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Knutsson L, Xu X, Ståhlberg F, Barker PB, Lind E, Sundgren PC, van Zijl PCM, Wirestam R. Dynamic Susceptibility Contrast MRI at 7 T: Tail-Scaling Analysis and Inferences About Field Strength Dependence. Tomography 2017; 3:74-78. [PMID: 28825038 PMCID: PMC5558863 DOI: 10.18383/j.tom.2017.00001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) following bolus injection of gadolinium contrast agent (CA) is widely used for the estimation of brain perfusion parameters such as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) for both clinical and research purposes. Although it is predicted that DSC-MRI will have superior performance at high magnetic field strengths, to the best of our knowledge, there are no reports of 7 T DSC-MRI in the literature. It is plausible that the transfer of DSC-MRI to 7 T may be accompanied by increased R2* relaxivity in tissue and a larger difference in ΔR2*-versus-concentration relationships between tissue and large vessels. If not accounted for, this will subsequently result in apparent CBV and CBF estimates that are higher than those reported previously at lower field strengths. The aims of this study were therefore to assess the feasibility of 7 T DSC-MRI and to investigate the apparent field-strength dependence of CBV and CBF estimates. In total, 8 healthy volunteers were examined using DSC-MRI at 7 T. A reduced CA dose of 0.05 mmol/kg was administered to decrease susceptibility artifacts. CBV, CBF, and MTT maps were calculated using standard DSC-MRI tracer-kinetic theory. Subject-specific arterial partial volume correction factors were obtained using a tail-scaling approach. Compared with literature values obtained using the tail-scaling approach at 1.5 T and 3 T, the CBV and CBF values of the present study were found to be further overestimated. This observation is potentially related to an inferred field-strength dependence of transverse relaxivities, although issues related to the CA dose must also be considered.
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Affiliation(s)
- Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,Department of Radiology (Adjunct), Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Xiang Xu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Freddy Ståhlberg
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,Department of Diagnostic Radiology, Lund University, Lund, Sweden.,Lund University Bioimaging Center, Lund University, Lund, Sweden
| | - Peter B Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Emelie Lind
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Pia C Sundgren
- Department of Diagnostic Radiology, Lund University, Lund, Sweden
| | - Peter C M van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Ronnie Wirestam
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
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Gordon Y, Partovi S, Müller-Eschner M, Amarteifio E, Bäuerle T, Weber MA, Kauczor HU, Rengier F. Dynamic contrast-enhanced magnetic resonance imaging: fundamentals and application to the evaluation of the peripheral perfusion. Cardiovasc Diagn Ther 2014; 4:147-64. [PMID: 24834412 DOI: 10.3978/j.issn.2223-3652.2014.03.01] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 02/08/2014] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The ability to ascertain information pertaining to peripheral perfusion through the analysis of tissues' temporal reaction to the inflow of contrast agent (CA) was first recognized in the early 1990's. Similar to other functional magnetic resonance imaging (MRI) techniques such as arterial spin labeling (ASL) and blood oxygen level-dependent (BOLD) MRI, dynamic contrast-enhanced MRI (DCE-MRI) was at first restricted to studies of the brain. Over the last two decades the spectrum of ailments, which have been studied with DCE-MRI, has been extensively broadened and has come to include pathologies of the heart notably infarction, stroke and further cerebral afflictions, a wide range of neoplasms with an emphasis on antiangiogenic treatment and early detection, as well as investigations of the peripheral vascular and musculoskeletal systems. APPLICATIONS TO PERIPHERAL PERFUSION DCE-MRI possesses an unparalleled capacity to quantitatively measure not only perfusion but also other diverse microvascular parameters such as vessel permeability and fluid volume fractions. More over the method is capable of not only assessing blood flowing through an organ, but in contrast to other noninvasive methods, the actual tissue perfusion. These unique features have recently found growing application in the study of the peripheral vascular system and most notably in the diagnosis and treatment of peripheral arterial occlusive disease (PAOD). REVIEW OUTLINE The first part of this review will elucidate the fundamentals of data acquisition and interpretation of DCE-MRI, two areas that often remain baffling to the clinical and investigating physician because of their complexity. The second part will discuss developments and exciting perspectives of DCE-MRI regarding the assessment of perfusion in the extremities. Emerging clinical applications of DCE-MRI will be reviewed with a special focus on investigation of physiology and pathophysiology of the microvascular and vascular systems of the extremities.
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Affiliation(s)
- Yaron Gordon
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Sasan Partovi
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Matthias Müller-Eschner
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Erick Amarteifio
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Tobias Bäuerle
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Marc-André Weber
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Hans-Ulrich Kauczor
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Fabian Rengier
- 1 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 2 Radiology and Nuclear Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Radiology (E010), German Cancer Research Center (dkfz), Heidelberg, Germany ; 4 Radiology, University Hospital Erlangen, Erlangen, Germany
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Knutsson L, Lindgren E, Ahlgren A, van Osch MJP, Markenroth Bloch K, Surova Y, Ståhlberg F, van Westen D, Wirestam R. Reduction of arterial partial volume effects for improved absolute quantification of DSC-MRI perfusion estimates: comparison between tail scaling and prebolus administration. J Magn Reson Imaging 2014; 41:903-8. [PMID: 24664642 DOI: 10.1002/jmri.24621] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 02/24/2014] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate and mutually compare the tail-scaling approach and the prebolus administration concept for reduction of arterial partial volume effects (PVEs), because reproducible absolute quantification of cerebral blood flow (CBF) by dynamic susceptibility contrast magnetic resonance imaging (MRI) is often hampered by PVEs in the arterial input function (AIF) registration. MATERIALS AND METHODS Twenty healthy volunteers were scanned in a test-retest study with 7-20 days between investigations to examine the quantitative values and the repeatability of CBF estimates obtained from the tail-scaling and the prebolus administration approaches. RESULTS Average grey matter CBF was 80 ± 18 mL/100 g/min (mean ± SD) using tail-scaling and 56 ± 18 mL/100 g/min using prebolus administration. The intraclass correlation coefficient was 0.52 for the tail-scaling approach and 0.86 for the prebolus administration concept. CONCLUSION Both correction methods resulted in considerably reduced arterial PVEs, leading to quantitative estimates of perfusion approaching those typically obtained by other perfusion modalities. The CBF estimates obtained using the prebolus administration concept showed superior repeatability. Potential sources of uncertainty in the tail-scaling approach include the use of venous concentration curves influenced by PVEs or by geometric distortions (ie, vessel pixel shifts) in the steady-state period.
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Affiliation(s)
- Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
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Lindgren E, Wirestam R, Markenroth Bloch K, Ahlgren A, van Osch MJP, van Westen D, Surova Y, Ståhlberg F, Knutsson L. Absolute quantification of perfusion by dynamic susceptibility contrast MRI using Bookend and VASO steady-state CBV calibration: a comparison with pseudo-continuous ASL. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2014; 27:487-99. [PMID: 24570336 DOI: 10.1007/s10334-014-0431-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/09/2013] [Accepted: 01/10/2014] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Dynamic susceptibility contrast MRI (DSC-MRI) tends to return elevated estimates of cerebral blood flow (CBF) and cerebral blood volume (CBV). In this study, subject-specific calibration factors (CFs), based on steady-state CBV measurements, were applied to rescale the absolute level of DSC-MRI CBF. MATERIALS AND METHODS Twenty healthy volunteers were scanned in a test-retest approach. Independent CBV measurements for calibration were accomplished using a T1-based contrast agent steady-state method (referred to as Bookend), as well as a blood-nulling vascular space occupancy (VASO) approach. Calibrated DSC-MRI was compared with pseudo-continuous arterial spin labeling (pCASL). RESULTS For segmented grey matter (GM) regions of interests (ROIs), pCASL-based CBF was 63 ± 11 ml/(min 100 g) (mean ± SD). Nominal CBF from non-calibrated DSC-MRI was 277 ± 61 ml/(min 100 g), while calibrations resulted in 56 ± 23 ml/(min 100 g) (Bookend) and 52 ± 16 ml/(min 100 g) (VASO). Calibration tended to eliminate the overestimation, although the repeatability was generally moderate and the correlation between calibrated DSC-MRI and pCASL was low (r < 0.25). However, using GM instead of WM ROIs for extraction of CFs resulted in improved repeatability. CONCLUSION Both calibration approaches provided reasonable absolute levels of GM CBF, although the calibration methods suffered from low signal-to-noise ratio, resulting in weak repeatability and difficulties in showing high degrees of correlation with pCASL measurements.
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Affiliation(s)
- Emelie Lindgren
- Department of Medical Radiation Physics, Lund University, Lund University Hospital, 22185, Lund, Sweden,
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Mehndiratta A, Calamante F, MacIntosh BJ, Crane DE, Payne SJ, Chappell MA. Modeling and correction of bolus dispersion effects in dynamic susceptibility contrast MRI. Magn Reson Med 2014; 72:1762-74. [PMID: 24453108 DOI: 10.1002/mrm.25077] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 10/16/2013] [Accepted: 11/04/2013] [Indexed: 11/06/2022]
Abstract
PURPOSE Bolus dispersion in DSC-MRI can lead to errors in cerebral blood flow (CBF) estimation by up to 70% when using singular value decomposition analysis. However, it might be possible to correct for dispersion using two alternative methods: the vascular model (VM) and control point interpolation (CPI). Additionally, these approaches potentially provide a means to quantify the microvascular residue function. METHODS VM and CPI were extended to correct for dispersion by means of a vascular transport function. Simulations were performed at multiple dispersion levels and an in vivo analysis was performed on a healthy subject and two patients with carotid atherosclerotic disease. RESULTS Simulations showed that methods that could not address dispersion tended to underestimate CBF (ratio in CBF estimation, CBFratio = 0.57-0.77) in the presence of dispersion; whereas modified CPI showed the best performance at low-to-medium dispersion; CBFratio = 0.99 and 0.81, respectively. The in vivo data showed trends in CBF estimation and residue function that were consistent with the predictions from simulations. CONCLUSION In patients with atherosclerotic disease the estimated residue function showed considerable differences in the ipsilateral hemisphere. These differences could partly be attributed to dispersive effects arising from the stenosis when dispersion corrected CPI was used. It is thus beneficial to correct for dispersion in perfusion analysis using this method.
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Affiliation(s)
- Amit Mehndiratta
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
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Mehndiratta A, Calamante F, MacIntosh BJ, Crane DE, Payne SJ, Chappell MA. Modeling the residue function in DSC-MRI simulations: Analytical approximation to in vivo data. Magn Reson Med 2013; 72:1486-91. [DOI: 10.1002/mrm.25056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/25/2013] [Accepted: 11/04/2013] [Indexed: 11/12/2022]
Affiliation(s)
- Amit Mehndiratta
- Institute of Biomedical Engineering; University of Oxford; United Kingdom
| | - Fernando Calamante
- Florey Institute of Neuroscience and Mental Health; Heidelberg Victoria Australia
- Department of Medicine, Austin Health and Northern Health; University of Melbourne; Melbourne Victoria Australia
| | - Bradley J. MacIntosh
- Medical Biophysics, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| | - David E. Crane
- Medical Biophysics, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| | - Stephen J. Payne
- Institute of Biomedical Engineering; University of Oxford; United Kingdom
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Knutsson L, Lindgren E, Ahlgren A, van Osch MJP, Bloch KM, Surova Y, Ståhlberg F, van Westen D, Wirestam R. Dynamic susceptibility contrast MRI with a prebolus contrast agent administration design for improved absolute quantification of perfusion. Magn Reson Med 2013; 72:996-1006. [PMID: 24285621 DOI: 10.1002/mrm.25006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 09/26/2013] [Accepted: 09/27/2013] [Indexed: 11/11/2022]
Abstract
PURPOSE Arterial partial-volume effects (PVEs) often hamper reproducible absolute quantification of cerebral blood flow (CBF) and cerebral blood volume (CBV) obtained by dynamic susceptibility contrast MRI (DSC-MRI). The aim of this study was to examine whether arterial PVEs in DSC-MRI data can be minimized by rescaling the arterial input function (AIF) using a sagittal-sinus venous output function obtained following a prebolus administration of a low dose of contrast agent. METHODS The study was carried out as a test-retest experiment in 20 healthy volunteers to examine the repeatability of the CBF and CBV estimates. All subjects were scanned twice with 7-20 days between investigations. RESULTS DSC-MRI returned an overestimated average whole-brain CBF of 220 ± 44 mL/100 g/min (mean ± SD) before correction and 44 ± 15 mL/100 g/min when applying the prebolus design, averaged over all scans. Average whole-brain CBV was 20 ± 2.0 mL/100 g before correction and 4.0 ± 1.0 mL/100 g after prebolus correction. CONCLUSION Quantitative estimates of CBF and CBV, obtained with the proposed prebolus DSC-MRI technique, approached those typically obtained by other perfusion modalities. The CBF and CBV estimates showed good repeatability.
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Affiliation(s)
- Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
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