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Woods JG, Achten E, Asllani I, Bolar DS, Dai W, Detre JA, Fan AP, Fernández-Seara M, Golay X, Günther M, Guo J, Hernandez-Garcia L, Ho ML, Juttukonda MR, Lu H, MacIntosh BJ, Madhuranthakam AJ, Mutsaerts HJ, Okell TW, Parkes LM, Pinter N, Pinto J, Qin Q, Smits M, Suzuki Y, Thomas DL, Van Osch MJ, Wang DJJ, Warnert EA, Zaharchuk G, Zelaya F, Zhao M, Chappell MA. Recommendations for quantitative cerebral perfusion MRI using multi-timepoint arterial spin labeling: Acquisition, quantification, and clinical applications. Magn Reson Med 2024; 92:469-495. [PMID: 38594906 PMCID: PMC11142882 DOI: 10.1002/mrm.30091] [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: 08/31/2023] [Revised: 02/09/2024] [Accepted: 03/07/2024] [Indexed: 04/11/2024]
Abstract
Accurate assessment of cerebral perfusion is vital for understanding the hemodynamic processes involved in various neurological disorders and guiding clinical decision-making. This guidelines article provides a comprehensive overview of quantitative perfusion imaging of the brain using multi-timepoint arterial spin labeling (ASL), along with recommendations for its acquisition and quantification. A major benefit of acquiring ASL data with multiple label durations and/or post-labeling delays (PLDs) is being able to account for the effect of variable arterial transit time (ATT) on quantitative perfusion values and additionally visualize the spatial pattern of ATT itself, providing valuable clinical insights. Although multi-timepoint data can be acquired in the same scan time as single-PLD data with comparable perfusion measurement precision, its acquisition and postprocessing presents challenges beyond single-PLD ASL, impeding widespread adoption. Building upon the 2015 ASL consensus article, this work highlights the protocol distinctions specific to multi-timepoint ASL and provides robust recommendations for acquiring high-quality data. Additionally, we propose an extended quantification model based on the 2015 consensus model and discuss relevant postprocessing options to enhance the analysis of multi-timepoint ASL data. Furthermore, we review the potential clinical applications where multi-timepoint ASL is expected to offer significant benefits. This article is part of a series published by the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group, aiming to guide and inspire the advancement and utilization of ASL beyond the scope of the 2015 consensus article.
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Affiliation(s)
- Joseph G. Woods
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Eric Achten
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Iris Asllani
- Department of Neuroscience, University of Sussex, UK and Department of Biomedical Engineering, Rochester Institute of Technology, USA
| | - Divya S. Bolar
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Weiying Dai
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA, 13902
| | - John A. Detre
- Department of Neurology, University of Pennsylvania, 3 Dulles Building, 3400 Spruce Street, Philadelphia, PA 19104 USA
| | - Audrey P. Fan
- Department of Biomedical Engineering, Department of Neurology, University of California Davis, Davis, CA, USA
| | - Maria Fernández-Seara
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain; IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Xavier Golay
- UCL Queen Square Institute of Neurology, University College London, London, UK; Gold Standard Phantoms, UK
| | - Matthias Günther
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- Departments of Physics and Electrical Engineering, University of Bremen, Bremen, Germany
| | - Jia Guo
- Department of Bioengineering, University of California Riverside, Riverside, CA, USA
| | | | - Mai-Lan Ho
- Department of Radiology, University of Missouri, Columbia, MO, USA. ORCID: 0000-0002-9455-1350
| | - Meher R. Juttukonda
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bradley J. MacIntosh
- Hurvitz Brain Sciences Program, Centre for Brain Resilience & Recovery, Sunnybrook Research Institute, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Computational Radiology & Artificial Intelligence unit, Oslo University Hospital, Oslo, Norway
| | - Ananth J. Madhuranthakam
- Department of Radiology and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Henk-Jan Mutsaerts
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
| | - Thomas W. Okell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Laura M. Parkes
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, UK
| | - Nandor Pinter
- Dent Neurologic Institute, Buffalo, New York, USA; University at Buffalo Neurosurgery, Buffalo, New York, USA
| | - Joana Pinto
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Medical Delta, Delft, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, NL
| | - Yuriko Suzuki
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - David L. Thomas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Matthias J.P. Van Osch
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Danny JJ Wang
- Laboratory of FMRI Technology (LOFT), Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Esther A.H. Warnert
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, NL
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Moss Zhao
- Department of Radiology, Stanford University, Stanford, CA, USA
- Maternal & Child Health Research Institute, Stanford University, Stanford, CA, USA
| | - Michael A. Chappell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK
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Suzuki Y, Clement P, Dai W, Dolui S, Fernández-Seara M, Lindner T, Mutsaerts HJMM, Petr J, Shao X, Taso M, Thomas DL. ASL lexicon and reporting recommendations: A consensus report from the ISMRM Open Science Initiative for Perfusion Imaging (OSIPI). Magn Reson Med 2024; 91:1743-1760. [PMID: 37876299 PMCID: PMC10950547 DOI: 10.1002/mrm.29815] [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: 03/07/2023] [Revised: 06/22/2023] [Accepted: 07/13/2023] [Indexed: 10/26/2023]
Abstract
The 2015 consensus statement published by the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group and the European Cooperation in Science and Technology ( COST) Action ASL in Dementia aimed to encourage the implementation of robust arterial spin labeling (ASL) perfusion MRI for clinical applications and promote consistency across scanner types, sites, and studies. Subsequently, the recommended 3D pseudo-continuous ASL sequence has been implemented by most major MRI manufacturers. However, ASL remains a rapidly and widely developing field, leading inevitably to further divergence of the technique and its associated terminology, which could cause confusion and hamper research reproducibility. On behalf of the ISMRM Perfusion Study Group, and as part of the ISMRM Open Science Initiative for Perfusion Imaging (OSIPI), the ASL Lexicon Task Force has been working on the development of an ASL Lexicon and Reporting Recommendations for perfusion imaging and analysis, aiming to (1) develop standardized, consensus nomenclature and terminology for the broad range of ASL imaging techniques and parameters, as well as for the physiological constants required for quantitative analysis; and (2) provide a community-endorsed recommendation of the imaging parameters that we encourage authors to include when describing ASL methods in scientific reports/papers. In this paper, the sequences and parameters in (pseudo-)continuous ASL, pulsed ASL, velocity-selective ASL, and multi-timepoint ASL for brain perfusion imaging are included. However, the content of the lexicon is not intended to be limited to these techniques, and this paper provides the foundation for a growing online inventory that will be extended by the community as further methods and improvements are developed and established.
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Affiliation(s)
- Yuriko Suzuki
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Patricia Clement
- Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Weiying Dai
- State University of New York at Binghamton, Binghamton, NY, USA
| | - Sudipto Dolui
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Maria Fernández-Seara
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | | | - Henk JMM Mutsaerts
- Department of Radiology and Nuclear medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, the Netherlands, Amsterdam
| | - Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Xingfeng Shao
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Manuel Taso
- Division of MRI Research, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - David L Thomas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
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Fan H, Bunker L, Wang Z, Durfee AZ, Lin DDM, Yedavalli V, Ge Y, Zhou XJ, Hillis AE, Lu H. Simultaneous perfusion, diffusion, T 2 *, and T 1 mapping with MR fingerprinting. Magn Reson Med 2024; 91:558-569. [PMID: 37749847 PMCID: PMC10872728 DOI: 10.1002/mrm.29880] [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: 07/05/2023] [Revised: 08/27/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Quantitative mapping of brain perfusion, diffusion, T2 *, and T1 has important applications in cerebrovascular diseases. At present, these sequences are performed separately. This study aims to develop a novel MRI technique to simultaneously estimate these parameters. METHODS This sequence to measure perfusion, diffusion, T2 *, and T1 mapping with magnetic resonance fingerprinting (MRF) was based on a previously reported MRF-arterial spin labeling (ASL) sequence, but the acquisition module was modified to include different TEs and presence/absence of bipolar diffusion-weighting gradients. We compared parameters derived from the proposed method to those derived from reference methods (i.e., separate sequences of MRF-ASL, conventional spin-echo DWI, and T2 * mapping). Test-retest repeatability and initial clinical application in two patients with stroke were evaluated. RESULTS The scan time of our proposed method was 24% shorter than the sum of the reference methods. Parametric maps obtained from the proposed method revealed excellent image quality. Their quantitative values were strongly correlated with those from reference methods and were generally in agreement with values reported in the literature. Repeatability assessment revealed that ADC, T2 *, T1 , and B1 + estimation was highly reliable, with voxelwise coefficient of variation (CoV) <5%. The CoV for arterial transit time and cerebral blood flow was 16% ± 3% and 25% ± 9%, respectively. The results from the two patients with stroke demonstrated that parametric maps derived from the proposed method can detect both ischemic and hemorrhagic stroke. CONCLUSION The proposed method is a promising technique for multi-parametric mapping and has potential use in patients with stroke.
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Affiliation(s)
- Hongli Fan
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lisa Bunker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Zihan Wang
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Alexandra Zezinka Durfee
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Doris Da May Lin
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vivek Yedavalli
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yulin Ge
- Department of Radiology, New York University Grossman School of Medicine, New York, NY, Unites States
| | - Xiaohong Joe Zhou
- Center for Magnetic Resonance Research and Department of Radiology, University of Illinois at Chicago, Chicago, IL, United States
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hanzhang Lu
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- The Russell H. Morgan Department of Radiology & Radiological Science, 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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Oh D, Lee D, Heo J, Kweon J, Yong U, Jang J, Ahn YJ, Kim C. Contrast Agent-Free 3D Renal Ultrafast Doppler Imaging Reveals Vascular Dysfunction in Acute and Diabetic Kidney Diseases. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303966. [PMID: 37847902 PMCID: PMC10754092 DOI: 10.1002/advs.202303966] [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: 06/15/2023] [Revised: 08/19/2023] [Indexed: 10/19/2023]
Abstract
To combat the irreversible decline in renal function associated with kidney disease, it is essential to establish non-invasive biomarkers for assessing renal microcirculation. However, the limited resolution and/or vascular sensitivity of existing diagnostic imaging techniques hinders the visualization of complex cortical vessels. Here, a 3D renal ultrafast Doppler (UFD) imaging system that uses a high ultrasound frequency (18 MHz) and ultrahigh frame rate (1 KHz per slice) to scan the entire volume of a rat's kidney in vivo is demonstrated. The system, which can visualize the full 3D renal vascular branching pyramid at a resolution of 167 µm without any contrast agent, is used to chronically and noninvasively monitor kidneys with acute kidney injury (AKI, 3 days) and diabetic kidney disease (DKD, 8 weeks). Multiparametric UFD analyses (e.g., vessel volume occupancy (VVO), fractional moving blood volume (FMBV), vessel number density (VND), and vessel tortuosity (VT)) describe rapid vascular rarefaction from AKI and long-term vascular degeneration from DKD, while the renal pathogeneses are validated by in vitro blood serum testing and stained histopathology. This work demonstrates the potential of 3D renal UFD to offer valuable insights into assessing kidney perfusion levels for future research in diabetes and kidney transplantation.
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Affiliation(s)
- Donghyeon Oh
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Donghyun Lee
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jinseok Heo
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jooyoung Kweon
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Uijung Yong
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jinah Jang
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Yong Joo Ahn
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Chulhong Kim
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
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Ravula S, Patil C, Kumar Ks P, Kollu R, Shaik AR, Bandari R, Songa R, Battula V, Arelly SPD, Gopagoni R. A Study to Evaluate the Role of Three-Dimensional Pseudo-Continuous Arterial Spin Labelling in Acute Ischemic Stroke. Cureus 2023; 15:e44030. [PMID: 37746491 PMCID: PMC10517431 DOI: 10.7759/cureus.44030] [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] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Magnetic resonance imaging (MRI) is well known to detect ischemic brain tissue and evaluate the tissue vulnerable to infarction. Diffusion-weighted imaging (DWI) has been a mainstay of stroke evaluation but has a few shortcomings, as it generally indicates only the core of ischemia and does not provide information regarding the tissue at risk or the ischemic penumbra surrounding the infarct. Perfusion imaging identifies brain tissue that has reduced blood flow as a potential target for reperfusion therapy. Arterial spin labelling (ASL) is a new non-invasive, non-contrast MRI perfusion sequence used to detect areas of hypoperfusion qualitatively and quantitatively and also identify the area at risk, i.e., the penumbra, in acute ischemic stroke. The most important component of the imaging is to determine the ischemic penumbra. One of the working definitions of penumbra is brain tissue that is ischemic but not yet infarcted and is at risk of further damage unless the flow is rapidly restored. Hence, perfusion-diffusion mismatch provides a realistic target for potential intervention. The aim of our study is to assess the role of ASL imaging in identifying the penumbra and providing insight into the management of acute ischemic stroke. Materials and methods Patients who presented with symptoms of acute ischemic stroke were included in the study, and an MRI stroke protocol comprising DWI, fluid-attenuated inversion recovery (FLAIR), ASL, and magnetic resonance angiogram (MRA) sequences was done. Post-thrombolysis, a follow-up MRI was done using DWI, ASL, and MRA to see the restoration of perfusion in the ischemic penumbra. Three-dimensional pseudo-continuous ASL (in our study, ASL refers to pseudo-continuous ASL) is included in the stroke protocol in cases of acute ischemic stroke and assessed qualitatively. Results Our study included 43 patients (n = 43), of whom 39.5% (17 patients) belong to the age group of 51-60 years and 2.3% (one patient) are in the age group of 21-30 years. All 43 cases demonstrated DWI-FLAIR mismatch, suggestive of ischemic stroke within the window period, and all 43 cases showed DWI-ASL mismatch, suggestive of a large yet potentially salvageable peri-infarct ischemic penumbra. The most common territory involved was the middle cerebral artery (MCA), and the posterior cerebral artery (PCA) was the least commonly involved territory. We had one case involving the MCA-PCA watershed zone. Conclusion Arterial spin labelling is a novel, non-invasive, non-contrast MRI sequence with the capability to provide qualitative information regarding the salvageable ischemic penumbra, and timely management prevents the progression of the penumbra. The incorporation of ASL as part of the standard neuroimaging protocol aids in the management of acute stroke, giving insight into the prediction of outcome.
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Affiliation(s)
- Smitha Ravula
- Radiodiagnosis, Malla Reddy Medical College for Women, Hyderabad, IND
| | | | | | - Raja Kollu
- Radiology, New Medical Centre (NMC) Speciality Hospital, Abu Dhabi, ARE
| | | | - Rohit Bandari
- Neurology, Malla Reddy Narayana Multispeciality Hospital, Hyderabad, IND
| | - Rajesh Songa
- Neurology, Malla Reddy Narayana Multispeciality Hospital, Hyderabad, IND
| | | | | | - Ragini Gopagoni
- Internal Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad, IND
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Chatha G, Dhaliwal T, Castle-Kirszbaum MD, Amukotuwa S, Lai L, Kwan E. The utility of arterial spin labelled perfusion-weighted magnetic resonance imaging in measuring the vascularity of high grade gliomas - A prospective study. Heliyon 2023; 9:e17615. [PMID: 37519684 PMCID: PMC10372548 DOI: 10.1016/j.heliyon.2023.e17615] [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: 11/28/2022] [Revised: 04/13/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
Background Dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) currently remains the gold standard technique for measuring cerebral perfusion in glioma diagnosis and surveillance. Arterial spin labelling (ASL) PWI is a non-invasive alternative that does not require gadolinium contrast administration, although it is yet to be applied in widespread clinical practice. This study aims to assess the utility of measuring signal intensity in ASL PWI in predicting glioma vascularity by measuring maximal tumour signal intensity in patients based on pre-operative imaging and comparing this to maximal vessel density on histopathology. Methods Pseudocontinuous ASL (pCASL) and DSC images were acquired pre-operatively in 21 patients with high grade gliomas. The maximal signal intensity within the gliomas over a region of interest of 100 mm2 was measured and also normalised to the contralateral cerebral cortex (nTBF-C), and cerebellum (nTBF-Cb). Maximal vessel density per 1 mm2 was determined on histopathology using CD31 and CD34 immunostaining on all participants. Results Using ASL, statistically significant correlation was observed between maximal signal intensity (p < 0.05) and nTBF-C (p < 0.05) to maximal vessel density based on histopathology. Although a positive trend was also observed nTBF-Cb, this did not reach statistical significance. Using DSC, no statistically significant correlation was found between signal intensity, nTBF-C and nTBF-Cb. There was no correlation between maximal signal intensity between ASL and DSC. Average vessel density did not correlate with age, sex, previous treatment, or IDH status. Conclusions ASL PWI imaging is a reliable marker of evaluating the vascularity of high grade gliomas and may be used as an adjunct to DSC PWI.
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Affiliation(s)
- Gurkirat Chatha
- Department of Neurosurgery, Monash Health, Melbourne, Australia
| | | | - Mendel David Castle-Kirszbaum
- Department of Neurosurgery, Monash Health, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | | | - Leon Lai
- Department of Neurosurgery, Monash Health, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | - Edward Kwan
- Department of Pathology, Monash Health, Melbourne, Australia
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Petitclerc L, Hirschler L, Örzsik B, Asllani I, van Osch MJP. Arterial spin labeling signal in the CSF: Implications for partial volume correction and blood-CSF barrier characterization. NMR IN BIOMEDICINE 2023; 36:e4852. [PMID: 36269104 PMCID: PMC10078195 DOI: 10.1002/nbm.4852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/21/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
For better quantification of perfusion with arterial spin labeling (ASL), partial volume correction (PVC) is used to disentangle the signals from gray matter (GM) and white matter within any voxel. Based on physiological considerations, PVC algorithms typically assume zero signal in the cerebrospinal fluid (CSF). Recent measurements, however, have shown that CSF-ASL signal can exceed 10% of GM signal, even when using recommended ASL labeling parameters. CSF signal is expected to particularly affect PVC results in the choroid plexus. This study aims to measure the impact of CSF signal on PVC perfusion measurements, and to investigate the potential use of PVC to retrieve pure CSF-ASL signal for blood-CSF barrier characterization. In vivo imaging included six pCASL sequences with variable label duration and post-labeling delay (PLD), and an eight-echo 3D-GRASE readout. A dataset was simulated to estimate the effect of CSF-PVC with known ground-truth parameters. Differences between the results of CSF-PVC and non-CSF-PVC were estimated for regions of interest (ROIs) based on GM probability, and a separate ROI isolating the choroid plexus. In vivo, the suitability of PVC-CSF signal as an estimate of pure CSF was investigated by comparing its time course with the long-TE CSF signal. Results from both simulation and in vivo data indicated that including the CSF signal in PVC improves quantification of GM CBF by approximately 10%. In simulated data, this improvement was greater for multi-PLD (model fitting) quantification than for single PLD (~1-5% difference). In the choroid plexus, the difference between CSF-PVC and non-CSF-PVC was much larger, averaging around 30%. Long-TE (pure) CSF signal could not be estimated from PVC CSF signal as it followed a different time course, indicating the presence of residual macrovascular signal in the PVC. The inclusion of CSF adds value to PVC for more accurate measurements of GM perfusion, and especially for quantification of perfusion in the choroid plexus and study of the glymphatic system.
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Affiliation(s)
- Léonie Petitclerc
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
- Leiden Institute for Brain and Cognition (LIBC)LeidenThe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Lydiane Hirschler
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Balázs Örzsik
- Clinical Imaging Science Center, Department of NeuroscienceUniversity of SussexBrightonUK
| | - Iris Asllani
- Clinical Imaging Science Center, Department of NeuroscienceUniversity of SussexBrightonUK
- Department of Biomedical EngineeringRochester Institute of TechnologyRochesterNYUSA
| | - Matthias J. P. van Osch
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
- Leiden Institute for Brain and Cognition (LIBC)LeidenThe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
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Veeger TTJ, Hirschler L, Baligand C, Franklin SL, Webb AG, de Groot JH, van Osch MJP, Kan HE. Microvascular response to exercise varies along the length of the tibialis anterior muscle. NMR IN BIOMEDICINE 2022; 35:e4796. [PMID: 35778859 PMCID: PMC9787660 DOI: 10.1002/nbm.4796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 06/10/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Microvascular function is an important component in the physiology of muscle. One of the major parameters, blood perfusion, can be measured noninvasively and quantitatively by arterial spin labeling (ASL) MRI. Most studies using ASL in muscle have only reported data from a single slice, thereby assuming that muscle perfusion is homogeneous within muscle, whereas recent literature has reported proximodistal differences in oxidative capacity and perfusion. Here, we acquired pulsed ASL data in 12 healthy volunteers after dorsiflexion exercise in two slices separated distally by 7 cm. We combined this with a Look-Locker scheme to acquire images at multiple postlabeling delays (PLDs) and with a multiecho readout to measure T2 *. This enabled the simultaneous evaluation of quantitative muscle blood flow (MBF), arterial transit time (ATT), and T2 * relaxation time in the tibialis anterior muscle during recovery. Using repeated measures analyses of variance we tested the effect of time, slice location, and their interaction on MBF, ATT, and T2 *. Our results showed a significant difference as a function of time postexercise for all three parameters (MBF: F = 34.0, p < .0001; T2 *: F = 73.7, p < .0001; ATT: F = 13.6, p < .001) and no average differences between slices over the total time postexercise were observed. The interaction effect between time postexercise and slice location was significant for MBF and T2 * (F = 5.5, p = 0.02, F = 6.1, p = 0.02, respectively), but not for ATT (F = 2.2, p = .16). The proximal slice showed a higher MBF and a lower ATT than the distal slice during the first 2 min of recovery, and T2 * showed a delayed response in the distal slice. These results imply a higher perfusion and faster microvascular response to exercise in the proximal slice, in line with previous literature. Moreover, the differences in ATT indicate that it is difficult to correctly determine perfusion based on a single PLD as is commonly performed in the muscle literature.
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Affiliation(s)
- Thom T. J. Veeger
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
| | - Lydiane Hirschler
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
| | - Celine Baligand
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- CEA, CNRS, MIRCen, Laboratoire des Maladies NeurodégénérativesUniversité Paris‐SaclayFontenay‐aux‐RosesFrance
| | - Suzanne L. Franklin
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- Center for Image SciencesUniversity Medical Centre UtrechtUtrechtthe Netherlands
| | - Andrew G. Webb
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
| | | | - Matthias J. P. van Osch
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenthe Netherlands
| | - Hermien E. Kan
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- Duchenne Centerthe Netherlands
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9
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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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10
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Daftari Besheli L, Ahmed A, Hamam O, Luna L, Sun LR, Urrutia V, Hillis AE, Tekes-Brady A, Yedavalli V. Arterial Spin Labeling technique and clinical applications of the intracranial compartment in stroke and stroke mimics - A case-based review. Neuroradiol J 2022; 35:437-453. [PMID: 35635512 PMCID: PMC9437493 DOI: 10.1177/19714009221098806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Magnetic resonance imaging perfusion (MRP) techniques can improve the selection of acute ischemic stroke patients for treatment by estimating the salvageable area of decreased perfusion, that is, penumbra. Arterial spin labeling (ASL) is a noncontrast MRP technique that is used to assess cerebral blood flow without the use of intravenous gadolinium contrast. Thus, ASL is of particular interest in stroke imaging. This article will review clinical applications of ASL in stroke such as assessment of the core infarct and penumbra, localization of the vascular occlusion, and collateral status. Given the nonspecific symptoms that patients can present with, differentiating between stroke and a stroke mimic is a diagnostic dilemma. ASL not only helps in differentiating stroke from stroke mimic but also can be used to specify the exact mimic when used in conjunction with the symptomatology and structural imaging. In addition to a case-based overview of clinical applications of the ASL in stroke and stroke mimics in this article, the more commonly used ASL labeling techniques as well as emerging ASL techniques, future developments, and limitations will be reviewed.
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Affiliation(s)
| | - Amara Ahmed
- Florida State University College of
Medicine, Tallahassee, FL, USA
| | - Omar Hamam
- Johns Hopkins School of
Medicine, Baltimore, MD, USA
| | - Licia Luna
- Johns Hopkins School of
Medicine, Baltimore, MD, USA
| | - Lisa R Sun
- Johns Hopkins School of
Medicine, Baltimore, MD, USA
| | | | - Argye E Hillis
- Johns Hopkins University School of
Medicine, Baltimore, MD, USA
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11
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Impact of Catheter Ablation on Brain Microstructure and Blood Flow Alterations for Cognitive Improvements in Patients with Atrial Fibrillation: A Pilot Longitudinal Study. J Clin Med 2022; 11:jcm11154346. [PMID: 35893438 PMCID: PMC9332426 DOI: 10.3390/jcm11154346] [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: 06/05/2022] [Revised: 07/08/2022] [Accepted: 07/23/2022] [Indexed: 12/04/2022] Open
Abstract
Atrial fibrillation (AF) predisposes patients to develop cognitive decline and dementia. Clinical and epidemiological data propose that catheter ablation may provide further benefit to improve neurocognitive function in patients with AF, but the underlying mechanism is poorly available. Here, we conducted a pilot prospective study to investigate whether AF ablation can alter regional cerebral blood flow (rCBF) and brain microstructures, using multimodal magnetic resonance imaging (MRI) technique. Eight patients (63 ± 7 years) with persistent AF underwent arterial-spin labeling (ASL) perfusion, 3D T1-structural images and cognitive test batteries before and 6 months after intervention. ASL and structural MR images were spatially normalized, and the rCBF and cortical thickness of different brain areas were compared between pre- and 6-month post-treatment. Cognitive–psychological function was improved, and rCBF was significantly increased in the left posterior cingulate cortex (PCC) (p = 0.013), whereas decreased cortical thickness was found in the left posterior insular cortex (p = 0.023). Given that the PCC is a strategic site in the limbic system, while the insular cortex is known to play an important part in the central autonomic nervous system, our findings extend the hypothesis that autonomic system alterations are an important mechanism explaining the positive effect of AF ablation on cognitive function.
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12
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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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13
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Spatial variation of perfusion MRI reflects cognitive decline in mild cognitive impairment and early dementia. Sci Rep 2021; 11:23325. [PMID: 34857793 PMCID: PMC8639710 DOI: 10.1038/s41598-021-02313-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/09/2021] [Indexed: 12/03/2022] Open
Abstract
Cerebral blood flow (CBF) measured with arterial spin labelling (ASL) magnetic resonance imaging (MRI) reflects cerebral perfusion, related to metabolism, and arterial transit time (ATT), related to vascular health. Our aim was to investigate the spatial coefficient of variation (sCoV) of CBF maps as a surrogate for ATT, in volunteers meeting criteria for subjective cognitive decline (SCD), amnestic mild cognitive impairment (MCI) and probable Alzheimer’s dementia (AD). Whole-brain pseudo continuous ASL MRI was performed at 3 T in 122 participants (controls = 20, SCD = 44, MCI = 45 and AD = 13) across three sites in New Zealand. From CBF maps that included all grey matter, sCoV progressively increased across each group with increased cognitive deficit. A similar overall trend was found when examining sCoV solely in the temporal lobe. We conclude that sCoV, a simple to compute imaging metric derived from ASL MRI, is sensitive to varying degrees of cognitive changes and supports the view that vascular health contributes to cognitive decline associated with Alzheimer’s disease.
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14
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Ishida S, Kimura H, Takei N, Fujiwara Y, Matsuda T, Kanamoto M, Matta Y, Kosaka N, Kidoya E. Separating spin compartments in arterial spin labeling using delays alternating with nutation for tailored excitation (DANTE) pulse: A validation study using T 2 -relaxometry and application to arterial cerebral blood volume imaging. Magn Reson Med 2021; 87:1329-1345. [PMID: 34687085 DOI: 10.1002/mrm.29052] [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: 06/06/2021] [Revised: 08/31/2021] [Accepted: 09/30/2021] [Indexed: 11/07/2022]
Abstract
PURPOSE To clarify the type of spin compartment in arterial spin labeling (ASL) that is eliminated by delays alternating with nutation for tailored excitation (DANTE) pulse using T2 -relaxometry, and to demonstrate the feasibility of arterial cerebral blood volume (CBVa ) imaging using DANTE-ASL in combination with a simplified two-compartment model. METHOD The DANTE and T2 -preparation modules were combined into a single ASL sequence. T2 values under the application of DANTE were determined to evaluate changes in T2 , along with the post-labeling delay (PLD) and the relationship between transit time without DANTE (TTnoVS ) and T2 . The reference tissue T2 (T2_ref ) was also obtained. Subsequently, the DANTE module was embedded into the Hadamard-encoded ASL. Cerebral blood flow (CBF) and CBVa were computed using two Hadamard-encoding datasets (with and without DANTE) in a rest and breath-holding (BH) task. RESULTS While T2 without DANTE (T2_noVS ) decreased as the PLD increased, T2 with DANTE (T2_DANTE ) was equivalent to T2_ref and did not change with the PLD. Although there was a significant positive correlation between TTnoVS and T2_noVS with short PLD, T2_DANTE was not correlated with TTnoVS nor PLD. Baseline CBVa values obtained at rest were 0.64 ± 0.12, 0.64 ± 0.11, and 0.58 ± 0.15 mL/100 g for anterior, middle, and posterior cerebral arteries, respectively. Significant CBF and CBVa elevations were observed in the BH task. CONCLUSION Microvascular compartment signals were eliminated from the total ASL signals by DANTE. CBVa can be measured using Hadamard-encoded DANTE-ASL in combination with a simplified two-compartment model.
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Affiliation(s)
- Shota Ishida
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Naoyuki Takei
- Global MR Applications and Workflow, GE Healthcare Japan, Hino, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tsuyoshi Matsuda
- Division of Ultra-high Field MRI, Institute for Biomedical Science, Iwate Medical University, Iwate, Japan
| | - Masayuki Kanamoto
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Yuki Matta
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Eiji Kidoya
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
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15
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Impact of the inversion time on regional brain perfusion estimation with clinical arterial spin labeling protocols. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:349-363. [PMID: 34643853 PMCID: PMC9188620 DOI: 10.1007/s10334-021-00964-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 11/19/2022]
Abstract
Objective Evaluating the impact of the Inversion Time (TI) on regional perfusion estimation in a pediatric cohort using Arterial Spin Labeling (ASL). Materials and methods Pulsed ASL (PASL) was acquired at 3 T both at TI 1500 ms and 2020 ms from twelve MRI-negative patients (age range 9–17 years). A volume of interest (VOIs) and a voxel-wise approach were employed to evaluate subject-specific TI-dependent Cerebral Blood Flow (CBF) differences, and grey matter CBF Z-score differences. A visual evaluation was also performed. Results CBF was higher for TI 1500 ms in the proximal territories of the arteries (PTAs) (e.g. insular cortex and basal ganglia — P < 0.01 and P < 0.05 from the VOI analysis, respectively), and for TI 2020 ms in the distal territories of the arteries (DTAs), including the watershed areas (e.g. posterior parietal and occipital cortex — P < 0.001 and P < 0.01 from the VOI analysis, respectively). Similar differences were also evident when analyzing patient-specific CBF Z-scores and at a visual inspection. Conclusions TI influences ASL perfusion estimates with a region-dependent effect. The presence of intraluminal arterial signal in PTAs and the longer arterial transit time in the DTAs (including watershed areas) may account for the TI-dependent differences. Watershed areas exhibiting a lower perfusion signal at short TIs (~ 1500 ms) should not be misinterpreted as focal hypoperfused areas. Supplementary Information The online version contains supplementary material available at 10.1007/s10334-021-00964-7.
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16
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Xu F, Zhu D, Fan H, Lu H, Liu D, Li W, Qin Q. Magnetic resonance angiography and perfusion mapping by arterial spin labeling using Fourier transform-based velocity-selective pulse trains: Examination on a commercial perfusion phantom. Magn Reson Med 2021; 86:1360-1368. [PMID: 33934396 PMCID: PMC8861891 DOI: 10.1002/mrm.28805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE Benchmarking of flow and perfusion MR techniques on standardized phantoms can facilitate the use of advanced angiography and perfusion-mapping techniques across multiple sites, field strength, and vendors. Here, MRA and perfusion mapping by arterial spin labeling (ASL) using Fourier transform (FT)-based velocity-selective saturation and inversion pulse trains were evaluated on a commercial perfusion phantom. METHODS The FT velocity-selective saturation-based MRA and FT velocity-selective inversion-based ASL perfusion imaging were compared with time-of-flight and pseudo-continuous ASL at 3 T on the perfusion phantom at two controlled flow rates, 175 mL/min and 350 mL/min. Velocity-selective MRA (VSMRA) and velocity-selective ASL (VSASL) were each performed with three velocity-encoding directions: foot-head, left-right, and oblique 45°. The contrast-to-noise ratio for MRA scans and perfusion-weighted signal, as well as labeling efficiency for ASL methods, were quantified. RESULTS On this phantom with feeding tubes having only vertical and transverse flow directions, VSMRA and VSASL exhibited the dependence of velocity-encoding directions. The foot-head-encoded VSMRA and VSASL generated similar signal contrasts as time of flight and pseudo-continuous ASL for the two flow rates, respectively. The oblique 45°-encoded VSMRA yielded more uniform contrast-to-noise ratio across slices than foot-head and left-right-encoded VSMRA scans. The oblique 45°-encoded VSASL elevated labeling efficiency from 0.22-0.68 to 0.82-0.90 through more uniform labeling of the entire feeding tubes. CONCLUSION Both FT velocity-selective saturation-based VSMRA and FT velocity-selective inversion-based VSASL were characterized on a commercial perfusion phantom. Careful selection of velocity-encoding directions along the major vessels is recommended for their applications in various organs.
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Affiliation(s)
- Feng Xu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Dan Zhu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hongli Fan
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, 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, Johns Hopkins University, 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, Johns Hopkins University, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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17
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van der Plas MCE, Craig M, Schmid S, Chappell MA, van Osch MJP. Validation of the estimation of the macrovascular contribution in multi-timepoint arterial spin labeling MRI using a 2-component kinetic model. Magn Reson Med 2021; 87:85-101. [PMID: 34390279 PMCID: PMC10138741 DOI: 10.1002/mrm.28960] [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: 02/19/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/08/2022]
Abstract
PURPOSE In this paper, the ability to quantify cerebral blood flow by arterial spin labeling (ASL) was studied by investigating the separation of the macrovascular and tissue component using a 2-component model. Underlying assumptions of this model, especially the inclusion of dispersion in the analysis, were studied, as well as the temporal resolution of the ASL datasets. METHODS Four different datasets were acquired: (1) 4D ASL angiography to characterize the macrovascular component and to study dispersion modeling within this component, (2) high temporal resolution ASL data to investigate the separation of the 2 components and the effect of dispersion modelling on this separation, (3) low temporal resolution ASL dataset to study the effect of the temporal resolution on the separation of the 2 components, and (4) low temporal resolution ASL data with vascular crushing. RESULTS The model that included a gamma dispersion kernel had the best fit to the 4D ASL angiography. For the high temporal resolution ASL dataset, inclusion of the gamma dispersion kernel led to more signal included in the arterial blood volume map, which resulted in decreased cerebral blood flow values. The arterial blood volume and cerebral blood flow maps showed overall higher arterial blood volume values and lower cerebral blood flow values for the high temporal resolution dataset compared to the low temporal resolution dataset. CONCLUSION Inclusion of a gamma dispersion kernel resulted in better fitting of the model to the data. The separation of the macrovascular and tissue component is affected by the inclusion of a gamma dispersion kernel and the temporal resolution of the ASL dataset.
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Affiliation(s)
- Merlijn C E van der Plas
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute of Brain and Cognition (LIBC), Leiden University Medical Center, Leiden, The Netherlands
| | - Martin Craig
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Center, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Sophie Schmid
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute of Brain and Cognition (LIBC), Leiden University Medical Center, Leiden, The Netherlands
| | - Michael A Chappell
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Center, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Nottingham Biomedical Research Centre, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - 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 of Brain and Cognition (LIBC), Leiden University Medical Center, Leiden, The Netherlands
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18
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Callewaert B, Jones EAV, Himmelreich U, Gsell W. Non-Invasive Evaluation of Cerebral Microvasculature Using Pre-Clinical MRI: Principles, Advantages and Limitations. Diagnostics (Basel) 2021; 11:diagnostics11060926. [PMID: 34064194 PMCID: PMC8224283 DOI: 10.3390/diagnostics11060926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/11/2022] Open
Abstract
Alterations to the cerebral microcirculation have been recognized to play a crucial role in the development of neurodegenerative disorders. However, the exact role of the microvascular alterations in the pathophysiological mechanisms often remains poorly understood. The early detection of changes in microcirculation and cerebral blood flow (CBF) can be used to get a better understanding of underlying disease mechanisms. This could be an important step towards the development of new treatment approaches. Animal models allow for the study of the disease mechanism at several stages of development, before the onset of clinical symptoms, and the verification with invasive imaging techniques. Specifically, pre-clinical magnetic resonance imaging (MRI) is an important tool for the development and validation of MRI sequences under clinically relevant conditions. This article reviews MRI strategies providing indirect non-invasive measurements of microvascular changes in the rodent brain that can be used for early detection and characterization of neurodegenerative disorders. The perfusion MRI techniques: Dynamic Contrast Enhanced (DCE), Dynamic Susceptibility Contrast Enhanced (DSC) and Arterial Spin Labeling (ASL), will be discussed, followed by less established imaging strategies used to analyze the cerebral microcirculation: Intravoxel Incoherent Motion (IVIM), Vascular Space Occupancy (VASO), Steady-State Susceptibility Contrast (SSC), Vessel size imaging, SAGE-based DSC, Phase Contrast Flow (PC) Quantitative Susceptibility Mapping (QSM) and quantitative Blood-Oxygenation-Level-Dependent (qBOLD). We will emphasize the advantages and limitations of each strategy, in particular on applications for high-field MRI in the rodent's brain.
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Affiliation(s)
- Bram Callewaert
- Biomedical MRI Group, University of Leuven, Herestraat 49, bus 505, 3000 Leuven, Belgium; (B.C.); (W.G.)
- CMVB, Center for Molecular and Vascular Biology, University of Leuven, Herestraat 49, bus 911, 3000 Leuven, Belgium;
| | - Elizabeth A. V. Jones
- CMVB, Center for Molecular and Vascular Biology, University of Leuven, Herestraat 49, bus 911, 3000 Leuven, Belgium;
- CARIM, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Uwe Himmelreich
- Biomedical MRI Group, University of Leuven, Herestraat 49, bus 505, 3000 Leuven, Belgium; (B.C.); (W.G.)
- Correspondence:
| | - Willy Gsell
- Biomedical MRI Group, University of Leuven, Herestraat 49, bus 505, 3000 Leuven, Belgium; (B.C.); (W.G.)
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19
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Zhang LX, Woods JG, Okell TW, Chappell MA. Examination of optimized protocols for pCASL: Sensitivity to macrovascular contamination, flow dispersion, and prolonged arterial transit time. Magn Reson Med 2021; 86:2208-2219. [PMID: 34009682 PMCID: PMC8581991 DOI: 10.1002/mrm.28839] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/19/2021] [Accepted: 04/23/2021] [Indexed: 01/01/2023]
Abstract
Purpose Previously, multi‐ post‐labeling delays (PLD) pseudo‐continuous arterial spin labeling (pCASL) protocols have been optimized for the estimation accuracy of the cerebral blood flow (CBF) with/without the arterial transit time (ATT) under a standard kinetic model and a normal ATT range. This study aims to examine the estimation errors of these protocols under the effects of macrovascular contamination, flow dispersion, and prolonged arrival times, all of which might differ substantially in elderly or pathological groups. Methods Simulated data for four protocols with varying degrees of arterial blood volume (aBV), flow dispersion, and ATTs were fitted with different kinetic models, both with and without explicit correction for macrovascular signal contamination (MVC), to obtain CBF and ATT estimates. Sensitivity to MVC was defined and calculated when aBV > 0.5%. A previously acquired dataset was retrospectively analyzed to compare with simulation. Results All protocols showed underestimation of CBF and ATT in the prolonged ATT range. With MVC, the protocol optimized for CBF only (CBFopt) had the lowest sensitivity value to MVC, 33.47% and 60.21% error per 1% aBV in simulation and in vivo, respectively, among multi‐PLD protocols. All multi‐PLD protocols showed a significant decrease in estimation error when an extended kinetic model was used. Increasing flow dispersion at short ATTs caused increasing CBF and ATT overestimation in all protocols. Conclusion CBFopt was the least sensitive protocol to prolonged ATT and MVC for CBF estimation while maintaining reasonably good performance in estimating ATT. Explicitly including a macrovascular component in the kinetic model was shown to be a feasible approach in controlling for MVC.
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Affiliation(s)
- Logan X Zhang
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Joseph G Woods
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom.,Department of Radiology, University of California San Diego, San Diego, California, USA
| | - Thomas W Okell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
| | - Michael A Chappell
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom.,Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom.,Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
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20
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Li W, Liu D, van Zijl PCM, Qin Q. Three-dimensional whole-brain mapping of cerebral blood volume and venous cerebral blood volume using Fourier transform-based velocity-selective pulse trains. Magn Reson Med 2021; 86:1420-1433. [PMID: 33955583 DOI: 10.1002/mrm.28815] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/28/2021] [Accepted: 04/01/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To develop 3D MRI methods for cerebral blood volume (CBV) and venous cerebral blood volume (vCBV) estimation with whole-brain coverage using Fourier transform-based velocity-selective (FT-VS) pulse trains. METHODS For CBV measurement, FT-VS saturation pulse trains were used to suppress static tissue, whereas CSF contamination was corrected voxel-by-voxel using a multi-readout acquisition and a fast CSF T2 scan. The vCBV mapping was achieved by inserting an arterial-nulling module that included a FT-VS inversion pulse train. Using these methods, CBV and vCBV maps were obtained on 6 healthy volunteers at 3 T. RESULTS The mean CBV and vCBV values in gray matter and white matter in different areas of the brain showed high correlation (r = 0.95 and P < .0001). The averaged CBV and vCBV values of the whole brain were 5.4 ± 0.6 mL/100 g and 2.5 ± 0.3 mL/100 g in gray matter, and 2.6 ± 0.5 mL/100 g and 1.5 ± 0.2 mL/100 g in white matter, respectively, comparable to the literature. CONCLUSION The feasibility of FT-VS-based CBV and vCBV estimation was demonstrated for 3D acquisition with large spatial coverage.
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Affiliation(s)
- 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
| | - 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
| | - 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
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21
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Martín-Noguerol T, Concepción-Aramendia L, Lim CT, Santos-Armentia E, Cabrera-Zubizarreta A, Luna A. Conventional and advanced MRI evaluation of brain vascular malformations. J Neuroimaging 2021; 31:428-445. [PMID: 33856735 DOI: 10.1111/jon.12853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/14/2021] [Accepted: 03/02/2021] [Indexed: 11/26/2022] Open
Abstract
Vascular malformations (VMs) of the central nervous system (CNS) include a wide range of pathological conditions related to intra and extracranial vessel abnormalities. Although some VMs show typical neuroimaging features, other VMs share and overlap pathological and neuroimaging features that hinder an accurate differentiation between them. Hence, it is not uncommon to misclassify different types of VMs under the general heading of arteriovenous malformations. Thorough knowledge of the imaging findings of each type of VM is mandatory to avoid these inaccuracies. Conventional MRI sequences, including MR angiography, have allowed the evaluation of CNS VMs without using ionizing radiation. Newer MRI techniques, such as susceptibility-weighted imaging, black blood sequences, arterial spin labeling, and 4D flow imaging, have an added value of providing physiopathological data in real time regarding the hemodynamics of VMs. Beyond MR images, new insights using 3D printed models are being incorporated as part of the armamentarium for a noninvasive evaluation of VMs. In this paper, we briefly review the pathophysiology of CNS VMs, focusing on the MRI findings that may be helpful to differentiate them. We discuss the role of each conventional and advanced MRI sequence for VMs assessment and provide some insights about the value of structured reports of 3D printing to evaluate VMs.
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Affiliation(s)
| | | | - Cc Tchoyoson Lim
- Neuroradiology Department, National Neuroscience Institute and Duke-NUS Medical School, Singapore
| | | | | | - Antonio Luna
- MRI Unit, Radiology Department, HT Medica, Jaén, Spain
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22
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Baas KPA, Petr J, Kuijer JPA, Nederveen AJ, Mutsaerts HJMM, van de Ven KCC. Effects of Acquisition Parameter Modifications and Field Strength on the Reproducibility of Brain Perfusion Measurements Using Arterial Spin-Labeling. AJNR Am J Neuroradiol 2021; 42:109-115. [PMID: 33184068 DOI: 10.3174/ajnr.a6856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/17/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Although the added diagnostic value of arterial spin-labeling is shown in various cerebral pathologies, its use in clinical practice is limited. To encourage clinical adoption of ASL, we investigated the reproducibility of CBF measurements and the effects of variations in acquisition parameters compared to the recommended ASL implementation. MATERIALS AND METHODS Thirty-four volunteers (mean age, 57.8 ± 17.0 years; range, 22-80 years) underwent two separate sessions (1.5T and 3T scanners from a single vendor) using a 15-channel head coil. Both sessions contained repeated 3D and 2D pseudocontinuous arterial spin-labeling scans using vendor-recommended acquisition parameters (recommendation paper-based), followed by three 3D pseudocontinuous arterial spin-labeling scans, two with postlabeling delays of 1600 and 2000 ms and one with increased spatial resolution. All scans were single postlabeling delay. Intrasession (identical acquisitions, scanned five minutes apart) and intersession (first 2D and 3D acquisitions of two sessions) reproducibility was examined as well as the effect of parameter variations on CBF. RESULTS Intrasession CBF reproducibility was similar across image readouts and field strengths (within-subject coefficient of variation between 4.0% and 6.7%). Intersession within-subject coefficient of variation ranged from 6.6% to 14.8%. At 3T, the 3D acquisition with a higher spatial resolution resulted in less mixing of GM and WM signal, thus decreasing the bias in GM CBF between the 2D and 3D acquisitions (ΔCBF = 2.49 mL/100g/min [P < .001]). Postlabeling delay variations caused a modest bias (ΔCBF between -3.78 [P < .001] and 2.83 [P < .001] mL/100g/min). CONCLUSIONS Arterial spin-labeling imaging is reproducible at both field strengths, and the reproducibility is not significantly correlated with age. Furthermore, 3T tolerates more acquisition parameter variations and allows more extensive optimizations so that 3D and 2D acquisitions can be compared.
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Affiliation(s)
- K P A Baas
- From the Department of Radiology and Nuclear Medicine (K.P.A.B., A.J.N.), Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - J Petr
- Institute of Radiopharmaceutical Cancer Research (J.P.), Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
- Department of Biomedical Engineering (J.P., H.J.M.M.M.), Institute Hall, Rochester Institute of Technology, Rochester, New York
| | - J P A Kuijer
- Department of Radiology and Nuclear Medicine (J.P.A.K., H.J.M.M.M.), Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | - A J Nederveen
- From the Department of Radiology and Nuclear Medicine (K.P.A.B., A.J.N.), Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - H J M M Mutsaerts
- Department of Biomedical Engineering (J.P., H.J.M.M.M.), Institute Hall, Rochester Institute of Technology, Rochester, New York
- Department of Radiology and Nuclear Medicine (J.P.A.K., H.J.M.M.M.), Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
- Department of Radiology and Nuclear Medicine (H.J.M.M.M.), University Hospital Ghent, Ghent, Belgium
| | - K C C van de Ven
- BIU MR (K.C.C.v.d.V.), Philips Healthcare, Best, the Netherlands
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23
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Takeuchi H, Taki Y, Nouchi R, Yokoyama R, Kotozaki Y, Nakagawa S, Sekiguchi A, Iizuka K, Yamamoto Y, Hanawa S, Araki T, Miyauchi CM, Sakaki K, Nozawa T, Ikeda S, Yokota S, Daniele M, Sassa Y, Kawashima R. Association of iron levels in hair with brain structures and functions in young adults. J Trace Elem Med Biol 2020; 58:126436. [PMID: 31760327 DOI: 10.1016/j.jtemb.2019.126436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 11/02/2019] [Accepted: 11/12/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Iron plays a critical role in normal brain functions and development, but it has also been known to have adverse neurological effects. METHODS Here, we investigated the associations of iron levels in hair with regional gray matter volume (rGMV), regional cerebral blood flow (rCBF), fractional anisotropy (FA), mean diffusivity (MD), and cognitive differences in a study cohort of 590 healthy young adults. RESULTS Our findings showed that high iron levels were associated with lower rGMV in areas including the hippocampus, lower rCBF in the anterior and posterior parts of the brain, greater FA in areas including the part of the splenium of the corpus callosum, lower MD in the overlapping area including the splenium of the corpus callosum, as well as greater MD in the left hippocampus and areas including the frontal lobe. CONCLUSION These results are compatible with the notion that iron plays diverse roles in neural mechanisms in healthy young adults.
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Affiliation(s)
- Hikaru Takeuchi
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
| | - Yasuyuki Taki
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan; Division of Medical Neuroimaging Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Radiology and Nuclear Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Rui Nouchi
- Creative Interdisciplinary Research Division, Frontier Research Institute for Interdisciplinary Science, Tohoku University, Sendai, Japan; Human and Social Response Research Division, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan; Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | | | - Yuka Kotozaki
- Division of Clinical research, Medical-Industry Translational Research Center, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seishu Nakagawa
- Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan; Division of Psychiatry, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Atsushi Sekiguchi
- Division of Medical Neuroimaging Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kunio Iizuka
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yuki Yamamoto
- Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Sugiko Hanawa
- Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | | | - Carlos Makoto Miyauchi
- Department of Language Sciences, Graduate School of Humanities, Tokyo Metropolitan University, Tokyo, Japan
| | - Kohei Sakaki
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Takayuki Nozawa
- Research Center for the Earth Inclusive Sensing Empathizing with Silent Voices, Tokyo Institute of Technology, Tokyo, Japan
| | - Shigeyuki Ikeda
- Department of Ubiquitous Sensing, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Susumu Yokota
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Magistro Daniele
- Department of Sport Science, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham, United Kingdom
| | - Yuko Sassa
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan; Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan; Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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24
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Gottschalk M. Look-Locker FAIR TrueFISP for arterial spin labelling on mouse at 9.4 T. NMR IN BIOMEDICINE 2020; 33:e4191. [PMID: 31829485 DOI: 10.1002/nbm.4191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 08/21/2019] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
Pulsed arterial spin labelling remains a non-invasive and highly used method for the study of rodent cerebral blood flow (CBF). Flow-sensitive alternating inversion recovery (FAIR) is one of the most commonly used MR-sequences for this purpose and exists with many different strategies to record the images. This study investigates Look-Locker (LL) TrueFISP readout for FAIR as an alternative to the standard EPI readout, which is provided by the manufacturer. The aim was to show the improved image quality using TrueFISP and to verify the reproducibility of the determination of the cerebral blood flow values. The measurement of many inversion points also allowed to investigate the influence of the correct blood relaxation rate on the fit of the CBF data. For the LL-FAIR TrueFISP an in-house written method was created. The method was tested on a group of C57BL/6 mice at the field strength of 9.4 T. The results show CBF maps with less distortion than for EPI and the values found are in good agreement with the literature. A comparison of the CBF values found with EPI and LL-TrueFISP shows very small differences, most being not significant. In conclusion, the method presented gives equivalent CBF maps in comparison to standard FAIR-EPI. Both methods have the same measurement time. TrueFISP has the advantage to EPI of producing undistorted images over larger areas of the mouse brain. It is advisable to check the value of the blood relaxation rate by measurement or to estimate it as a fitting parameter.
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25
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Zhang Q, Su P, Chen Z, Liao Y, Chen S, Guo R, Qi H, Li X, Zhang X, Hu Z, Lu H, Chen H. Deep learning–based MR fingerprinting ASL ReconStruction (DeepMARS). Magn Reson Med 2020; 84:1024-1034. [DOI: 10.1002/mrm.28166] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/23/2019] [Accepted: 12/17/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Qiang Zhang
- Center for Biomedical Imaging Research Department of Biomedical Engineering School of Medicine Tsinghua University Beijing China
| | - Pan Su
- The Russell H. MorganDepartment of Radiology Johns Hopkins University School of Medicine Baltimore Maryland
| | - Zhensen Chen
- Vascular Imaging Laboratory Department of Radiology University of Washington Seattle Washington
| | - Ying Liao
- Center for Biomedical Imaging Department of Radiology New York University School of Medicine New York New York
| | - Shuo Chen
- Center for Biomedical Imaging Research Department of Biomedical Engineering School of Medicine Tsinghua University Beijing China
| | - Rui Guo
- Department of Medicine (Cardiovascular Division) Beth Israel deaconess Medical Center and Harvard Medical School Boston Massachusetts
| | - Haikun Qi
- School of Biomedical Engineering and Imaging Sciences King’s College London London, London United Kingdom
| | - Xuesong Li
- School of Computer Science and Technology Beijing Institute of Technology Beijing China
| | - Xue Zhang
- Center for Biomedical Imaging Research Department of Biomedical Engineering School of Medicine Tsinghua University Beijing China
| | - Zhangxuan Hu
- Center for Biomedical Imaging Research Department of Biomedical Engineering School of Medicine Tsinghua University Beijing China
| | - Hanzhang Lu
- The Russell H. MorganDepartment of Radiology Johns Hopkins University School of Medicine Baltimore Maryland
| | - Huijun Chen
- Center for Biomedical Imaging Research Department of Biomedical Engineering School of Medicine Tsinghua University Beijing China
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Suman G, Rusin JA, Lebel RM, Hu HH. Multidelay Arterial Spin Labeling MRI in the Assessment of Cerebral Blood Flow: Preliminary Clinical Experience in Pediatrics. Pediatr Neurol 2020; 103:79-83. [PMID: 31570299 DOI: 10.1016/j.pediatrneurol.2019.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES We attempted to demonstrate the clinical applicability and utility of a three-dimensional multidelay arterial spin labeling magnetic resonance imaging technique in pediatric neuroimaging through a series of case studies. METHODS Whole-brain three-dimensional multidelay arterial spin labeling data were acquired in five pediatric patients with different neurological conditions using 3 mm to 4 mm slices and a scan time of six to seven minutes. RESULTS Three-dimensional multidelay arterial spin labeling provided complementary diagnostic information via quantitative cerebral blood flow and arterial transit time maps. CONCLUSIONS Three-dimensional multidelay arterial spin labeling sequence provides simultaneous quantification of cerebral blood flow and arterial transit time and is feasible for pediatric patients.
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Affiliation(s)
- Garima Suman
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio
| | - Jerome A Rusin
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio
| | | | - Houchun H Hu
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio.
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27
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Su P, Fan H, Liu P, Li Y, Qiao Y, Hua J, Lin D, Jiang D, Pillai JJ, Hillis AE, Lu H. MR fingerprinting ASL: Sequence characterization and comparison with dynamic susceptibility contrast (DSC) MRI. NMR IN BIOMEDICINE 2020; 33:e4202. [PMID: 31682305 PMCID: PMC7229700 DOI: 10.1002/nbm.4202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/12/2019] [Accepted: 09/26/2019] [Indexed: 06/03/2023]
Abstract
MR Fingerprinting (MRF)-based Arterial-Spin-Labeling (ASL) has the potential to measure multiple parameters such as cerebral blood flow (CBF), bolus arrival time (BAT), and tissue T1 in a single scan. However, the previous reports have only demonstrated a proof-of-principle of the technique but have not examined the performance of the sequence in the context of key imaging parameters. Furthermore, there has not been a study to directly compare the technique to clinically used perfusion method of dynamic-susceptibility-contrast (DSC) MRI. The present report consists of two studies. In the first study (N = 8), we examined the dependence of MRF-ASL sequence on TR time pattern. Ten different TR patterns with a range of temporal characteristics were examined by both simulations and experiments. The results revealed that there was a significance dependence of the sequence performance on TR pattern (p < 0.001), although there was not a single pattern that provided dramatically improvements. Among the TR patterns tested, a sinusoidal pattern with a period of 125 TRs provided an overall best estimation in terms of spatial consistency. These experimental observations were consistent with those of numerical simulations. In the second study (N = 8), we compared MRF-ASL results with those of DSC MRI. It was found that MRF-ASL and DSC MRI provided highly comparable maps of cerebral blood flow (CBF) and bolus-arrival-time (BAT), with spatial correlation coefficients of 0.79 and 0.91, respectively. However, in terms of quantitative values, BAT obtained with MRF-ASL was considerably lower than that from DSC (p < 0.001), presumably because of the differences in tracer characteristics in terms of diffusible versus intravascular tracers. Test-retest assessment of MRF-ASL MRI revealed that the spatial correlations of parametric maps were 0.997, 0.962, 0.746 and 0.863 for B1+ , T1 , CBF, and BAT, respectively. MRF-ASL is a promising technique for assessing multiple perfusion parameters simultaneously without contrast agent.
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Affiliation(s)
- Pan Su
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hongli Fan
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peiying Liu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yang Li
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ye Qiao
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jun Hua
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
| | - Doris Lin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dengrong Jiang
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jay J. Pillai
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Cognitive Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
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Intravascular signal suppression and microvascular signal mapping using delays alternating with nutation for tailored excitation (DANTE) pulse for arterial spin labeling perfusion imaging. MAGMA (NEW YORK, N.Y.) 2019; 33:367-376. [PMID: 31625029 DOI: 10.1007/s10334-019-00785-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/30/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To optimize the delays alternating with nutation for tailored excitation (DANTE) pulse as a vascular crushing gradient to eliminate macro-and micro-vascular signals and to generate a macrovascular space-related map by applying DANTE with multiple conditions. MATERIALS AND METHODS Numerical simulation was performed to estimate the optimal flip angle (FA) of the DANTE. A phantom study was conducted to evaluate the impact of the FA and gradient area (GA) of the DANTE with three flow velocities and various parameters of the DANTE. Finally, an in vivo study was performed to assess the optimal DANTE parameters and to map the estimated macrovascular signal of the arterial spin labeling (ASL) signal. RESULTS Numerical simulation revealed that the decrease of magnetization plateaued at 12.5° of FA. The phantom study showed that the setting of larger FA or GA decreased the ASL signals. The decrease of the ASL signal depended on the flow velocity, and the dependence increased with decreasing GA. The in vivo study revealed that larger FA and GA decreased the perfusion signal. DISCUSSION An optimized DANTE makes it possible to efficiently suppress the macro-and-micro vascular signals depending on the flow velocity. Moreover, macrovascular signal mapping may be useful to assess altered hemodynamic states.
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Zhao MY, Václavů L, Petersen ET, Biemond BJ, Sokolska MJ, Suzuki Y, Thomas DL, Nederveen AJ, Chappell MA. Quantification of cerebral perfusion and cerebrovascular reserve using Turbo-QUASAR arterial spin labeling MRI. Magn Reson Med 2019; 83:731-748. [PMID: 31513311 PMCID: PMC6899879 DOI: 10.1002/mrm.27956] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/12/2019] [Accepted: 07/29/2019] [Indexed: 01/10/2023]
Abstract
Purpose To compare cerebral blood flow (CBF) and cerebrovascular reserve (CVR) quantification from Turbo‐QUASAR (quantitative signal targeting with alternating radiofrequency labeling of arterial regions) arterial spin labeling (ASL) and single post‐labeling delay pseudo‐continuous ASL (PCASL). Methods A model‐based method was developed to quantify CBF and arterial transit time (ATT) from Turbo‐QUASAR, including a correction for magnetization transfer effects caused by the repeated labeling pulses. Simulations were performed to assess the accuracy of the model‐based method. Data from an in vivo experiment conducted on a healthy cohort were retrospectively analyzed to compare the CBF and CVR (induced by acetazolamide) measurement from Turbo‐QUASAR and PCASL on the basis of global and regional differences. The quality of the two ASL data sets was examined using the coefficient of variation (CoV). Results The model‐based method for Turbo‐QUASAR was accurate for CBF estimation (relative error was 8% for signal‐to‐noise ratio = 5) in simulations if the bolus duration was known. In the in vivo experiment, the mean global CVR estimated by Turbo‐QUASAR and PCASL was between 63% and 64% and not significantly different. Although global CBF values of the two ASL techniques were not significantly different, regional CBF differences were found in deep gray matter in both pre‐ and postacetazolamide conditions. The CoV of Turbo‐QUASAR data was significantly higher than PCASL. Conclusion Both ASL techniques were effective for quantifying CBF and CVR, despite the regional differences observed. Although CBF estimated from Turbo‐QUASAR demonstrated a higher variability than PCASL, Turbo‐QUASAR offers the advantage of being able to measure and control for variation in ATT.
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Affiliation(s)
- Moss Y Zhao
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom.,Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Lena Václavů
- Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Amsterdam, Netherlands
| | - Esben T Petersen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Centre for Magnetic Resonance, DTU Elektro, Technical University of Denmark, Kgs Lyngby, Denmark
| | - Bart J Biemond
- Amsterdam UMC, University of Amsterdam, Haematology, Internal Medicine, Amsterdam, Netherlands
| | - Magdalena J Sokolska
- Medical Physics and Biomedical Engineering, University College London Hospitals, London, United Kingdom
| | - Yuriko Suzuki
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom.,Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - David L Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.,Leonard Wolfson Experimental Neurology Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Aart J Nederveen
- Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Amsterdam, Netherlands
| | - Michael A Chappell
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom.,Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Shao X, Zhao Z, Russin J, Amar A, Sanossian N, Wang DJ, Yan L. Quantification of intracranial arterial blood flow using noncontrast enhanced 4D dynamic MR angiography. Magn Reson Med 2019; 82:449-459. [PMID: 30847971 DOI: 10.1002/mrm.27712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/16/2019] [Accepted: 02/05/2019] [Indexed: 01/27/2023]
Abstract
PURPOSE Noncontrast enhanced dynamic magnetic resonance angiography delineates the pattern of dynamic blood flow of the cerebral vasculature. A model-free solution was proposed to quantify arterial blood flow (aBF) by using the monotonic property of the residual function. THEORY AND METHODS Analytical simulations and in-vivo studies were performed to evaluate the performance of the proposed method by comparing the aBF values generated from the proposed and conventional singular value decomposition methods. The aBF values were compared with blood flow velocity measured by 2D phase contrast MRI, and compared between balanced steady-state free precession-based radial and spoiled GRE-based Cartesian acquisitions. Hemodynamic parametric maps were generated in 1 patient with arteriovenous malformation. RESULTS The proposed method generates reliable aBF measurement at different signal-to-noise ratio levels, whereas overestimation/underestimation of aBF was observed when a high/low threshold was applied in the singular value decomposition method. Average aBF in large vascular branches was 214.4 and 214.5 mL/mL/min with radial and Cartesian acquisitions, respectively. Significant correlations were found between aBF and blood flow velocity measured by phase contrast MRI (P = 0.0008), and between Cartesian and radial acquisitions (P < 0.0001). Altered hemodynamics were observed at the lesion site of the arteriovenous malformation patient. CONCLUSION A robust analytical solution was proposed for quantifying aBF. This model-free method is robust to noise, and its clinical value in the diagnosis of cerebrovascular disorders awaits further evaluation.
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Affiliation(s)
- Xingfeng Shao
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Ziwei Zhao
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jonathan Russin
- Center for Neurorestoration, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Arun Amar
- Center for Neurorestoration, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Nerses Sanossian
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Danny Jj Wang
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Lirong Yan
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California
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31
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Wesolowski R, Blockley NP, Driver ID, Francis ST, Gowland PA. Coupling between cerebral blood flow and cerebral blood volume: Contributions of different vascular compartments. NMR IN BIOMEDICINE 2019; 32:e4061. [PMID: 30657208 PMCID: PMC6492110 DOI: 10.1002/nbm.4061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 06/09/2023]
Abstract
A better understanding of the coupling between changes in cerebral blood flow (CBF) and cerebral blood volume (CBV) is vital for furthering our understanding of the BOLD response. The aim of this study was to measure CBF-CBV coupling in different vascular compartments during neural activation. Three haemodynamic parameters were measured during a visual stimulus. Look-Locker flow-sensitive alternating inversion recovery was used to measure changes in CBF and arterial CBV (CBVa ) using sequence parameters optimized for each contrast. Changes in total CBV (CBVtot ) were measured using a gadolinium-based contrast agent technique. Haemodynamic changes were extracted from a region of interest based on voxels that were activated in the CBF experiments. The CBF-CBVtot coupling constant αtot was measured as 0.16 ± 0.14 and the CBF-CBVa coupling constant αa was measured as 0.65 ± 0.24. Using a two-compartment model of the vasculature (arterial and venous), the change in venous CBV (CBVv ) was predicted for an assumed value of baseline arterial and venous blood volume. These results will enhance the accuracy and reliability of applications that rely on models of the BOLD response, such as calibrated BOLD.
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Affiliation(s)
- Roman Wesolowski
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
- Medical Physics and ImagingUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Nicholas P. Blockley
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Ian D. Driver
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUK
| | - Susan T. Francis
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
| | - Penny A. Gowland
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
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32
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Atwi S, Shao H, Crane DE, da Costa L, Aviv RI, Mikulis DJ, Black SE, MacIntosh BJ. BOLD-based cerebrovascular reactivity vascular transfer function isolates amplitude and timing responses to better characterize cerebral small vessel disease. NMR IN BIOMEDICINE 2019; 32:e4064. [PMID: 30693582 DOI: 10.1002/nbm.4064] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 12/03/2018] [Accepted: 12/18/2018] [Indexed: 06/09/2023]
Abstract
Cerebrovascular reactivity (CVR) is a dynamic measure of the cerebral blood vessel response to vasoactive stimulus. Conventional CVR measures amplitude changes in the blood-oxygenation-level-dependent (BOLD) signal per unit change in end-tidal CO2 (PET CO2 ), effectively discarding potential timing information. This study proposes a deconvolution procedure to characterize CVR responses based on a vascular transfer function (VTF) that separates amplitude and timing CVR effects. We implemented the CVR-VTF to primarily evaluate normal-appearing white matter (WM) responses in those with a range of small vessel disease. Comparisons between simulations of PET CO2 input models revealed that boxcar and ramp hypercapnia paradigms had the lowest relative deconvolution error. We used a T2 * BOLD-MRI sequence on a 3 T MRI scanner, with a boxcar delivery model of CO2 , to test the CVR-VTF approach in 18 healthy adults and three white matter hyperintensity (WMH) groups: 20 adults with moderate WMH, 12 adults with severe WMH, and 10 adults with genetic WMH (CADASIL). A subset of participants performed a second CVR session at a one-year follow-up. Conventional CVR, area under the curve of VTF (VTF-AUC), and VTF time-to-peak (VTF-TTP) were assessed in WM and grey matter (GM) at baseline and one-year follow-up. WMH groups had lower WM VTF-AUC compared with the healthy group (p < 0.0001), whereas GM CVR did not differ between groups (p > 0.1). WM VTF-TTP of the healthy group was less than that in the moderate WMH group (p = 0.016). Baseline VTF-AUC was lower than follow-up VTF-AUC in WM (p = 0.013) and GM (p = 0.026). The intraclass correlation for VTF-AUC in WM was 0.39 and coefficient of repeatability was 0.08 [%BOLD/mm Hg]. This study assessed CVR timing and amplitude information without applying model assumptions to the CVR response; this approach may be useful in the development of robust clinical biomarkers of CSVD.
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Affiliation(s)
- Sarah Atwi
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Han Shao
- Division of Engineering Science, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, Canada
| | - David E Crane
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Leodante da Costa
- Division of Neurosurgery, Department of Surgery, Sunnybrook Hospital, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Richard I Aviv
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - David J Mikulis
- Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, 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 Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Centre, Toronto, ON, Canada
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
| | - Bradley J MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
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33
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Kronenburg A, Bulder MMM, Bokkers RPH, Hartkamp NS, Hendrikse J, Vonken EJ, Kappelle LJ, van der Zwan A, Klijn CJM, Braun KPJ. Cerebrovascular Reactivity Measured with ASL Perfusion MRI, Ivy Sign, and Regional Tissue Vascularization in Moyamoya. World Neurosurg 2019; 125:e639-e650. [PMID: 30716498 DOI: 10.1016/j.wneu.2019.01.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) may be used to determine brain regions at risk for ischemia in patients with moyamoya vasculopathy and to identify patients who may benefit from surgical revascularization. We aimed to investigate whether 1) the severity of moyamoya is related to the presence of leptomeningeal collaterals and cerebrovascular reactivity (CVR), 2) the presence of collaterals and ivy sign reflects disturbed CVR, and 3) arterial transit artefacts (ATAs) and ivy sign reflect the presence of collaterals. METHODS We determined severity of moyamoya on digital subtraction angiography (DSA) according to the modified Suzuki classification in 20 brain regions and scored regional tissue revascularization using a 4-point scale. Regional CVR and ATAs were assessed on ASL perfusion MRI, ivy sign on fluid attenuation inversion recovery MRI. RESULTS In 11 patients (median age 36 years; 91% female), we studied 203 regions. ATAs were associated with the presence of collaterals on DSA (P < 0.01). Of all regions with clearly visible collateral vessels on DSA, however, only 24% had ATAs. Ivy sign was not related to the presence or absence of collaterals nor to CVR. In 10% of regions with good vascularization on DSA, CVR was poor or showed steal. CONCLUSIONS ATAs were associated with the presence of collaterals on DSA. Although DSA vascularization scores correlated with CVR, 10% of regions with good vascularization on DSA had absent CVR or steal on ASL-MRI. DSA and ivy sign did not provide adequate information on the hemodynamic status of brain tissue in patients with moyamoya vasculopathy.
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Affiliation(s)
- Annick Kronenburg
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht, the Netherlands.
| | - Marcel M M Bulder
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht, the Netherlands; Department of Neurology, Bravis Hospital, Bergen op Zoom, the Netherlands
| | - Reinoud P H Bokkers
- Department of Radiology, UMC Utrecht, Utrecht, the Netherlands; Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | | | | | - L Jaap Kappelle
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Albert van der Zwan
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Catharina J M Klijn
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht, the Netherlands; Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Center for Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Kees P J Braun
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht, the Netherlands
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Li Y, Liu P, Li Y, Fan H, Su P, Peng SL, Park DC, Rodrigue KM, Jiang H, Faria AV, Ceritoglu C, Miller M, Mori S, Lu H. ASL-MRICloud: An online tool for the processing of ASL MRI data. NMR IN BIOMEDICINE 2019; 32:e4051. [PMID: 30588671 PMCID: PMC6324946 DOI: 10.1002/nbm.4051] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/27/2018] [Accepted: 11/13/2018] [Indexed: 05/30/2023]
Abstract
Arterial spin labeling (ASL) MRI is increasingly used in research and clinical settings. The purpose of this work is to develop a cloud-based tool for ASL data processing, referred to as ASL-MRICloud, which may be useful to the MRI community. In contrast to existing ASL toolboxes, which are based on software installation on the user's local computer, ASL-MRICloud uses a web browser for data upload and results download, and the computation is performed on the remote server. As such, this tool is independent of the user's operating system, software version, and CPU speed. The ASL-MRICloud tool was implemented to be compatible with data acquired by scanners from all major MRI manufacturers, is capable of processing several common forms of ASL, including pseudo-continuous ASL and pulsed ASL, and can process single-delay and multi-delay ASL data. The outputs of ASL-MRICloud include absolute and relative values of cerebral blood flow, arterial transit time, voxel-wise masks indicating regions with potential hyper-perfusion and hypo-perfusion, and an image quality index. The ASL tool is also integrated with a T1 -based brain segmentation and normalization tool in MRICloud to allow generation of parametric maps in standard brain space as well as region-of-interest values. The tool was tested on a large data set containing 309 ASL scans as well as on publicly available ASL data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study.
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Affiliation(s)
- Yang Li
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peiying Liu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yue Li
- AnatomyWorks, LLC, Baltimore, MD, USA
| | - Hongli Fan
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Pan Su
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung City, Taiwan
| | - Denise C. Park
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Karen M. Rodrigue
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hangyi Jiang
- The Russell H. Morgan Department of Radiology & 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
| | - Andreia V. Faria
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Can Ceritoglu
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA
| | - Michael Miller
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA
| | - Susumu Mori
- The Russell H. Morgan Department of Radiology & 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
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
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Gai ND, Butman JA. Determining the optimal postlabeling delay for arterial spin labeling using subject-specific estimates of blood velocity in the carotid artery. J Magn Reson Imaging 2019; 50:951-960. [PMID: 30681220 DOI: 10.1002/jmri.26670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Arterial spin labeling with 3D acquisition requires determining a single postlabeling delay (PLD) value. PLD affects the signal-to-noise ratio (SNR) per unit time as well as quantitative cerebral blood flow (CBF) values due to its bearing on the presence of a vascular signal. PURPOSE To search for an optimal PLD for pseudocontinuous arterial spin labeling (pCASL) using patient-specific carotid artery blood velocity measurements. STUDY TYPE Prospective. SUBJECTS A control group of 11 volunteers with no known pathology. Corroboration was through a separate group of six volunteers and a noncontrol group of five sickle cell disease (SCD) patients. FIELD STRENGTH/SEQUENCE Pseudocontinuous arterial spin labeling with 3D nonsegmented echo planar imaging acquisition at 3T. ASSESSMENT A perfusion-based measure was determined over a range of PLDs for each of 11 volunteers. A third-order polynomial was used to find the optimal PLD where the defined measure was maximum. This was plotted against the corresponding carotid artery velocity to determine a relationship between the perfusion measure and velocity. Corroboration was done using a group of six volunteers and a noncontrol group of five patients with SCD. PLD was determined from the carotid artery velocity and derived relationship and compared with optimal PLD obtained from measured perfusion over a range of PLD values. Error between the perfusion measure at predicted and measured optimal PLD was determined. STATISTICAL TESTS Chi-squared goodness of fit; Pearson correlation; Bland-Altman. RESULTS Carotid artery velocity was 63.8 ± 6.6 cm/s (53.1 ≤ v ≤ 72.3 cm/s) while optimal PLD was 1374 ± 226.5 msec (1102 ≤ PLD ≤ 1787 msec) across the 11 volunteers. PLD as a function of carotid velocity was determined to be PLD = -31.94. v + 3410 msec (Pearson correlation -0.93). In six volunteers, mean error between the perfusion measure at predicted and measured optimal PLD was 1.35%. Pearson correlation between the perfusion measure at the predicted PLD and the measure obtained experimentally was r = 0.96 (P < 0.001). Bland-Altman revealed a slight bias of 1.3%. For the test case of five SCD patients, the mean error was 1.3%. DATA CONCLUSION Carotid artery velocity was used to determine optimal PLD for pCASL with 3D acquisition. The derived relationship was used to predict optimal PLD and the associated perfusion measure, which was found to be accurate when compared with its measured counterpart. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:951-960.
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Affiliation(s)
- Neville D Gai
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - John A Butman
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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Antolak AG, Jackson EF. Development and evaluation of an arterial spin-labeling digital reference object for quality control and comparison of data analysis applications. Phys Med Biol 2019; 64:02NT01. [PMID: 30540982 DOI: 10.1088/1361-6560/aaf83b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Longitudinal assessment of quantitative imaging biomarkers (QIBs) requires a comprehensive quality control (QC) program to minimize bias and variance in measurement results. In addition, the availability of data analysis software from multiple vendors emphasizes the need for a means of quantitatively comparing the computed QIB measures produced by the applications. The purpose of this work is to describe a digital reference object (DRO) that has been developed for the evaluation of arterial spin-labeling (ASL) measurement results. The ASL DRO is a synthetic data set consisting of 10 × 10 voxel square blocks with a range of ASL control image signal-to-noise ratio (SNRControl), blood flow (BF), and proton density (PD) image SNR values (SNRControl:1-100, BF:10-210 ml/100 g min-1, SNRPD:10-100). A pseudo-continuous ASL sequence was simulated with acquisition parameters and modeled signal intensities defined according to those typically associated with clinically-acquired ASL images. ASL parameters were estimated using the commercially-available nordicICE software package (NordicNeuroLab, Inc, Milwaukee, WI). Percent bias measures and Bland-Altman analyses demonstrated decreased bias and variance with increasing SNRControl and BF values. Excellent agreement with reference values was seen for all BF values above an SNRControl of 5 (concordance correlation coefficient greater than 0.92 for all SNRPD values). The ASL DRO developed in this work allows for the evaluation of software bias and variance across physiologically-meaningful BF and SNRControl values. Such studies are essential to the transition of quantitative ASL-based BF measurements into widespread clinical research applications, and ultimately, routine clinical care.
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Affiliation(s)
- Alexander G Antolak
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue, Madison, WI 53705-2275, United States of America
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Okell TW. Combined angiography and perfusion using radial imaging and arterial spin labeling. Magn Reson Med 2019; 81:182-194. [PMID: 30024066 PMCID: PMC6282709 DOI: 10.1002/mrm.27366] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/28/2018] [Accepted: 04/25/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE To demonstrate the feasibility of a novel noninvasive MRI technique for the comprehensive evaluation of blood flow to the brain: combined angiography and perfusion using radial imaging and arterial spin labeling (CAPRIA). METHODS In the CAPRIA pulse sequence, blood labeled with a pseudocontinuous arterial spin labeling pulse train is continuously imaged as it flows through the arterial tree and into the brain tissue using a golden ratio radial readout. From a single raw data set, this flexible imaging approach allows the reconstruction of both high spatial/temporal resolution angiographic images with a high undersampling factor and low spatial/temporal resolution perfusion images with a low undersampling factor. The sparse and high SNR nature of angiographic images ensures that radial undersampling artifacts are relatively benign, even when using a simple regridding image reconstruction. Pulse sequence parameters were optimized through sampling efficiency calculations and the numerical evaluation of modified pseudocontinuous arterial spin labeling signal models. A comparison was made against conventional pseudocontinuous arterial spin labeling angiographic and perfusion acquisitions. RESULTS 2D CAPRIA data in healthy volunteers demonstrated the feasibility of this approach, with good vessel visualization in the angiographic images and clear tissue perfusion signal when reconstructed at 108-ms and 252-ms temporal resolution, respectively. Images were qualitatively similar to those from conventional acquisitions, but CAPRIA had significantly higher SNR efficiency (48% improvement on average, P = 0.02). CONCLUSION The CAPRIA technique shows potential for the efficient evaluation of both macrovascular blood flow and tissue perfusion within a single scan, with potential applications in a range of cerebrovascular diseases.
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Affiliation(s)
- Thomas W. Okell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
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Fallatah SM, Pizzini FB, Gomez-Anson B, Magerkurth J, De Vita E, Bisdas S, Jäger HR, Mutsaerts HJMM, Golay X. A visual quality control scale for clinical arterial spin labeling images. Eur Radiol Exp 2018; 2:45. [PMID: 30569375 PMCID: PMC6300452 DOI: 10.1186/s41747-018-0073-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Image-quality assessment is a fundamental step before clinical evaluation of magnetic resonance images. The aim of this study was to introduce a visual scoring system that provides a quality control standard for arterial spin labeling (ASL) and that can be applied to cerebral blood flow (CBF) maps, as well as to ancillary ASL images. METHODS The proposed image quality control (QC) system had two components: (1) contrast-based QC (cQC), describing the visual contrast between anatomical structures; and (2) artifact-based QC (aQC), evaluating image quality of the CBF map for the presence of common types of artifacts. Three raters evaluated cQC and aQC for 158 quantitative signal targeting with alternating radiofrequency labelling of arterial regions (QUASAR) ASL scans (CBF, T1 relaxation rate, arterial blood volume, and arterial transient time). Spearman correlation coefficient (r), intraclass correlation coefficients (ICC), and receiver operating characteristic analysis were used. RESULTS Intra/inter-rater agreement ranged from moderate to excellent; inter-rater ICC was 0.72 for cQC, 0.60 for aQC, and 0.74 for the combined QC (cQC + aQC). Intra-rater ICC was 0.90 for cQC; 0.80 for aQC, and 0.90 for the combined QC. Strong correlations were found between aQC and CBF maps quality (r = 0.75), and between aQC and cQC (r = 0.70). A QC score of 18 was optimal to discriminate between high and low quality clinical scans. CONCLUSIONS The proposed QC system provided high reproducibility and a reliable threshold for discarding low quality scans. Future research should compare this visual QC system with an automatic QC system.
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Affiliation(s)
- S M Fallatah
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.,The National Hospital for Neurology and Neurosurgery, London, UK.,Radiology Department, King Abdualaziz Medical City, Riyadh, Saudi Arabia
| | - F B Pizzini
- Neuroradiology, University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy.
| | - B Gomez-Anson
- Unitat Neuroradiologia, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Universitat Autonoma, Barcelona, Spain
| | - J Magerkurth
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK
| | - E De Vita
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.,The National Hospital for Neurology and Neurosurgery, London, UK
| | - S Bisdas
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.,The National Hospital for Neurology and Neurosurgery, London, UK
| | - H R Jäger
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.,The National Hospital for Neurology and Neurosurgery, London, UK
| | - H J M M Mutsaerts
- Radiology Department, Academic Medical Center, Amsterdam, The Netherlands.,Radiology Department, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands.,Radiology Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | - X Golay
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.,The National Hospital for Neurology and Neurosurgery, London, UK
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39
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Havsteen I, Damm Nybing J, Christensen H, Christensen AF. Arterial spin labeling: a technical overview. Acta Radiol 2018; 59:1232-1238. [PMID: 29313361 DOI: 10.1177/0284185117752552] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Arterial spin labeling (ASL) is a non-invasive magnetic resonance imaging perfusion method based on changes in net-magnetization of blood water. The absence of contrast use and ionizing radiation, renders ASL valuable in hyper-acute settings as a monitoring tool for repeated dynamical measurements during and after intervention, and for patients with known co-morbidities. This text provides a short methodological introduction to ASL and contrasts it with traditional contrast-enhanced perfusion imaging. The review focused on sequence usefulness in the clinical setting of acute cerebral ischemia investigation.
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Affiliation(s)
- Inger Havsteen
- Department of Radiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Janus Damm Nybing
- Department of Radiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Hanne Christensen
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Anders F Christensen
- Department of Radiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
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40
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van der Thiel M, Rodriguez C, Giannakopoulos P, Burke MX, Lebel RM, Gninenko N, Van De Ville D, Haller S. Brain Perfusion Measurements Using Multidelay Arterial Spin-Labeling Are Systematically Biased by the Number of Delays. AJNR Am J Neuroradiol 2018; 39:1432-1438. [PMID: 29976831 DOI: 10.3174/ajnr.a5717] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 05/09/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Multidelay arterial spin-labeling is a promising emerging method in clinical practice. The effect of imaging parameters in multidelay arterial spin-labeling on estimated cerebral blood flow measurements remains unknown. We directly compared 3-delay versus 7-delay sequences, assessing the difference in the estimated transit time and blood flow. MATERIALS AND METHODS This study included 87 cognitively healthy controls (78.7 ± 3.8 years of age; 49 women). We assessed delay and transit time-uncorrected and transit time-corrected CBF maps. Data analysis included voxelwise permutation-based between-sequence comparisons of 3-delay versus 7-delay, within-sequence comparison of transit time-uncorrected versus transit time-corrected maps, and average CBF calculations in regions that have been shown to differ. RESULTS The 7-delay sequence estimated a higher CBF value than the 3-delay for the transit time-uncorrected and transit time-corrected maps in regions corresponding to the watershed areas (transit time-uncorrected = 27.62 ± 12.23 versus 24.58 ± 11.70 mL/min/100 g, Cohen's d = 0.25; transit time-corrected = 33.48 ± 14.92 versus 30.16 ± 14.32 mL/min/100 g, Cohen's d = 0.23). In the peripheral regions of the brain, the estimated delay was found to be longer for the 3-delay sequence (1.52408 ± 0.25236 seconds versus 1.47755 ± 0.24242 seconds, Cohen's d = 0.19), while the inverse was found in the center of the brain (1.39388 ± 0.22056 seconds versus 1.42565 ± 0.21872 seconds, Cohen's d = 0.14). Moreover, 7-delay had lower hemispheric asymmetry. CONCLUSIONS The results of this study support the necessity of standardizing acquisition parameters in multidelay arterial spin-labeling and identifying basic parameters as a confounding factor in CBF quantification studies. Our findings conclude that multidelay arterial spin-labeling sequences with a high number of delays estimate higher CBF values than those with a lower number of delays.
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Affiliation(s)
- M van der Thiel
- From the Faculty of Medicine of the University of Geneva (M.v.d.T., P.G., N.G., D.v.d.V., S.H.), Geneva, Switzerland
- Institute of Bioengineering (M.v.d.T., N.G., D.v.d.V.), School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - C Rodriguez
- Division of Institutional Measures (C.R., P.G.), Medical Direction, University Hospitals of Geneva, Geneva, Switzerland
| | - P Giannakopoulos
- From the Faculty of Medicine of the University of Geneva (M.v.d.T., P.G., N.G., D.v.d.V., S.H.), Geneva, Switzerland
- Division of Institutional Measures (C.R., P.G.), Medical Direction, University Hospitals of Geneva, Geneva, Switzerland
| | - M X Burke
- GE Healthcare (M.X.B., M.L.), Little Chalfont, UK
| | - R Marc Lebel
- GE Healthcare (M.X.B., M.L.), Little Chalfont, UK
| | - N Gninenko
- From the Faculty of Medicine of the University of Geneva (M.v.d.T., P.G., N.G., D.v.d.V., S.H.), Geneva, Switzerland
- Institute of Bioengineering (M.v.d.T., N.G., D.v.d.V.), School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - D Van De Ville
- From the Faculty of Medicine of the University of Geneva (M.v.d.T., P.G., N.G., D.v.d.V., S.H.), Geneva, Switzerland
- Institute of Bioengineering (M.v.d.T., N.G., D.v.d.V.), School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - S Haller
- From the Faculty of Medicine of the University of Geneva (M.v.d.T., P.G., N.G., D.v.d.V., S.H.), Geneva, Switzerland
- Affidea Centre de Diagnostic Radiologique de Carouge (S.H.), Geneva, Switzerland
- Department of Surgical Sciences and Radiology (S.H.), Uppsala University, Uppsala, Sweden
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41
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Sakai M, Takeuchi H, Yu Z, Kikuchi Y, Ono C, Takahashi Y, Ito F, Matsuoka H, Tanabe O, Yasuda J, Taki Y, Kawashima R, Tomita H. Polymorphisms in the microglial marker molecule CX3CR1 affect the blood volume of the human brain. Psychiatry Clin Neurosci 2018; 72:409-422. [PMID: 29485193 DOI: 10.1111/pcn.12649] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/12/2018] [Accepted: 02/21/2018] [Indexed: 12/18/2022]
Abstract
AIM CX3CR1, a G-protein-coupled receptor, is involved in various inflammatory processes. Two non-synonymous single nucleotide polymorphisms, V249I (rs3732379) and T280M (rs3732378), are located in the sixth and seventh transmembrane domains of the CX3CR1 protein, respectively. Previous studies have indicated significant associations between T280M and leukocyte functional characteristics, including adhesion, signaling, and chemotaxis, while the function of V249I is unclear. In the brain, microglia are the only proven and widely accepted CX3CR1-expressing cells. This study aimed to specify whether there were specific brain regions on which these two single nucleotide polymorphisms exert their biological impacts through their functional effects on microglia. METHODS Associations between the single nucleotide polymorphisms and brain characteristics, including gray and white matter volumes, white matter integrity, resting arterial blood volume, and cerebral blood flow, were evaluated among 1300 healthy Japanese individuals. RESULTS The major allele carriers (V249 and T280) were significantly associated with an increased total arterial blood volume of the whole brain, especially around the bilateral precuneus, left posterior cingulate cortex, and left posterior parietal cortex. There were no significant associations between the genotypes and other brain structural indicators. CONCLUSION This finding suggests that the CX3CR1 variants may affect arterial structures in the brain, possibly via interactions between microglia and brain microvascular endothelial cells.
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Affiliation(s)
- Mai Sakai
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hikaru Takeuchi
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Zhiqian Yu
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yoshie Kikuchi
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Chiaki Ono
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yuta Takahashi
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Fumiaki Ito
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Hiroo Matsuoka
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Osamu Tanabe
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Jun Yasuda
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Nuclear Medicine and Radiology, Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Functional Brain Imaging, Smart Aging Research Center, Tohoku University, Sendai, Japan
| | - Hiroaki Tomita
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
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42
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Overview and Critical Appraisal of Arterial Spin Labelling Technique in Brain Perfusion Imaging. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:5360375. [PMID: 29853806 PMCID: PMC5964483 DOI: 10.1155/2018/5360375] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/11/2018] [Indexed: 12/02/2022]
Abstract
Arterial spin labelling (ASL) allows absolute quantification of CBF via a diffusible intrinsic tracer (magnetically labelled blood water) that disperses from the vascular system into neighbouring tissue. Thus, it can provide absolute CBF quantification, which eliminates the need for the contrast agent, and can be performed repeatedly. This review will focus on the common ASL acquisition techniques (continuous, pulsed, and pseudocontinuous ASL) and how ASL image quality might be affected by intrinsic factors that may bias the CBF measurements. We also provide suggestions to mitigate these risks, model appropriately the acquired signal, increase the image quality, and hence estimate the reliability of the CBF, which consists an important noninvasive biomarker. Emerging methodologies for extraction of new ASL-based biomarkers, such as arterial arrival time (AAT) and arterial blood volume (aBV), will be also briefly discussed.
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43
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Jezzard P, Chappell MA, Okell TW. Arterial spin labeling for the measurement of cerebral perfusion and angiography. J Cereb Blood Flow Metab 2018; 38:603-626. [PMID: 29168667 PMCID: PMC5888859 DOI: 10.1177/0271678x17743240] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Arterial spin labeling (ASL) is an MRI technique that was first proposed a quarter of a century ago. It offers the prospect of non-invasive quantitative measurement of cerebral perfusion, making it potentially very useful for research and clinical studies, particularly where multiple longitudinal measurements are required. However, it has suffered from a number of challenges, including a relatively low signal-to-noise ratio, and a confusing number of sequence variants, thus hindering its clinical uptake. Recently, however, there has been a consensus adoption of an accepted acquisition and analysis framework for ASL, and thus a better penetration onto clinical MRI scanners. Here, we review the basic concepts in ASL and describe the current state-of-the-art acquisition and analysis approaches, and the versatility of the method to perform both quantitative cerebral perfusion measurement, along with quantitative cerebral angiographic measurement.
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Affiliation(s)
- Peter Jezzard
- 1 Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Thomas W Okell
- 1 Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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44
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Ahlgren A, Wirestam R, Knutsson L, Petersen ET. Improved calculation of the equilibrium magnetization of arterial blood in arterial spin labeling. Magn Reson Med 2018; 80:2223-2231. [DOI: 10.1002/mrm.27193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 03/03/2018] [Accepted: 03/05/2018] [Indexed: 11/07/2022]
Affiliation(s)
- André Ahlgren
- Department of Medical Radiation PhysicsLund UniversityLund Sweden
| | - Ronnie Wirestam
- Department of Medical Radiation PhysicsLund UniversityLund Sweden
| | - Linda Knutsson
- Department of Medical Radiation PhysicsLund UniversityLund Sweden
- Department of RadiologyJohns Hopkins School of MedicineBaltimore Maryland
| | - Esben Thade Petersen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and ResearchCopenhagen University Hospital HvidovreHvidovre Denmark
- Center for Magnetic Resonance, DTU ElektroTechnical University of DenmarkKgs Lyngby Denmark
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45
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Phyu P, Merwick A, Davagnanam I, Bolsover F, Jichi F, Wheeler-Kingshott C, Golay X, Hughes D, Cipolotti L, Murphy E, Lachmann RH, Werring DJ. Increased resting cerebral blood flow in adult Fabry disease: MRI arterial spin labeling study. Neurology 2018; 90:e1379-e1385. [PMID: 29661900 DOI: 10.1212/wnl.0000000000005330] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/23/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess resting cerebral blood flow (CBF) in the whole-brain and cerebral white matter (WM) and gray matter (GM) of adults with Fabry disease (FD), using arterial spin labeling (ASL) MRI, and to investigate CBF correlations with WM hyperintensity (WMH) volume and the circulating biomarker lyso-Gb3. METHODS This cross-sectional, case-control study included 25 patients with genetically confirmed FD and 18 age-matched healthy controls. We quantified resting CBF using Quantitative Signal Targeting With Alternating Radiofrequency Labeling of Arterial Regions (QUASAR) ASL MRI. We measured WMH volume using semiautomated software. We measured CBF in regions of interest in whole-brain, WM, and deep GM, and assessed correlations with WMH volume and plasma lyso-Gb3. RESULTS The mean age (% male) for FD and healthy controls was 42.2 years (44%) and 37.1 years (50%). Mean whole-brain CBF was 27.56 mL/100 mL/min (95% confidence interval [CI] 23.78-31.34) for FD vs 22.39 mL/100 mL/min (95% CI 20.08-24.70) for healthy controls, p = 0.03. In WM, CBF was higher in FD (22.42 mL/100 mL/min [95% CI 17.72-27.12] vs 16.25 mL/100 mL/min [95% CI 14.03-18.48], p = 0.05). In deep GM, CBF was similar between groups (40.41 mL/100 mL/min [95% CI 36.85-43.97] for FD vs 37.46 mL/100 mL/min [95% CI 32.57-42.35], p = 0.38). In patients with FD with WMH (n = 20), whole-brain CBF correlated with WMH volume (r = 0.59, p = 0.006), not with plasma lyso-Gb3. CONCLUSION In FD, resting CBF is increased in WM but not deep GM. In FD, CBF correlates with WMH, suggesting that cerebral perfusion changes might contribute to, or result from, WM injury.
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Affiliation(s)
- Po Phyu
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Aine Merwick
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Indran Davagnanam
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Fay Bolsover
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Fatima Jichi
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Claudia Wheeler-Kingshott
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Xavier Golay
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Deralynn Hughes
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Lisa Cipolotti
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Elaine Murphy
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - Robin H Lachmann
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK
| | - David John Werring
- From the Stroke Research Centre, Department of Brain Repair and Rehabilitation (P.P., A.M., I.D., X.G., D.J.W.), UCL Institute of Neurology; Charles Dent Metabolic Unit (A.M., E.M., R.H.L.), National Hospital for Neurology and Neurosurgery, London; Beaumont Hospital and Royal College of Surgeons in Ireland (A.M.), Beaumont, Dublin; Academic Department of Neuroradiology (I.D., X.G.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London; Department of Neuropsychology (F.B., L.C.), National Hospital for Neurology and Neurosurgery; Department of Biostatistics (F.J.), UCL and University College London Hospitals; Department of Neuroinflammation (C.W.-K.), UCL Institute of Neurology; and Lysosomal Storage Disorders Unit (D.H.), Royal Free Hospital, London, UK.
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46
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Lin Z, Li Y, Su P, Mao D, Wei Z, Pillai JJ, Moghekar A, van Osch M, Ge Y, Lu H. Non-contrast MR imaging of blood-brain barrier permeability to water. Magn Reson Med 2018; 80:1507-1520. [PMID: 29498097 DOI: 10.1002/mrm.27141] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/05/2018] [Accepted: 01/29/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Many brain diseases are associated with an alteration in blood-brain barrier (BBB) and its permeability. Current methods using contrast agent are primarily sensitive to major leakage of BBB to macromolecules, but may not detect subtle changes in BBB permeability. The present study aims to develop a novel non-contrast MRI technique for the assessment of BBB permeability to water. METHODS The central principle is that by measuring arterially labeled blood spins that are drained into cerebral veins, water extraction fraction (E) and permeability-surface-area product (PS) of BBB can be determined. Four studies were performed. We first demonstrated the proof-of-principle using conventional ASL with very long post-labeling delays (PLD). Next, a new sequence, dubbed water-extraction-with-phase-contrast-arterial-spin-tagging (WEPCAST), and its Look-Locker (LL) version were developed. Finally, we demonstrated that the sensitivity of the technique can be significantly enhanced by acquiring the data under mild hypercapnia. RESULTS By combining a strong background suppression with long PLDs (2500-4500 ms), ASL spins were reliably detected in the superior sagittal sinus (SSS), demonstrating the feasibility of measuring this signal. The WEPCAST sequence eliminated partial voluming effects of tissue perfusion and allowed quantitative estimation of E = 95.5 ± 1.1% and PS = 188.9 ± 13.4 mL/100 g/min, which were in good agreement with literature reports. LL-WEPCAST sequence shortened the scan time from 19 min to 5 min while providing results consistent with multiple single-PLD acquisitions. Mild hypercapnia increased SNR by 78 ± 25% without causing a discomfort in participants. CONCLUSION A new non-contrast technique for the assessment of global BBB permeability was developed, which may have important clinical applications.
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Affiliation(s)
- Zixuan Lin
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Yang Li
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Pan Su
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Deng Mao
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Zhiliang Wei
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland
| | - Jay J Pillai
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Abhay Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthias van Osch
- Department of Radiology, C. J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, the Netherlands
| | - Yulin Ge
- Department of Radiology, New York University Langone Medical Center, New York, New York
| | - Hanzhang Lu
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland.,The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland
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47
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Stivaros S, Garg S, Tziraki M, Cai Y, Thomas O, Mellor J, Morris AA, Jim C, Szumanska-Ryt K, Parkes LM, Haroon HA, Montaldi D, Webb N, Keane J, Castellanos FX, Silva AJ, Huson S, Williams S, Gareth Evans D, Emsley R, Green J. Randomised controlled trial of simvastatin treatment for autism in young children with neurofibromatosis type 1 (SANTA). Mol Autism 2018; 9:12. [PMID: 29484149 PMCID: PMC5824534 DOI: 10.1186/s13229-018-0190-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background Neurofibromatosis 1 (NF1) is a monogenic model for syndromic autism. Statins rescue the social and cognitive phenotype in animal knockout models, but translational trials with subjects > 8 years using cognition/behaviour outcomes have shown mixed results. This trial breaks new ground by studying statin effects for the first time in younger children with NF1 and co-morbid autism and by using multiparametric imaging outcomes. Methods A single-site triple-blind RCT of simvastatin vs. placebo was done. Assessment (baseline and 12-week endpoint) included peripheral MAPK assay, awake magnetic resonance imaging spectroscopy (MRS; GABA and glutamate+glutamine (Glx)), arterial spin labelling (ASL), apparent diffusion coefficient (ADC), resting state functional MRI, and autism behavioural outcomes (Aberrant Behaviour Checklist and Clinical Global Impression). Results Thirty subjects had a mean age of 8.1 years (SD 1.8). Simvastatin was well tolerated. The amount of imaging data varied by test. Simvastatin treatment was associated with (i) increased frontal white matter MRS GABA (t(12) = - 2.12, p = .055), GABA/Glx ratio (t(12) = - 2.78, p = .016), and reduced grey nuclei Glx (ANCOVA p < 0.05, Mann-Whitney p < 0.01); (ii) increased ASL perfusion in ventral diencephalon (Mann-Whitney p < 0.01); and (iii) decreased ADC in cingulate gyrus (Mann-Whitney p < 0.01). Machine-learning classification of imaging outcomes achieved 79% (p < .05) accuracy differentiating groups at endpoint against chance level (64%, p = 0.25) at baseline. Three of 12 (25%) simvastatin cases compared to none in placebo met 'clinical responder' criteria for behavioural outcome. Conclusions We show feasibility of peripheral MAPK assay and autism symptom measurement, but the study was not powered to test effectiveness. Multiparametric imaging suggests possible simvastatin effects in brain areas previously associated with NF1 pathophysiology and the social brain network. Trial registration EU Clinical Trial Register (EudraCT) 2012-005742-38 (www.clinicaltrialsregister.eu).
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Affiliation(s)
- Stavros Stivaros
- Academic Unit of Paediatric Radiology, Royal Manchester Children’s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Shruti Garg
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, Room 3.311, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Maria Tziraki
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Ying Cai
- Departments of Neurobiology, Psychiatry and Biobehavioral Sciences and Psychology, Integrative Center for Learning and Memory, Brain Research Institute, Brain Research Institute, University of California, California, LA 90095 USA
| | - Owen Thomas
- Academic Unit of Radiology, Salford Royal Foundation NHS Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Joseph Mellor
- Computer Science, University of Manchester, Manchester, UK
| | - Andrew A. Morris
- Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Carly Jim
- Manchester Metropolitan University, Manchester, UK
| | - Karolina Szumanska-Ryt
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Laura M Parkes
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Hamied A. Haroon
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Daniela Montaldi
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Nicholas Webb
- Department of Paediatric Nephrology, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Academic Health Sciences Centre, Manchester, UK
| | - John Keane
- Computer Science, University of Manchester, Manchester, UK
| | - Francisco X. Castellanos
- Hassenfeld Children’s Hospital at NYU Langone, Nathan S. Kline Institute for Psychiatric Research, New York, USA
| | - Alcino J. Silva
- Departments of Neurobiology, Psychiatry and Biobehavioral Sciences and Psychology, Integrative Center for Learning and Memory, Brain Research Institute, Brain Research Institute, University of California, California, LA 90095 USA
| | - Sue Huson
- Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Academic Health Sciences Centre, Manchester, UK
| | - Stephen Williams
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - D. Gareth Evans
- Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Academic Health Sciences Centre, Manchester, UK
| | - Richard Emsley
- Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, Room 3.311, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
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Hua J, Liu P, Kim T, Donahue M, Rane S, Chen JJ, Qin Q, Kim SG. MRI techniques to measure arterial and venous cerebral blood volume. Neuroimage 2018; 187:17-31. [PMID: 29458187 DOI: 10.1016/j.neuroimage.2018.02.027] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/12/2018] [Accepted: 02/14/2018] [Indexed: 12/14/2022] Open
Abstract
The measurement of cerebral blood volume (CBV) has been the topic of numerous neuroimaging studies. To date, however, most in vivo imaging approaches can only measure CBV summed over all types of blood vessels, including arterial, capillary and venous vessels in the microvasculature (i.e. total CBV or CBVtot). As different types of blood vessels have intrinsically different anatomy, function and physiology, the ability to quantify CBV in different segments of the microvascular tree may furnish information that is not obtainable from CBVtot, and may provide a more sensitive and specific measure for the underlying physiology. This review attempts to summarize major efforts in the development of MRI techniques to measure arterial (CBVa) and venous CBV (CBVv) separately. Advantages and disadvantages of each type of method are discussed. Applications of some of the methods in the investigation of flow-volume coupling in healthy brains, and in the detection of pathophysiological abnormalities in brain diseases such as arterial steno-occlusive disease, brain tumors, schizophrenia, Huntington's disease, Alzheimer's disease, and hypertension are demonstrated. We believe that the continual development of MRI approaches for the measurement of compartment-specific CBV will likely provide essential imaging tools for the advancement and refinement of our knowledge on the exquisite details of the microvasculature in healthy and diseased brains.
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Affiliation(s)
- Jun Hua
- Neurosection, Div. of MRI Research, Dept. of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
| | - Peiying Liu
- Neurosection, Div. of MRI Research, Dept. of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Tae Kim
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Manus Donahue
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Swati Rane
- Radiology, University of Washington Medical Center, Seattle, WA, USA
| | - J Jean Chen
- Rotman Research Institute, Baycrest Centre, Canada; Department of Medical Biophysics, University of Toronto, Canada
| | - Qin Qin
- Neurosection, Div. of MRI Research, Dept. of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea; Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
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49
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Impaired cerebrovascular reactivity in obstructive sleep apnea: a case-control study. Sleep Med 2017; 43:7-13. [PMID: 29482816 DOI: 10.1016/j.sleep.2017.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/28/2017] [Accepted: 10/06/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is an independent risk factor for stroke. Little is known about the cerebrovascular hemodynamic changes during apnea. Hypercapnia occurs in apneas and hypopneas, and a reduced cerebral vasodilatory response to CO2 could compromise the cerebral blood flow (CBF). Therefore, we aimed to evaluate whether the apnea-hypopnea index (AHI) affected the cerebrovascular response to CO2. METHODS A total of 11 patients with OSA were compared to 16 controls. We assessed the cerebrovascular responses with arterial spin labeling (ASL) and blood oxygen level-dependent (BOLD) magnetic resonance imaging during hypercapnia or breath-holding tasks. RESULTS The CBF response to CO2 was impaired with increasing AHI (average CBF: p = 0.018; gray matter: p = 0.038; white matter: p = 0.045), that is, increased OSA severity. When comparing the OSA patients to the control subjects, the OSA patients had a significantly reduced CO2 response of the white matter CBF (p = 0.04). However, the BOLD response to CO2 and the breath-holding task did not show any significant differences between OSA patients and control subjects. CONCLUSION The cerebrovascular CO2 reactivity, measured by the CBF, was impaired with increasing AHI, that is, OSA severity. These findings may add to the understanding of the increased stroke risk found in OSA patients.
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50
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Croal PL, Leung J, Kosinski P, Shroff M, Odame I, Kassner A. Assessment of cerebral blood flow with magnetic resonance imaging in children with sickle cell disease: A quantitative comparison with transcranial Doppler ultrasonography. Brain Behav 2017; 7:e00811. [PMID: 29201539 PMCID: PMC5698856 DOI: 10.1002/brb3.811] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/01/2017] [Accepted: 08/05/2017] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Transcranial Doppler ultrasonography (TCD) is a clinical tool for stratifying ischemic stroke risk by identifying abnormal elevations in blood flow velocity (BFV) in the middle cerebral artery (MCA). However, TCD is not effective at screening for subtle neurologic injury such as silent cerebral infarcts. To better understand this disparity, we compared TCD measures of BFV with tissue-level cerebral blood flow (CBF) using arterial spin-labeling MRI in children with and without sickle cell disease, and correlated these measurements against clinical hematologic measures of disease severity. METHODS TCD and MRI assessment were performed in 13 pediatric sickle cell disease patients and eight age-matched controls. Using MRI measures of MCA diameter and territory weight, TCD measures of BFV in the MCA [cm/s] were converted into units of CBF [ml min-1100 g-1] for comparison. RESULTS There was no significant association between TCD measures of BFV in the MCA and corresponding MRI measures of CBF in patients (r = .28, p = .39) or controls (r = .10, p = .81). After conversion from BFV into units of CBF, a strong association was observed between TCD and MRI measures (r = .67, p = .017 in patients, r = .86, p = .006 in controls). While BFV in the MCA showed a lack of correlation with arterial oxygen content, an inverse association was observed for CBF measurements. CONCLUSIONS This study demonstrates that BFV in the MCA cannot be used as a surrogate marker for tissue-level CBF in children with sickle cell disease. Therefore, TCD alone may not be sufficient for understanding and predicting subtle pathophysiology in this population, highlighting the potential clinical value of tissue-level CBF.
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Affiliation(s)
- Paula L Croal
- Physiology & Experimental Medicine The Hospital for Sick Children Toronto ON Canada
| | - Jackie Leung
- Physiology & Experimental Medicine The Hospital for Sick Children Toronto ON Canada
| | | | - Manohar Shroff
- Department of Diagnostic Imaging The Hospital for Sick Children Toronto ON Canada
| | - Isaac Odame
- Division of Haematology/Oncology The Hospital for Sick Children Toronto ON Canada
| | - Andrea Kassner
- Physiology & Experimental Medicine The Hospital for Sick Children Toronto ON Canada.,Institute of Medical Science University of Toronto Toronto ON Canada
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