31354613 PMCID: PMC6637756 DOI: 10.3389/fneur.2019.00747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/26/2019] [Indexed: 12/18/2022] Open
Abstract
Background and Purpose: Susceptibility-weighted imaging (SWI) has emerged as a useful clinical tool in many neurological diseases including multiple sclerosis (MS). This study aims to investigate the relationship between SWI signal changes due to iron deposition in MS lesions and tissue blood perfusion and microstructural abnormalities to better understand their underlying histopathologies. Methods: Forty-six patients with relapsing remitting MS were recruited for this study. Conventional FLAIR, pre- and post-contrast T1-weighted imaging, SWI, diffusion tensor imaging (DTI), and dynamic susceptibility contrast (DSC) perfusion MRI were performed in these patients at 3T. The SWI was processed using both magnitude and phase information with one slice minimal intensity projection (mIP) and phase multiplication factor of 4. MS lesions were classified into 3 types based on their lesional signal appearance on SWI mIP relative to perilesional normal appearing white matter (peri-NAWM): Type-1: hypointense, Type-2: isointense, and Type-3: hyperintense lesions. The DTI and DSC MRI data were processed offline to generate DTI-derived mean diffusivity (MD) and fractional anisotropy (FA) maps, as well as DSC-derived cerebral blood flow (CBF) and cerebral blood volume (CBV) maps. Comparisons of diffusion and perfusion measurements between lesions and peri-NAWM, as well between different types of lesions, were performed. Results: A total of 137 lesions were identified on FLAIR in these patients that include 40 Type-1, 46 Type-2, and 51 Type-3 lesions according to their SWI intensity relative to peri-NAWM. All lesion types showed significant higher MD and lower FA compared to their peri-NAWM (P < 0.0001). Compared to Type-1 lesions (likely represent iron deposition), Type-2 lesions had significantly higher MD and lower FA (P < 0.001) as well as lower perfusion measurements (P < 0.05), while Type 3 lesions had significantly higher perfusion (P < 0.001) and lower FA (P < 0.05). Compared to Type-2, Type-3 lesions had higher perfusion (P < 0.0001) and marginally higher MD and lower FA (P < 0.05). Conclusion: The significant differences in diffusion and perfusion MRI metrics associated with MS lesions, that appear with different signal appearance on SWI, may help to identify the underlying destructive pathways of myelin and axons and their evolution related to inflammatory activities.
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Affiliation(s)
- Huaqiang Sheng
- Department of Medical Imaging, Qianfoshan Hospital Affiliated to Shandong University, Jinan, China.,Department of Radiology, New York University School of Medicine, New York, NY, United States
| | - Bin Zhao
- Department of Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Yulin Ge
- Department of Radiology, New York University School of Medicine, New York, NY, United States
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33
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Qin Q, Qu Y, Li W, Liu D, Shin T, Zhao Y, Lin DD, van Zijl PC, Wen Z. Cerebral blood volume mapping using Fourier-transform-based velocity-selective saturation pulse trains. Magn Reson Med 2019; 81:3544-3554. [PMID: 30737847 PMCID: PMC6820852 DOI: 10.1002/mrm.27668] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/28/2018] [Accepted: 12/30/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE Velocity-selective saturation (VSS) pulse trains provide a viable alternative to the spatially selective methods for measuring cerebral blood volume (CBV) by reducing the sensitivity to arterial transit time. This study is to compare the Fourier-transform-based velocity-selective saturation (FT-VSS) pulse trains with the conventional flow-dephasing VSS techniques for CBV quantification. METHODS The proposed FT-VSS label and control modules were compared with VSS pulse trains utilizing double refocused hyperbolic tangent (DRHT) and 8-segment B1-insensitive rotation (BIR-8). This was done using both numerical simulations and phantom studies to evaluate their sensitivities to gradient imperfections such as eddy currents. DRHT, BIR-8, and FT-VSS prepared CBV mapping was further compared for velocity-encoding gradients along 3 orthogonal directions in healthy subjects at 3T. RESULTS The phantom studies exhibited more consistent immunity to gradient imperfections for the utilized FT-VSS pulse trains. Compared to DRHT and BIR-8, FT-VSS delivered more robust CBV results across the 3 VS encoding directions with significantly reduced artifacts along the superior-inferior direction and improved temporal signal-to-noise ratio (SNR) values. Average CBV values obtained from FT-VSS based sequences were 5.3 mL/100 g for gray matter and 2.3 mL/100 g for white matter, comparable to literature expectations. CONCLUSION Absolute CBV quantification utilizing advanced FT-VSS pulse trains had several advantages over the existing approaches using flow-dephasing VSS modules. A greater immunity to gradient imperfections and the concurrent tissue background suppression of FT-VSS pulse trains enabled more robust CBV measurements and higher SNR than the conventional VSS pulse trains.
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Affiliation(s)
- Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Yaoming Qu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Wenbo Li
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Dapeng Liu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Taehoon Shin
- Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul, South Korea
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | | | - Doris D. Lin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peter C.M. van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
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Lu J, Zhao Y, Ma L, Chen Y, Li M, Ye X, Wang R, Chen X, Zhao Y. Multimodal neuronavigation-guided precision bypass in adult ischaemic patients with moyamoya disease: study protocol for a randomised controlled trial. BMJ Open 2019; 9:e025566. [PMID: 30898819 PMCID: PMC6475208 DOI: 10.1136/bmjopen-2018-025566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Revascularisation surgery is an important treatment of moyamoya disease (MMD). Several general methods of revascularisation had been used: direct, indirect and combined techniques. However, there had been no reports about the criteria of recipient arteries selection in bypass surgery for MMD. Surgeons usually choose the recipient arteries by their own experiences. Their choices of the recipient arteries are various and may contribute the different outcome of patients. The purpose is to identify utility and efficacy of precision bypass guided by multimodal neuronavigation of MMD in a prospective randomised controlled trial. METHOD AND ANALYSIS This study is a prospective randomised controlled clinical trial. This study will enrol a total of 100 eligible patients. These eligible patients will be randomised to the empirical bypass group and the multimodal neuronavigation-guided precision bypass group in a 1:1 ratio. Patient baseline characteristics and MMD characteristics will be described. In the multimodal neuronavigation-guided group, the blood velocity and blood flow of the recipient arteries will be identified. Surgical complications and outcomes at pretreatment, post-treatment, at discharge and at 3 month, 6 month, 12 month and end of trial will be analysed with CT perfusion, MRI, digital subtraction angiography, modified Rankin Scale, National Institute of Health Stroke Scale and modified Barthel Scale. This trial will determine whether multimodal neuronavigation-guided precision bypass is superior to empirical bypass in patients with MMD and identify the safety and efficacy of multimodal neuronavigation-guided precision bypass. ETHICS AND DISSEMINATION The study protocol and written informed consent were reviewed and approved by the Clinical Research Ethics Committee of Peking University International Hospital. Study findings will be disseminated in the printed media. The study started in August, 2018 and expected to be completed in December, 2020. TRIAL REGISTRATION NUMBER NCT03516851; Pre-results.
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Affiliation(s)
- Junlin Lu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yahui Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Li Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Mingtao Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xun Ye
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, PekingUniversity International Hospital, Beijing, China
| | - Rong Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, PekingUniversity International Hospital, Beijing, China
| | - Xiaolin Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, PekingUniversity International Hospital, Beijing, China
| | - Yuanli Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, PekingUniversity International Hospital, Beijing, China
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35
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Knutsson L, Xu J, Ahlgren A, van Zijl P. CEST, ASL, and magnetization transfer contrast: How similar pulse sequences detect different phenomena. Magn Reson Med 2018; 80:1320-1340. [PMID: 29845640 PMCID: PMC6097930 DOI: 10.1002/mrm.27341] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 12/28/2022]
Abstract
Chemical exchange saturation transfer (CEST), arterial spin labeling (ASL), and magnetization transfer contrast (MTC) methods generate different contrasts for MRI. However, they share many similarities in terms of pulse sequences and mechanistic principles. They all use RF pulse preparation schemes to label the longitudinal magnetization of certain proton pools and follow the delivery and transfer of this magnetic label to a water proton pool in a tissue region of interest, where it accumulates and can be detected using any imaging sequence. Due to the versatility of MRI, differences in spectral, spatial or motional selectivity of these schemes can be exploited to achieve pool specificity, such as for arterial water protons in ASL, protons on solute molecules in CEST, and protons on semi-solid cell structures in MTC. Timing of these sequences can be used to optimize for the rate of a particular delivery and/or exchange transfer process, for instance, between different tissue compartments (ASL) or between tissue molecules (CEST/MTC). In this review, magnetic labeling strategies for ASL and the corresponding CEST and MTC pulse sequences are compared, including continuous labeling, single-pulse labeling, and multi-pulse labeling. Insight into the similarities and differences among these techniques is important not only to comprehend the mechanisms and confounds of the contrasts they generate, but also to stimulate the development of new MRI techniques to improve these contrasts or to reduce their interference. This, in turn, should benefit many possible applications in the fields of physiological and molecular imaging and spectroscopy.
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Affiliation(s)
- L Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - J Xu
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
| | - A Ahlgren
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - P.C.M van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
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Donahue MJ, Achten E, Cogswell PM, De Leeuw FE, Derdeyn CP, Dijkhuizen RM, Fan AP, Ghaznawi R, Heit JJ, Ikram MA, Jezzard P, Jordan LC, Jouvent E, Knutsson L, Leigh R, Liebeskind DS, Lin W, Okell TW, Qureshi AI, Stagg CJ, van Osch MJP, van Zijl PCM, Watchmaker JM, Wintermark M, Wu O, Zaharchuk G, Zhou J, Hendrikse J. Consensus statement on current and emerging methods for the diagnosis and evaluation of cerebrovascular disease. J Cereb Blood Flow Metab 2018; 38:1391-1417. [PMID: 28816594 PMCID: PMC6125970 DOI: 10.1177/0271678x17721830] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/26/2017] [Accepted: 06/10/2017] [Indexed: 01/04/2023]
Abstract
Cerebrovascular disease (CVD) remains a leading cause of death and the leading cause of adult disability in most developed countries. This work summarizes state-of-the-art, and possible future, diagnostic and evaluation approaches in multiple stages of CVD, including (i) visualization of sub-clinical disease processes, (ii) acute stroke theranostics, and (iii) characterization of post-stroke recovery mechanisms. Underlying pathophysiology as it relates to large vessel steno-occlusive disease and the impact of this macrovascular disease on tissue-level viability, hemodynamics (cerebral blood flow, cerebral blood volume, and mean transit time), and metabolism (cerebral metabolic rate of oxygen consumption and pH) are also discussed in the context of emerging neuroimaging protocols with sensitivity to these factors. The overall purpose is to highlight advancements in stroke care and diagnostics and to provide a general overview of emerging research topics that have potential for reducing morbidity in multiple areas of CVD.
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Affiliation(s)
- Manus J Donahue
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, USA
| | - Eric Achten
- Department of Radiology and Nuclear Medicine, Universiteit Gent, Gent, Belgium
| | - Petrice M Cogswell
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Frank-Erik De Leeuw
- Radboud University, Nijmegen Medical Center, Donders Institute Brain Cognition & Behaviour, Center for Neuroscience, Department of Neurology, Nijmegen, The Netherlands
| | - Colin P Derdeyn
- Department of Radiology and Neurology, University of Iowa, Iowa City, IA, USA
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Audrey P Fan
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Rashid Ghaznawi
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeremy J Heit
- Department of Radiology, Neuroimaging and Neurointervention Division, Stanford University, CA, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Peter Jezzard
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Lori C Jordan
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eric Jouvent
- Department of Neurology, AP-HP, Lariboisière Hospital, Paris, France
| | - Linda Knutsson
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Richard Leigh
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | | | - Weili Lin
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas W Okell
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Adnan I Qureshi
- Department of Neurology, Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA
| | - Charlotte J Stagg
- Oxford Centre for Human Brain Activity, University of Oxford, Oxford, UK
| | | | - Peter CM van Zijl
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jennifer M Watchmaker
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Max Wintermark
- Department of Radiology, Neuroimaging and Neurointervention Division, Stanford University, CA, USA
| | - Ona Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Greg Zaharchuk
- Department of Radiology, Neuroimaging and Neurointervention Division, Stanford University, CA, USA
| | - Jinyuan Zhou
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
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Zun Z, Limperopoulos C. Placental perfusion imaging using velocity-selective arterial spin labeling. Magn Reson Med 2018; 80:1036-1047. [PMID: 29436733 DOI: 10.1002/mrm.27100] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/30/2017] [Accepted: 01/02/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Zungho Zun
- Division of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC.,Division of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC.,Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC.,Department of Radiology, School of Medicine and Health Sciences, George Washington University, Washington, DC
| | - Catherine Limperopoulos
- Division of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC.,Division of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC.,Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC.,Department of Radiology, School of Medicine and Health Sciences, George Washington University, Washington, DC
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Yun TJ, Sohn CH, Yoo RE, Kang KM, Choi SH, Kim JH, Park SW, Hwang M, Lebel RM. Transit time corrected arterial spin labeling technique aids to overcome delayed transit time effect. Neuroradiology 2017; 60:255-265. [PMID: 29288284 DOI: 10.1007/s00234-017-1969-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 12/18/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to evaluate the usefulness of transit time corrected cerebral blood flow (CBF) maps based on multi-phase arterial spin labeling MR perfusion imaging (ASL-MRP). METHODS The Institutional Review Board of our hospital approved this retrospective study. Written informed consent was waived. Conventional and multi-phase ASL-MRPs and dynamic susceptibility contrast MR perfusion imaging (DSC-MRP) were acquired for 108 consecutive patients. Vascular territory-based volumes of interest were applied to CBF and time to peak (TTP) maps obtained from DSC-MRP and CBF maps obtained from conventional and multi-phase ASL-MRPs. The concordances between normalized CBF (nCBF) from DSC-MRP and nCBF from conventional and transition time corrected CBF maps from multi-phase ASL-MRP were evaluated using Bland-Altman analysis. In addition, the dependence of difference between nCBF (ΔnCBF) values obtained from DSC-MRP and conventional ASL-MRP (or multi-phase ASL-MRP) on TTP obtained from DSC-MRP was also analyzed using regression analysis. RESULTS The values of nCBFs from conventional and multi-phase ASL-MRPs had lower values than nCBF based on DSC-MRP (mean differences, 0.08 and 0.07, respectively). The values of ΔnCBF were dependent on TTP values from conventional ASL-MRP technique (F = 5.5679, P = 0.0384). No dependency of ΔnCBF on TTP values from multi-phase ASL-MRP technique was revealed (F = 0.1433, P > 0.05). CONCLUSION The use of transit time corrected CBF maps based on multi-phase ASL-MRP technique can overcome the effect of delayed transit time on perfusion maps based on conventional ASL-MRP.
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Affiliation(s)
- Tae Jin Yun
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Chul-Ho Sohn
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. .,Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Roh-Eul Yoo
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung Mi Kang
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Seung Hong Choi
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ji-Hoon Kim
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Sun-Won Park
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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Non-Invasive Placental Perfusion Imaging in Pregnancies Complicated by Fetal Heart Disease Using Velocity-Selective Arterial Spin Labeled MRI. Sci Rep 2017; 7:16126. [PMID: 29170468 PMCID: PMC5700998 DOI: 10.1038/s41598-017-16461-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/13/2017] [Indexed: 11/27/2022] Open
Abstract
The placenta is a vital organ for fetal growth and development during pregnancy. Congenital heart disease (CHD) is a leading cause of morbidity and mortality in newborns. Despite the parallel development of the placenta and fetal heart early in pregnancy, very few studies suggested an association between placental dysfunction and fetal CHD. In this study, we report placental perfusion of healthy pregnancies and pregnancies complicated by fetal CHD measured using advanced fetal MRI techniques. We studied forty-eight pregnant women (31 healthy volunteers and 17 with fetal CHD) that underwent fetal MRI during their second or third trimester of pregnancy. Placental perfusion imaging was performed using velocity-selective arterial spin labeling (VSASL) and 3D image acquisition with whole-placenta coverage. In pregnancies with fetal CHD, global placental perfusion significantly decreased and regional variation of placental perfusion significantly increased with advancing gestational age; however, no such correlation was found in healthy pregnancies. Also, global placental perfusion was significantly higher in fetal CHD versus controls, in the lateral side-lying patient position versus supine, and in the posterior placental position versus anterior placental position. This study reports for the first time non-invasive whole-placenta perfusion imaging in utero. These data suggest that placental VSASL may serve as a potential biomarker of placental dysfunction in fetuses diagnosed with CHD.
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Jao TR, Nayak KS. Demonstration of velocity selective myocardial arterial spin labeling perfusion imaging in humans. Magn Reson Med 2017; 80:272-278. [PMID: 29106745 DOI: 10.1002/mrm.26994] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/19/2017] [Accepted: 10/13/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE Transit delay is a potential source of error in cardiac arterial spin-labeled (ASL) in heart failure or with collateral circulation. This study demonstrates the feasibility of using transit delay insensitive velocity selective ASL and compares its performance with flow-sensitive alternating inversion recovery (FAIR) ASL. METHODS Velocity selective labeling was achieved using an adiabatic BIR8 preparation. FAIR and velocity-selective ASL (VSASL) with various velocity cutoffs (VC = 10-40 cm/s) and labeling directions (anterior-posterior X, lateral-septal Y, and apical-basal Z) were carried out in 10 healthy volunteers (1F/9M age 23-30 y). Myocardial blood flow (MBF) and temporal signal-to-noise (TSNR) were measured. RESULTS VSASL sensitivity to perfusion decreased with increasing VC . At low VC (<5 cm/s), spurious labeling of myocardium occurs and overestimates MBF. MBF measured with FAIR (1.12 ± 0.26 ml/g/min) and VASL (1.26 ± 0.27 ml/g/min) at VC of 10 cm/s in Z were comparable (TOST with difference of 0.30 ml/g/min, P = 0.049). TSNR was 2.8 times larger using FAIR (13.62 ± 5.25) than in VSASL (4.87 ± 1.58). VSASL was insensitive to perfusion in the Y direction. X and Z performed similarly with TSNR of 4.17 ± 2.32 and 3.97 ± 0.56, respectively. CONCLUSION VSASL is a promising alternative to FAIR ASL in the heart and is well suited for scenarios when transit delays are long. Magn Reson Med 80:272-278, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Terrence R Jao
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
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Fan AP, Guo J, Khalighi MM, Gulaka PK, Shen B, Park JH, Gandhi H, Holley D, Rutledge O, Singh P, Haywood T, Steinberg GK, Chin FT, Zaharchuk G. Long-Delay Arterial Spin Labeling Provides More Accurate Cerebral Blood Flow Measurements in Moyamoya Patients: A Simultaneous Positron Emission Tomography/MRI Study. Stroke 2017; 48:2441-2449. [PMID: 28765286 DOI: 10.1161/strokeaha.117.017773] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/05/2017] [Accepted: 06/21/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE Arterial spin labeling (ASL) MRI is a promising, noninvasive technique to image cerebral blood flow (CBF) but is difficult to use in cerebrovascular patients with abnormal, long arterial transit times through collateral pathways. To be clinically adopted, ASL must first be optimized and validated against a reference standard in these challenging patient cases. METHODS We compared standard-delay ASL (post-label delay=2.025 seconds), multidelay ASL (post-label delay=0.7-3.0 seconds), and long-label long-delay ASL acquisitions (post-label delay=4.0 seconds) against simultaneous [15O]-positron emission tomography (PET) CBF maps in 15 Moyamoya patients on a hybrid PET/MRI scanner. Dynamic susceptibility contrast was performed in each patient to identify areas of mild, moderate, and severe time-to-maximum (Tmax) delays. Relative CBF measurements by each ASL scan in 20 cortical regions were compared with the PET reference standard, and correlations were calculated for areas with moderate and severe Tmax delays. RESULTS Standard-delay ASL underestimated relative CBF by 20% in areas of severe Tmax delays, particularly in anterior and middle territories commonly affected by Moyamoya disease (P<0.001). Arterial transit times correction by multidelay acquisitions led to improved consistency with PET, but still underestimated CBF in the presence of long transit delays (P=0.02). Long-label long-delay ASL scans showed the strongest correlation relative to PET, and there was no difference in mean relative CBF between the modalities, even in areas of severe delays. CONCLUSIONS Post-label delay times of ≥4 seconds are needed and may be combined with multidelay strategies for robust ASL assessment of CBF in Moyamoya disease.
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Affiliation(s)
- Audrey P Fan
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.).
| | - Jia Guo
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Mohammad M Khalighi
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Praveen K Gulaka
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Bin Shen
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Jun Hyung Park
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Harsh Gandhi
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Dawn Holley
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Omar Rutledge
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Prachi Singh
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Tom Haywood
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Gary K Steinberg
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Frederick T Chin
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
| | - Greg Zaharchuk
- From the Departments of Radiology (A.P.F., J.G., P.K.G., B.S., J.H.P., H.G., D.H., O.R., P.S., T.H., F.T.C., G.Z.) and Neurosurgery (G.K.S.), Stanford University, CA; and Global Applied Science Lab, GE Healthcare, Menlo Park, CA (M.M.K.)
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Dolui S, Vidorreta M, Wang Z, Nasrallah IM, Alavi A, Wolk DA, Detre JA. Comparison of PASL, PCASL, and background-suppressed 3D PCASL in mild cognitive impairment. Hum Brain Mapp 2017; 38:5260-5273. [PMID: 28737289 DOI: 10.1002/hbm.23732] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/30/2017] [Accepted: 07/09/2017] [Indexed: 12/21/2022] Open
Abstract
We compared three implementations of single-shot arterial spin labeled (ASL) perfusion magnetic resonance imaging: two-dimensional (2D) pulsed ASL (PASL), 2D pseudocontinuous ASL (PCASL), and background-suppressed (BS) 3D PCASL obtained in a cohort of patients with mild cognitive impairment (MCI) and elderly controls. Study subjects also underwent 18 F-fluorodeoxyglucose positron emission tomography (18 F-FDG PET). While BS 3D PCASL showed the lowest (P < 0.001) gray matter-white matter cerebral blood flow (CBF) contrast ratio, it provided the highest (P < 0.001) temporal signal-to-noise ratio. Mean relative CBF estimated using the PCASL methods in posterior cingulate cortex (PCC), precuneus, and hippocampus showed hypoperfusion in the MCI cohort compared to the controls consistent with hypometabolism measured by 18 F-FDG PET. BS 3D PCASL demonstrated the highest discrimination between controls and patients with effect size comparable to that seen with 18 F-FDG PET. 2D PASL did not demonstrate group differentiation with relative CBF in any ROI, whereas 2D PCASL demonstrated significant differences only in PCC and hippocampus. Mean global CBF values did not differ across methods and were highly correlated; however, the correlations were significantly higher (P < 0.001) when either the same labeling (PCASL) or the same acquisition strategy (2D) was used as compared to when both the labeling and readout methods differed. In addition, there were differences in regional distribution of CBF between the three modalities, which can be attributed to differences in sequence parameters. These results demonstrate the superiority of ASL with PCASL and BS 3D readout as a biomarker for regional brain function changes in MCI. Hum Brain Mapp 38:5260-5273, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Sudipto Dolui
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Functional Neuroimaging, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marta Vidorreta
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Functional Neuroimaging, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ze Wang
- Department of Radiology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Ilya M Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Abass Alavi
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John A Detre
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Functional Neuroimaging, University of Pennsylvania, Philadelphia, Pennsylvania
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Shirzadi Z, Stefanovic B, Chappell MA, Ramirez J, Schwindt G, Masellis M, Black SE, MacIntosh BJ. Enhancement of automated blood flow estimates (ENABLE) from arterial spin-labeled MRI. J Magn Reson Imaging 2017; 47:647-655. [DOI: 10.1002/jmri.25807] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/20/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Zahra Shirzadi
- Department of Medical Biophysics; University of Toronto; Toronto ON Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| | - Bojana Stefanovic
- Department of Medical Biophysics; University of Toronto; Toronto ON Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| | - Michael A. Chappell
- Institute of Biomedical Engineering, Department of Engineering Science; University of Oxford; Oxford UK
- Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences; University of Oxford; Oxford UK
| | - Joel Ramirez
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| | - Graeme Schwindt
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Department of Family and Community Medicine; University of Toronto; Toronto ON Canada
| | - Mario Masellis
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre; University of Toronto; Toronto ON Canada
| | - Sandra E. Black
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre; University of Toronto; Toronto ON Canada
| | - Bradley J. MacIntosh
- Department of Medical Biophysics; University of Toronto; Toronto ON Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
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Hara S, Tanaka Y, Ueda Y, Hayashi S, Inaji M, Ishiwata K, Ishii K, Maehara T, Nariai T. Noninvasive Evaluation of CBF and Perfusion Delay of Moyamoya Disease Using Arterial Spin-Labeling MRI with Multiple Postlabeling Delays: Comparison with 15O-Gas PET and DSC-MRI. AJNR Am J Neuroradiol 2017; 38:696-702. [PMID: 28209582 DOI: 10.3174/ajnr.a5068] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 11/09/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE Arterial spin-labeling MR imaging with multiple postlabeling delays has a potential to evaluate various hemodynamic parameters. To clarify whether arterial spin-labeling MR imaging can identify CBF and perfusion delay in patients with Moyamoya disease, we compared arterial spin-labeling, DSC, and 15O-gas PET in terms of their ability to identify these parameters. MATERIALS AND METHODS Eighteen patients with Moyamoya disease (5 men, 13 women; ages, 21-55 years) were retrospectively analyzed. CBF values of pulsed continuous arterial spin-labeling using 2 postlabeling delays (short arterial spin-labeling, 1525 ms; delayed arterial spin-labeling, 2525 ms) were compared with CBF values measured by 15O-gas PET. All plots were divided into 2 groups by the cutoff of time-based parameters (the time of the maximum observed concentration, TTP, MTT, delay of MTT to cerebellum, and disease severity [symptomatic or not]). The ratio of 2 arterial spin-labeling CBFs (delayed arterial spin-labeling CBF to short arterial spin-labeling CBF) was compared with time-based parameters: time of the maximum observed concentration, TTP, and MTT. RESULTS The short arterial spin-labeling-CBF values were significantly correlated with the PET-CBF values (r = 0.63; P = .01). However, the short arterial spin-labeling-CBF value dropped in the regions with severe perfusion delay. The delayed arterial spin-labeling CBF overestimated PET-CBF regardless of the degree of perfusion delay. Delayed arterial spin-labeling CBF/short arterial spin-labeling CBF was well correlated with the time of the maximum observed concentration, TTP, and MTT (ρ = 0.71, 0.64, and 0.47, respectively). CONCLUSIONS Arterial spin-labeling using 2 postlabeling delays may detect PET-measured true CBF and perfusion delay in patients with Moyamoya disease. Provided its theoretic basis and limitations are considered, noninvasive arterial spin-labeling could be a useful alternative for evaluating the hemodynamics of Moyamoya disease.
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Affiliation(s)
- S Hara
- From the Department of Neurosurgery (S.H., Y.T., Y.U., S.H., M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Tanaka
- From the Department of Neurosurgery (S.H., Y.T., Y.U., S.H., M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Ueda
- From the Department of Neurosurgery (S.H., Y.T., Y.U., S.H., M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - S Hayashi
- From the Department of Neurosurgery (S.H., Y.T., Y.U., S.H., M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - M Inaji
- From the Department of Neurosurgery (S.H., Y.T., Y.U., S.H., M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
- Research Team for Neuroimaging (M.I., K. Ishiwata, K. Ishii, T.N.), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - K Ishiwata
- Research Team for Neuroimaging (M.I., K. Ishiwata, K. Ishii, T.N.), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - K Ishii
- Research Team for Neuroimaging (M.I., K. Ishiwata, K. Ishii, T.N.), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - T Maehara
- From the Department of Neurosurgery (S.H., Y.T., Y.U., S.H., M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - T Nariai
- From the Department of Neurosurgery (S.H., Y.T., Y.U., S.H., M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
- Research Team for Neuroimaging (M.I., K. Ishiwata, K. Ishii, T.N.), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Ni WW, Christen T, Rosenberg J, Zun Z, Moseley ME, Zaharchuk G. Imaging of cerebrovascular reserve and oxygenation in Moyamoya disease. J Cereb Blood Flow Metab 2017; 37:1213-1222. [PMID: 27207169 PMCID: PMC5453445 DOI: 10.1177/0271678x16651088] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to determine whether measurements of cerebrovascular reserve and oxygenation, assessed with spin relaxation rate R2', yield similar information about pathology in pre-operative Moyamoya disease patients, and to assess whether R2' is a better measure of oxygenation than other proposed markers, such as R2* and R2. Twenty-five pre-operative Moyamoya disease patients were scanned at 3.0T with acetazolamide challenge. Cerebral blood flow mapping with multi-delay arterial spin labeling, and R2*, R2, and R2' mapping with Gradient-Echo Sampling of Free Induction Decay and Echo were performed. No baseline cerebral blood flow difference was found between angiographically abnormal and normal regions (49 ± 12 vs. 48 ± 11 mL/100 g/min, p = 0.44). However, baseline R2' differed between these regions (3.2 ± 0.7 vs. 2.9 ± 0.6 s-1, p < 0.001), indicating reduced oxygenation in abnormal regions. Cerebrovascular reserve was lower in angiographically abnormal regions (21 ± 38 vs. 41 ± 26%, p = 0.001). All regions showed trend toward significantly improved oxygenation post-acetazolamide. Regions with poorer cerebrovascular reserve had lower baseline oxygenation (Kendall's τ = -0.24, p = 0.003). A number of angiographically abnormal regions demonstrated preserved cerebrovascular reserve, likely due to the presence of collaterals. Finally, of the concurrently measured relaxation rates, R2' was superior for oxygenation assessment.
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Affiliation(s)
- Wendy W Ni
- 1 Department of Radiology, Stanford University, Stanford, CA, USA.,2 Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Thomas Christen
- 1 Department of Radiology, Stanford University, Stanford, CA, USA
| | | | - Zungho Zun
- 3 Division of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC, USA.,4 Department of Pediatrics, George Washington University, Washington, DC, USA
| | | | - Greg Zaharchuk
- 1 Department of Radiology, Stanford University, Stanford, CA, USA
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Boulouis G, Dangouloff-Ros V, Boccara O, Garabedian N, Soupre V, Picard A, Couloigner V, Boddaert N, Naggara O, Brunelle F. Arterial Spin-Labeling to Discriminate Pediatric Cervicofacial Soft-Tissue Vascular Anomalies. AJNR Am J Neuroradiol 2017; 38:633-638. [PMID: 28104640 DOI: 10.3174/ajnr.a5065] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 10/18/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Differentiating major subtypes of cervicofacial vascular lesions is crucial for appropriate management. The aim of our study was to evaluate the performance of an MR imaging arterial spin-labeling perfusion sequence in discriminating pediatric cervicofacial soft-tissue vascular anomalies. MATERIALS AND METHODS We conducted a retrospective analysis of data from a prospectively maintained registry including pediatric patients at a tertiary pediatric center between January 2012 and January 2014. We included pediatric patients with a final diagnosis of soft-tissue vascular anomalies and an MR imaging, including an arterial spin-labeling sequence at presentation. We performed an analysis of lesion perfusion, blinded to clinical data, by using concurrent spiral 3D pseudocontinuous arterial spin-labeling (1.5T magnet; spiral matrix, 512 × 8 mm; postlabeling delay, 1025 ms). Lesional flow was recorded with calibrated intralesional ROIs. Perfusion characteristics were compared among lesion subtypes with the Mood Median test. RESULTS Among 840 patients screened, 46 matched the inclusion criteria and were included (median age, 1.45 years; interquartile range, 0.4-5.1 years; 27 females). Hemangiomas, including infantile hemangiomas (n = 18 patients) and noninvoluting (n = 2) and rapidly involuting (n = 1) congenital types, demonstrated marked hyperperfusion (median flow, 436 mL/min/100 g; interquartile range, 212.5-603 mL/min/100 g), significantly higher than that of lymphatic malformations (median, 22.5 mL/min/100 g; interquartile range, 16-60 mL/min/100 g; P < .001) or venous malformations (median, 25 mL/min/100 g; interquartile range, 15-66.5 mL/min/100 g; P = .003). CONCLUSIONS MR imaging arterial spin-labeling is a valuable tool for the assessment of soft-tissue vascular anomaly hemodynamics and for the classification of major lesion subtypes.
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Affiliation(s)
- G Boulouis
- From the Department of Pediatric Radiology (G.B., V.D.-R., N.B., O.N., F.B.) .,Institut National de la Santé et de la Recherche Médicale U894 (G.B., O.N.), Descartes University, Paris, France.,Department of Neuroradiology (G.B., O.N.), Centre Hospitalier Sainte Anne, Paris, France
| | - V Dangouloff-Ros
- From the Department of Pediatric Radiology (G.B., V.D.-R., N.B., O.N., F.B.).,Institut National de la Santé et de la Recherche Médicale U1000 (V.D.-R., N.B., F.B.)
| | - O Boccara
- Departments of Pediatric Dermatology (O.B.).,Pediatric Oto-Rhino-Laryngology (O.B., N.G., V.C.).,Pediatric Maxillo-Facial and Plastic Surgery (O.B., V.S., A.P., O.N.), Necker Children's Hospital, Descartes University, Paris, France.,Centre de Référence des Malformations Rares de la Face de la Cavite Buccale (O.B., V.S., A.P.), Maxillofacial Malformation Reference Center, Paris, France.,Faculté de Médecine Paris-Descartes (O.B., N.G., V.S., A.P., V.C., N.B., F.B.), Université Paris 5, Paris, France
| | - N Garabedian
- Pediatric Oto-Rhino-Laryngology (O.B., N.G., V.C.).,Faculté de Médecine Paris-Descartes (O.B., N.G., V.S., A.P., V.C., N.B., F.B.), Université Paris 5, Paris, France
| | - V Soupre
- Pediatric Maxillo-Facial and Plastic Surgery (O.B., V.S., A.P., O.N.), Necker Children's Hospital, Descartes University, Paris, France.,Centre de Référence des Malformations Rares de la Face de la Cavite Buccale (O.B., V.S., A.P.), Maxillofacial Malformation Reference Center, Paris, France.,Faculté de Médecine Paris-Descartes (O.B., N.G., V.S., A.P., V.C., N.B., F.B.), Université Paris 5, Paris, France
| | - A Picard
- Pediatric Maxillo-Facial and Plastic Surgery (O.B., V.S., A.P., O.N.), Necker Children's Hospital, Descartes University, Paris, France.,Centre de Référence des Malformations Rares de la Face de la Cavite Buccale (O.B., V.S., A.P.), Maxillofacial Malformation Reference Center, Paris, France.,Faculté de Médecine Paris-Descartes (O.B., N.G., V.S., A.P., V.C., N.B., F.B.), Université Paris 5, Paris, France
| | - V Couloigner
- Pediatric Oto-Rhino-Laryngology (O.B., N.G., V.C.).,Faculté de Médecine Paris-Descartes (O.B., N.G., V.S., A.P., V.C., N.B., F.B.), Université Paris 5, Paris, France
| | - N Boddaert
- From the Department of Pediatric Radiology (G.B., V.D.-R., N.B., O.N., F.B.).,Institut National de la Santé et de la Recherche Médicale U1000 (V.D.-R., N.B., F.B.).,Faculté de Médecine Paris-Descartes (O.B., N.G., V.S., A.P., V.C., N.B., F.B.), Université Paris 5, Paris, France.,Unite Mixte de Recherche 1163 (N.B., F.B.), Institut Imagine, Paris, France
| | - O Naggara
- From the Department of Pediatric Radiology (G.B., V.D.-R., N.B., O.N., F.B.).,Institut National de la Santé et de la Recherche Médicale U894 (G.B., O.N.), Descartes University, Paris, France.,Pediatric Maxillo-Facial and Plastic Surgery (O.B., V.S., A.P., O.N.), Necker Children's Hospital, Descartes University, Paris, France.,Department of Neuroradiology (G.B., O.N.), Centre Hospitalier Sainte Anne, Paris, France
| | - F Brunelle
- From the Department of Pediatric Radiology (G.B., V.D.-R., N.B., O.N., F.B.).,Institut National de la Santé et de la Recherche Médicale U1000 (V.D.-R., N.B., F.B.).,Faculté de Médecine Paris-Descartes (O.B., N.G., V.S., A.P., V.C., N.B., F.B.), Université Paris 5, Paris, France.,Unite Mixte de Recherche 1163 (N.B., F.B.), Institut Imagine, Paris, France
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47
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Hart J, Novak V, Saunders C, Gremaud PA. Transcranial Doppler-Based Surrogates for Cerebral Blood Flow: A Statistical Study. PLoS One 2016; 11:e0165536. [PMID: 27880813 PMCID: PMC5120791 DOI: 10.1371/journal.pone.0165536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 10/13/2016] [Indexed: 11/18/2022] Open
Abstract
It is commonly assumed that perfusion in a given cerebral territory can be inferred from Blood Flow Velocity (BFV) measurements in the corresponding stem artery. In order to test this hypothesis, we construct a cerebral blood flow (CBF) estimator based on transcranial Doppler (TCD) blood flow velocity and ten other easily available patient characteristics and clinical parameters. A total of 261 measurements were collected from 88 older patients. The estimator is based on local regression (Random Forest). Its performance is analyzed against baseline CBF from 3-D pseudocontinuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI). Patient specific CBF predictions are of poor quality (r = 0.41 and p-value = 4.5 × 10−12); the hypothesis is thus not clearly supported by evidence.
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Affiliation(s)
- Joseph Hart
- Department of Mathematics, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Vera Novak
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Charles Saunders
- Engineering and the Environment, University of Southampton, Southampton, United Kingdom
| | - Pierre A. Gremaud
- Department of Mathematics, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
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48
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Schmid S, Petersen ET, Van Osch MJP. Insight into the labeling mechanism of acceleration selective arterial spin labeling. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 30:165-174. [PMID: 27787676 PMCID: PMC5364255 DOI: 10.1007/s10334-016-0596-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 10/11/2016] [Accepted: 10/13/2016] [Indexed: 11/21/2022]
Abstract
Objectives Acceleration selective arterial spin labeling (AccASL) is a spatially non-selective labeling technique, used in traditional ASL methods, which labels spins based on their flow acceleration rather than spatial localization. The exact origin of the AccASL signal within the vasculature is not completely understood. To obtain more insight into this, the acceleration selective module was performed followed by a velocity selective module, which is used in velocity selective arterial spin labeling (VS-ASL). Materials and methods Nine healthy volunteers were scanned with various combinations of the control and label conditions in both the acceleration and velocity selective module. The cut-off acceleration (0.59 m/s2) or velocity (2 cm/s) was kept constant in one module, while it was varied over a large range in the other module. With the right subtractions this resulted in AccASL, VS-ASL, combined AccASL and VS-ASL signal, and signal from one module with crushing from the other. Results The label created with AccASL has an overlap of approximately 50% in the vascular region with VS-ASL, but also originates from smaller vessels closer to the capillaries. Conclusion AccASL is able to label spins both in the macro- and meso-vasculature, as well as in the microvasculature. Electronic supplementary material The online version of this article (doi:10.1007/s10334-016-0596-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sophie Schmid
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, C3-Q, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| | - Esben T Petersen
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Matthias J P Van Osch
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, C3-Q, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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49
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Qin Q, van Zijl PCM. Velocity-selective-inversion prepared arterial spin labeling. Magn Reson Med 2016; 76:1136-48. [PMID: 26507471 PMCID: PMC4848210 DOI: 10.1002/mrm.26010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/22/2015] [Accepted: 09/15/2015] [Indexed: 12/17/2022]
Abstract
PURPOSE To develop a Fourier-transform based velocity-selective inversion (FT-VSI) pulse train for velocity-selective arterial spin labeling (VSASL). METHODS This new pulse contains paired and phase cycled refocusing pulses. Its sensitivities to B0/B1 inhomogeneity and gradient imperfections such as eddy currents were evaluated through simulation and phantom studies. Cerebral blood flow (CBF) quantification using FT-VSI prepared VSASL was compared with conventional VSASL and pseudocontinuous ASL (PCASL) at 3 Tesla. RESULTS Simulation and phantom results of the proposed FT-VSI pulse train demonstrated excellent robustness to B0/B1 field inhomogeneity and eddy currents. The estimated CBF of gray matter and white matter for the FT-VSI prepared VSASL, averaged among eight healthy volunteers, were 49.5 ± 7.5 mL/100 g/min and 14.8 ± 2.4 mL/100 g/min, respectively. Excellent correlation and agreement between the FT-VSI method and conventional VSASL and PCASL were found. The averaged signal-to-noise ratio (SNR) value in gray matter of the FT-VSI method was 39% higher than VSASL using conventional double refocused hyperbolic tangent pulses and 9% lower than PCASL. CONCLUSION A novel FT-VSI pulse train was demonstrated to be a suitable labeling module for VSASL with robustness of velocity-selective profile to B0/B1 field inhomogeneity and gradient imperfections. Compared with conventional VSASL, FT-VSI prepared VSASL produced consistent CBF maps with higher SNR values. Magn Reson Med 76:1136-1148, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.
| | - Peter C M van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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50
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Tsujikawa T, Kimura H, Matsuda T, Fujiwara Y, Isozaki M, Kikuta KI, Okazawa H. Arterial Transit Time Mapping Obtained by Pulsed Continuous 3D ASL Imaging with Multiple Post-Label Delay Acquisitions: Comparative Study with PET-CBF in Patients with Chronic Occlusive Cerebrovascular Disease. PLoS One 2016; 11:e0156005. [PMID: 27275779 PMCID: PMC4898726 DOI: 10.1371/journal.pone.0156005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 05/06/2016] [Indexed: 11/18/2022] Open
Abstract
Arterial transit time (ATT) is most crucial for measuring absolute cerebral blood flow (CBF) by arterial spin labeling (ASL), a noninvasive magnetic resonance (MR) perfusion assessment technique, in patients with chronic occlusive cerebrovascular disease. We validated ASL-CBF and ASL-ATT maps calculated by pulsed continuous ASL (pCASL) with multiple post-label delay acquisitions in patients with occlusive cerebrovascular disease. Fifteen patients underwent MR scans, including pCASL, and positron emission tomography (PET) scans with 15O-water to obtain PET-CBF. MR acquisitions with different post-label delays (1.0, 1.5, 2.0, 2.5 and 3.0 sec) were also obtained for ATT correction. The theoretical framework of 2-compartmental model (2CM) was also used for the delay compensation. ASL-CBF and ASL-ATT were calculated based on the proposed 2CM, and the effect on the CBF values and the ATT correction characteristics were discussed. Linear regression analyses were performed both on pixel-by-pixel and region-of-interest bases in the middle cerebral artery (MCA) territory. There were significant correlations between ASL-CBF and PET-CBF both for voxel values (r = 0.74 ± 0.08, slope: 0.87 ± 0.22, intercept: 6.1 ± 4.9) and for the MCA territorial comparison in both affected (R2 = 0.67, y = 0.83x + 6.3) and contralateral sides (R2 = 0.66, y = 0.74x + 6.3). ASL-ATTs in the affected side were significantly longer than those in the contralateral side (1.51 ± 0.41 sec and 1.12 ± 0.30 sec, respectively, p <0.0005). CBF measurement using pCASL with delay compensation was feasible and fairly accurate even in altered hemodynamic states.
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Affiliation(s)
- Tetsuya Tsujikawa
- Biomedical Imaging Research Center, University of Fukui, Eiheiji, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
- * E-mail:
| | | | - Yasuhiro Fujiwara
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
- Department of Medical Imaging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Makoto Isozaki
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Ken-ichiro Kikuta
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center, University of Fukui, Eiheiji, Fukui, Japan
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