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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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Poulin JM, Bigford GE, Lanctôt KL, Giacobbe P, Schaffer A, Sinyor M, Rabin JS, Masellis M, Singnurkar A, Pople CB, Lipsman N, Husain MI, Rosenblat JD, Cao X, MacIntosh BJ, Nestor SM. Engaging Mood Brain Circuits with Psilocybin (EMBRACE): a study protocol for a randomized, placebo-controlled and delayed-start, neuroimaging trial in depression. Trials 2024; 25:441. [PMID: 38956594 PMCID: PMC11221029 DOI: 10.1186/s13063-024-08268-6] [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: 10/24/2023] [Accepted: 06/18/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a leading cause of disability worldwide across domains of health and cognition, affecting overall quality of life. Approximately one third of individuals with depression do not fully respond to treatments (e.g., conventional antidepressants, psychotherapy) and alternative strategies are needed. Recent early phase trials suggest psilocybin may be a safe and efficacious intervention with rapid-acting antidepressant properties. Psilocybin is thought to exert therapeutic benefits by altering brain network connectivity and inducing neuroplastic changes that endure for weeks post-treatment. Although early clinical results are encouraging, psilocybin's acute neurobiological effects on neuroplasticity have not been fully investigated. We aim to examine for the first time how psilocybin acutely (intraday) and subacutely (weeks) alters functional brain networks implicated in depression. METHODS Fifty participants diagnosed with MDD or persistent depressive disorder (PDD) will be recruited from a tertiary mood disorders clinic and undergo 1:1 randomization into either an experimental or control arm. Participants will be given either 25 mg psilocybin or 25 mg microcrystalline cellulose (MCC) placebo for the first treatment. Three weeks later, those in the control arm will transition to receiving 25 mg psilocybin. We will investigate whether treatments are associated with changes in arterial spin labelling and blood oxygenation level-dependent contrast neuroimaging assessments at acute and subacute timepoints. Primary outcomes include testing whether psilocybin demonstrates acute changes in (1) cerebral blood flow and (2) functional brain activity in networks associated with mood regulation and depression when compared to placebo, along with changes in MADRS score over time compared to placebo. Secondary outcomes include changes across complementary clinical psychiatric, cognitive, and functional scales from baseline to final follow-up. Serum peripheral neurotrophic and inflammatory biomarkers will be collected at baseline and follow-up to examine relationships with clinical response, and neuroimaging measures. DISCUSSION This study will investigate the acute and additive subacute neuroplastic effects of psilocybin on brain networks affected by depression using advanced serial neuroimaging methods. Results will improve our understanding of psilocybin's antidepressant mechanisms versus placebo response and whether biological measures of brain function can provide early predictors of treatment response. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT06072898. Registered on 6 October 2023.
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Affiliation(s)
- Joshua M Poulin
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Gregory E Bigford
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Peter Giacobbe
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ayal Schaffer
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Mark Sinyor
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jennifer S Rabin
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Amit Singnurkar
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Christopher B Pople
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Nir Lipsman
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Muhammad I Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Xingshan Cao
- Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Bradley J MacIntosh
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Sean M Nestor
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Ishida S, Fujiwara Y, Matta Y, Takei N, Kanamoto M, Kimura H, Tsujikawa T. Enhanced parameter estimation in multiparametric arterial spin labeling using artificial neural networks. Magn Reson Med 2024. [PMID: 38852172 DOI: 10.1002/mrm.30184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE Multiparametric arterial spin labeling (MP-ASL) can quantify cerebral blood flow (CBF) and arterial cerebral blood volume (CBVa). However, its accuracy is compromised owing to its intrinsically low SNR, necessitating complex and time-consuming parameter estimation. Deep neural networks (DNNs) offer a solution to these limitations. Therefore, we aimed to develop simulation-based DNNs for MP-ASL and compared the performance of a supervised DNN (DNNSup), physics-informed unsupervised DNN (DNNUns), and the conventional lookup table method (LUT) using simulation and in vivo data. METHODS MP-ASL was performed twice during resting state and once during the breath-holding task. First, the accuracy and noise immunity were evaluated in the first resting state. Second, CBF and CBVa values were statistically compared between the first resting state and the breath-holding task using the Wilcoxon signed-rank test and Cliff's delta. Finally, reproducibility of the two resting states was assessed. RESULTS Simulation and first resting-state analyses demonstrated that DNNSup had higher accuracy, noise immunity, and a six-fold faster computation time than LUT. Furthermore, all methods detected task-induced CBF and CBVa elevations, with the effect size being larger with the DNNSup (CBF, p = 0.055, Δ = 0.286; CBVa, p = 0.008, Δ = 0.964) and DNNUns (CBF, p = 0.039, Δ = 0.286; CBVa, p = 0.008, Δ = 1.000) than that with LUT (CBF, p = 0.109, Δ = 0.214; CBVa, p = 0.008, Δ = 0.929). Moreover, all the methods exhibited comparable and satisfactory reproducibility. CONCLUSION DNNSup outperforms DNNUns and LUT with respect to estimation performance and computation time.
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Affiliation(s)
- Shota Ishida
- Department of Radiological Technology, Faculty of Medical Sciences, Kyoto College of Medical Science, Nantan, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuki Matta
- Radiological Center, University of Fukui Hospital, Eiheiji, Japan
| | | | | | - Hirohiko Kimura
- Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- Radiology Section, National Health Insurance Echizen-cho Ota Hospital, Echizen, Japan
| | - Tetsuya Tsujikawa
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Zhao MY, Tong E, Duarte Armindo R, Fettahoglu A, Choi J, Bagley J, Yeom KW, Moseley M, Steinberg GK, Zaharchuk G. Short- and Long-Term MRI Assessed Hemodynamic Changes in Pediatric Moyamoya Patients After Revascularization. J Magn Reson Imaging 2024; 59:1349-1357. [PMID: 37515518 DOI: 10.1002/jmri.28902] [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: 06/04/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Cerebrovascular reserve (CVR) reflects the capacity of cerebral blood flow (CBF) to change following a vasodilation challenge. Decreased CVR is associated with a higher stroke risk in patients with cerebrovascular diseases. While revascularization can improve CVR and reduce this risk in adult patients with vasculopathy such as those with Moyamoya disease, its impact on hemodynamics in pediatric patients remains to be elucidated. Arterial spin labeling (ASL) is a quantitative MRI technique that can measure CBF, CVR, and arterial transit time (ATT) non-invasively. PURPOSE To investigate the short- and long-term changes in hemodynamics after bypass surgeries in patients with Moyamoya disease. STUDY TYPE Longitudinal. POPULATION Forty-six patients (11 months-18 years, 28 females) with Moyamoya disease. FIELD STRENGTH/SEQUENCE 3-T, single- and multi-delay ASL, T1-weighted, T2-FLAIR, 3D MRA. ASSESSMENT Imaging was performed 2 weeks before and 1 week and 6 months after surgical intervention. Acetazolamide was employed to induce vasodilation during the imaging procedure. CBF and ATT were measured by fitting the ASL data to the general kinetic model. CVR was computed as the percentage change in CBF. The mean CBF, ATT, and CVR values were measured in the regions affected by vasculopathy. STATISTICAL TESTS Pre- and post-revascularization CVR, CBF, and ATT were compared for different regions of the brain. P-values <0.05 were considered statistically significant. RESULTS ASL-derived CBF in flow territories affected by vasculopathy significantly increased after bypass by 41 ± 31% within a week. At 6 months, CBF significantly increased by 51 ± 34%, CVR increased by 68 ± 33%, and ATT was significantly reduced by 6.6 ± 2.9%. DATA CONCLUSION There may be short- and long-term improvement in the hemodynamic parameters of pediatric Moyamoya patients after bypass surgery. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Elizabeth Tong
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Rui Duarte Armindo
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Neuroradiology, Hospital Beatriz Ângelo, Lisbon, Portugal
| | - Ates Fettahoglu
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Jason Choi
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Jacob Bagley
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Kristen W Yeom
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Michael Moseley
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, California, USA
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Breutigam NJ, Hoinkiss DC, Konstandin S, Buck MA, Mahroo A, Eickel K, von Samson-Himmelstjerna F, Günther M. Subject-specific timing adaption in time-encoded arterial spin labeling imaging. MAGMA (NEW YORK, N.Y.) 2024; 37:53-68. [PMID: 37768433 PMCID: PMC10876770 DOI: 10.1007/s10334-023-01121-y] [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: 06/23/2023] [Revised: 08/18/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVES One challenge in arterial spin labeling (ASL) is the high variability of arterial transit times (ATT), which causes associated arterial transit delay (ATD) artifacts. In patients with pathological changes, these artifacts occur when post-labeling delay (PLD) and bolus durations are not optimally matched to the subject, resulting in difficult quantification of cerebral blood flow (CBF) and ATT. This is also true for the free lunch approach in Hadamard-encoded pseudocontinuous ASL (H-pCASL). MATERIAL AND METHODS Five healthy volunteers were scanned with a 3 T MR-system. pCASL-subbolus timing was adjusted individually by the developed adaptive Walsh-ordered pCASL sequence and an automatic feedback algorithm. The quantification results for CBF and ATT and the respective standard deviations were compared with results obtained using recommended timings and intentionally suboptimal timings. RESULTS The algorithm individually adjusted the pCASL-subbolus PLD for each subject within the range of recommended timing for healthy subjects, with a mean intra-subject adjustment deviation of 47.15 ms for single-shot and 44.5 ms for segmented acquisition in three repetitions. DISCUSSION A first positive assessment of the results was performed on healthy volunteers. The extent to which the results can be transferred to patients and are of benefit must be investigated in follow-up studies.
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Affiliation(s)
- Nora-Josefin Breutigam
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359, Bremen, Germany.
| | - Daniel Christopher Hoinkiss
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359, Bremen, Germany
| | - Simon Konstandin
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359, Bremen, Germany
- Mediri GmbH, Heidelberg, Germany
| | - Mareike Alicja Buck
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359, Bremen, Germany
- Faculty 1 (Physics/Electrical Engineering), University of Bremen, Bremen, Germany
| | - Amnah Mahroo
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359, Bremen, Germany
| | - Klaus Eickel
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359, Bremen, Germany
- Mediri GmbH, Heidelberg, Germany
- Bremerhaven University of Applied Science, Bremerhaven, Germany
| | - Federico von Samson-Himmelstjerna
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359, Bremen, Germany
- Faculty 1 (Physics/Electrical Engineering), University of Bremen, Bremen, Germany
| | - Matthias Günther
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359, Bremen, Germany
- Mediri GmbH, Heidelberg, Germany
- Faculty 1 (Physics/Electrical Engineering), University of Bremen, Bremen, Germany
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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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Zhao MY, Tong E, Armindo RD, Woodward A, Yeom KW, Moseley ME, Zaharchuk G. Measuring Quantitative Cerebral Blood Flow in Healthy Children: A Systematic Review of Neuroimaging Techniques. J Magn Reson Imaging 2024; 59:70-81. [PMID: 37170640 PMCID: PMC10638464 DOI: 10.1002/jmri.28758] [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: 02/03/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/13/2023] Open
Abstract
Cerebral blood flow (CBF) is an important hemodynamic parameter to evaluate brain health. It can be obtained quantitatively using medical imaging modalities such as magnetic resonance imaging and positron emission tomography (PET). Although CBF in adults has been widely studied and linked with cerebrovascular and neurodegenerative diseases, CBF data in healthy children are sparse due to the challenges in pediatric neuroimaging. An understanding of the factors affecting pediatric CBF and its normal range is crucial to determine the optimal CBF measuring techniques in pediatric neuroradiology. This review focuses on pediatric CBF studies using neuroimaging techniques in 32 articles including 2668 normal subjects ranging from birth to 18 years old. A systematic literature search was conducted in PubMed, Embase, and Scopus and reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA). We identified factors (such as age, gender, mood, sedation, and fitness) that have significant effects on pediatric CBF quantification. We also investigated factors influencing the CBF measurements in infants. Based on this review, we recommend best practices to improve CBF measurements in pediatric neuroimaging. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Elizabeth Tong
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Rui Duarte Armindo
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Neuroradiology, Hospital Beatriz Ângelo, Loures, Lisbon, Portugal
| | - Amanda Woodward
- Lane Medical Library, Stanford University, Stanford, CA, USA
| | - Kristen W. Yeom
- Department of Radiology, Stanford University, Stanford, CA, USA
| | | | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA, USA
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8
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Tseng CH, Jaspers J, Romero AM, Wielopolski P, Smits M, van Osch MJP, Vos F. Improved reliability of perfusion estimation in dynamic susceptibility contrast MRI by using the arterial input function from dynamic contrast enhanced MRI. NMR IN BIOMEDICINE 2024; 37:e5038. [PMID: 37712359 DOI: 10.1002/nbm.5038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/02/2023] [Accepted: 08/23/2023] [Indexed: 09/16/2023]
Abstract
The arterial input function (AIF) plays a crucial role in estimating quantitative perfusion properties from dynamic susceptibility contrast (DSC) MRI. An important issue, however, is that measuring the AIF in absolute contrast-agent concentrations is challenging, due to uncertainty in relation to the measuredR 2 ∗ -weighted signal, signal depletion at high concentration, and partial-volume effects. A potential solution could be to derive the AIF from separately acquired dynamic contrast enhanced (DCE) MRI data. We aim to compare the AIF determined from DCE MRI with the AIF from DSC MRI, and estimated perfusion coefficients derived from DSC data using a DCE-driven AIF with perfusion coefficients determined using a DSC-based AIF. AIFs were manually selected in branches of the middle cerebral artery (MCA) in both DCE and DSC data in each patient. In addition, a semi-automatic AIF-selection algorithm was applied to the DSC data. The amplitude and full width at half-maximum of the AIFs were compared statistically using the Wilcoxon rank-sum test, applying a 0.05 significance level. Cerebral blood flow (CBF) was derived with different AIF approaches and compared further. The results showed that the AIFs extracted from DSC scans yielded highly variable peaks across arteries within the same patient. The semi-automatic DSC-AIF had significantly narrower width compared with the manual AIFs, and a significantly larger peak than the manual DSC-AIF. Additionally, the DCE-based AIF provided a more stable measurement of relative CBF and absolute CBF values estimated with DCE-AIFs that were compatible with previously reported values. In conclusion, DCE-based AIFs were reproduced significantly better across vessels, showed more realistic profiles, and delivered more stable and reasonable CBF measurements. The DCE-AIF can, therefore, be considered as an alternative AIF source for quantitative perfusion estimations in DSC MRI.
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Affiliation(s)
- Chih-Hsien Tseng
- Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands
- Medical Delta, Delft, the Netherlands
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
| | - Jaap Jaspers
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Alejandra Mendez Romero
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Piotr Wielopolski
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marion Smits
- Medical Delta, Delft, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Brain Tumour Center, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Matthias J P van Osch
- Medical Delta, Delft, the Netherlands
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frans Vos
- Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands
- Medical Delta, Delft, the Netherlands
- Holland Proton Therapy Center Consortium-Erasmus MC, Rotterdam, Holland Proton Therapy Centre, Delft, Leiden University Medical Center, Leiden and Delft University of Technology, Delft, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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9
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Sollmann N, Hoffmann G, Schramm S, Reichert M, Hernandez Petzsche M, Strobel J, Nigris L, Kloth C, Rosskopf J, Börner C, Bonfert M, Berndt M, Grön G, Müller HP, Kassubek J, Kreiser K, Koerte IK, Liebl H, Beer A, Zimmer C, Beer M, Kaczmarz S. Arterial Spin Labeling (ASL) in Neuroradiological Diagnostics - Methodological Overview and Use Cases. ROFO-FORTSCHR RONTG 2024; 196:36-51. [PMID: 37467779 DOI: 10.1055/a-2119-5574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Arterial spin labeling (ASL) is a magnetic resonance imaging (MRI)-based technique using labeled blood-water of the brain-feeding arteries as an endogenous tracer to derive information about brain perfusion. It enables the assessment of cerebral blood flow (CBF). METHOD This review aims to provide a methodological and technical overview of ASL techniques, and to give examples of clinical use cases for various diseases affecting the central nervous system (CNS). There is a special focus on recent developments including super-selective ASL (ssASL) and time-resolved ASL-based magnetic resonance angiography (MRA) and on diseases commonly not leading to characteristic alterations on conventional structural MRI (e. g., concussion or migraine). RESULTS ASL-derived CBF may represent a clinically relevant parameter in various pathologies such as cerebrovascular diseases, neoplasms, or neurodegenerative diseases. Furthermore, ASL has also been used to investigate CBF in mild traumatic brain injury or migraine, potentially leading to the establishment of imaging-based biomarkers. Recent advances made possible the acquisition of ssASL by selective labeling of single brain-feeding arteries, enabling spatial perfusion territory mapping dependent on blood flow of a specific preselected artery. Furthermore, ASL-based MRA has been introduced, providing time-resolved delineation of single intracranial vessels. CONCLUSION Perfusion imaging by ASL has shown promise in various diseases of the CNS. Given that ASL does not require intravenous administration of a gadolinium-based contrast agent, it may be of particular interest for investigations in pediatric cohorts, patients with impaired kidney function, patients with relevant allergies, or patients that undergo serial MRI for clinical indications such as disease monitoring. KEY POINTS · ASL is an MRI technique that uses labeled blood-water as an endogenous tracer for brain perfusion imaging.. · It allows the assessment of CBF without the need for administration of a gadolinium-based contrast agent.. · CBF quantification by ASL has been used in several pathologies including brain tumors or neurodegenerative diseases.. · Vessel-selective ASL methods can provide brain perfusion territory mapping in cerebrovascular diseases.. · ASL may be of particular interest in patient cohorts with caveats concerning gadolinium administration..
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- cBrain, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Gabriel Hoffmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Severin Schramm
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Miriam Reichert
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Moritz Hernandez Petzsche
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joachim Strobel
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
| | - Lorenzo Nigris
- cBrain, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christopher Kloth
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Johannes Rosskopf
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Section of Neuroradiology, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Corinna Börner
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Michaela Bonfert
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maria Berndt
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Georg Grön
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Ulm, Germany
| | | | - Jan Kassubek
- Department of Neurology, University Hospital Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), Ulm University, Ulm, Germany
| | - Kornelia Kreiser
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Radiology and Neuroradiology, Universitäts- und Rehabilitationskliniken Ulm, Ulm, Germany
| | - Inga K Koerte
- cBrain, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Boston, United States
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, United States
| | - Hans Liebl
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany
| | - Ambros Beer
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
- MoMan - Center for Translational Imaging, University Hospital Ulm, Ulm, Germany
- i2SouI - Innovative Imaging in Surgical Oncology, University Hospital Ulm, Ulm, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- MoMan - Center for Translational Imaging, University Hospital Ulm, Ulm, Germany
- i2SouI - Innovative Imaging in Surgical Oncology, University Hospital Ulm, Ulm, Germany
| | - Stephan Kaczmarz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Market DACH, Philips GmbH, Hamburg, Germany
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10
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Zhao MY, Dahlen A, Ramirez NJ, Moseley M, Van Haren K, Zaharchuk G. Effect of vitamin D supplementation on cerebral blood flow in male patients with adrenoleukodystrophy. J Neurosci Res 2023; 101:1086-1097. [PMID: 36967233 DOI: 10.1002/jnr.25187] [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: 03/22/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023]
Abstract
One-third of boys with X-linked adrenoleukodystrophy (ALD) develop inflammatory demyelinating lesions, typically at the splenium. These lesions share similarities with multiple sclerosis, including cerebral hypoperfusion and links to vitamin D insufficiency. We hypothesized that increasing vitamin D levels would increase cerebral blood flow (CBF) in ALD boys. We conducted an exploratory analysis of vitamin D supplementation and CBF using all available data from participants enrolled in a recent single-arm interventional study of vitamin D supplementation in boys with ALD. We measured whole brain and splenium CBF using arterial spin labeling (ASL) from three study time points (baseline, 6 months, and 12 months). We used linear generalized estimating equations to evaluate CBF changes between time points and to test for an association between CBF and vitamin D. ASL data were available for 16 participants, aged 2-22 years. Mean vitamin D levels increased by 72.7% (p < .001) after 6 months and 88.6% (p < .01) after 12 months. Relative to baseline measures, mean CBF of the whole brain (6 months: +2.5%, p = .57; 12 months: +6.1%, p = .18) and splenium (6 months: +1.2%, p = .80; 12 months: +7.4%, p = .058) were not significantly changed. Vitamin D levels were positively correlated with CBF in the splenium (slope = .59, p < .001). In this exploratory analysis, we observed a correlation between vitamin D levels and splenial CBF in ALD boys. We confirm the feasibility of measuring CBF in this brain region and population, but further work is needed to establish a causal role for vitamin D in modulating CBF.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, California, Stanford, USA
| | - Alex Dahlen
- Quantitative Sciences Unit, Stanford University School of Medicine, California, Stanford, USA
| | | | - Michael Moseley
- Department of Radiology, Stanford University, California, Stanford, USA
| | - Keith Van Haren
- Department of Neurology and Neurological Sciences, Stanford University, California, Stanford, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, California, Stanford, USA
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11
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Knutsson L, Xu X, van Zijl PCM, Chan KWY. Imaging of sugar-based contrast agents using their hydroxyl proton exchange properties. NMR IN BIOMEDICINE 2023; 36:e4784. [PMID: 35665547 PMCID: PMC9719573 DOI: 10.1002/nbm.4784] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/30/2022] [Accepted: 06/03/2022] [Indexed: 05/13/2023]
Abstract
The ability of CEST MRI to detect the presence of millimolar concentrations of non-metallic contrast agents has made it possible to study, non-invasively, important biological molecules such as proteins and sugars, as well as drugs already approved for clinical use. Here, we review efforts to use sugar and sugar polymers as exogenous contrast agents, which is possible based on the exchange of their hydroxyl protons with water protons. While this capability has raised early enthusiasm, for instance about the possibility of imaging D-glucose metabolism with MRI in a way analogous to PET, experience over the past decade has shown that this is not trivial. On the other hand, many studies have confirmed the possibility of imaging a large variety of sugar analogues, each with potentially interesting applications to assess tissue physiology. Some promising applications are the study of (i) sugar delivery and transport to assess blood-brain barrier integrity and (ii) sugar uptake by cells for their characterization (e.g., cancer versus healthy), as well as (iii) clearance of sugars to assess tissue drainage-for instance, through the glymphatic system. To judge these opportunities and their challenges, especially in the clinic, it is necessary to understand the technical aspects of detecting the presence of rapidly exchanging protons through the water signal in MRI, especially as a function of magnetic field strength. We expect that novel approaches in terms of MRI detection (both saturation transfer and relaxation based), MRI data analysis, and sugar design will push this young field forward in the next decade.
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Affiliation(s)
- Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, US
| | - Xiang Xu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Peter CM van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, US
| | - Kannie WY Chan
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering, Hong Kong, China
- Tung Biomedical Sciences Centre, City University of Hong Kong
- City University of Hong Kong Shenzhen Institute, Shenzhen, China
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12
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Pinto J, Blockley NP, Harkin JW, Bulte DP. Modelling spatiotemporal dynamics of cerebral blood flow using multiple-timepoint arterial spin labelling MRI. Front Physiol 2023; 14:1142359. [PMID: 37304817 PMCID: PMC10250662 DOI: 10.3389/fphys.2023.1142359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/14/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction: Cerebral blood flow (CBF) is an important physiological parameter that can be quantified non-invasively using arterial spin labelling (ASL) imaging. Although most ASL studies are based on single-timepoint strategies, multi-timepoint approaches (multiple-PLD) in combination with appropriate model fitting strategies may be beneficial not only to improve CBF quantification but also to retrieve other physiological information of interest. Methods: In this work, we tested several kinetic models for the fitting of multiple-PLD pCASL data in a group of 10 healthy subjects. In particular, we extended the standard kinetic model by incorporating dispersion effects and the macrovascular contribution and assessed their individual and combined effect on CBF quantification. These assessments were performed using two pseudo-continuous ASL (pCASL) datasets acquired in the same subjects but during two conditions mimicking different CBF dynamics: normocapnia and hypercapnia (achieved through a CO2 stimulus). Results: All kinetic models quantified and highlighted the different CBF spatiotemporal dynamics between the two conditions. Hypercapnia led to an increase in CBF whilst decreasing arterial transit time (ATT) and arterial blood volume (aBV). When comparing the different kinetic models, the incorporation of dispersion effects yielded a significant decrease in CBF (∼10-22%) and ATT (∼17-26%), whilst aBV (∼44-74%) increased, and this was observed in both conditions. The extended model that includes dispersion effects and the macrovascular component has been shown to provide the best fit to both datasets. Conclusion: Our results support the use of extended models that include the macrovascular component and dispersion effects when modelling multiple-PLD pCASL data.
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Affiliation(s)
- Joana Pinto
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Nicholas P. Blockley
- David Greenfield Human Physiology Unit, School of Life Sciences, University of Nottingham, Nottingham, United Kingdom
| | | | - Daniel P. Bulte
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
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13
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Xu F, Liu D, Zhu D, Hillis AE, Bakker A, Soldan A, Albert MS, Lin DDM, Qin Q. Test-retest reliability of 3D velocity-selective arterial spin labeling for detecting normal variations of cerebral blood flow. Neuroimage 2023; 271:120039. [PMID: 36931331 PMCID: PMC10150252 DOI: 10.1016/j.neuroimage.2023.120039] [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: 12/28/2022] [Revised: 02/23/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
Velocity-selective inversion (VSI) based velocity-selective arterial spin labeling (VSASL) has been developed to measure cerebral blood flow (CBF) with low susceptibility to the prolonged arterial transit time and high sensitivity to brain perfusion signal. The purpose of this magnetic resonance imaging study is to evaluate the test-retest reliability of a VSI-prepared 3D VSASL protocol with whole-brain coverage to detect baseline CBF variations among cognitively normal participants in different brain regions. Coefficients of variation (CoV) of both absolute and relative CBF across scans or sessions, subjects, and gray matter regions were calculated, and corresponding intraclass correlation coefficients (ICC) were computed. The higher between-subject CoV of absolute CBF (13.4 ± 2.0%) over within-subject CoV (within-session: 3.8 ± 1.1%; between-session: 4.9 ± 0.9%) yielded moderate to excellent ICC (within-session: 0.88±0.08; between-session: 0.77±0.14) to detect normal variations of individual CBF. The higher between-region CoV of relative CBF (11.4 ± 3.0%) over within-region CoV (within-session: 2.3 ± 0.9%; between-session: 3.3 ± 1.0%) yielded excellent ICC (within-session: 0.92±0.06; between-session: 0.85±0.12) to detect normal variations of regional CBF. Age, blood pressure, end-tidal CO2, and hematocrit partially explained the variability of CBF across subjects. Together these results show excellent test-retest reliability of VSASL to detect both between-subject and between-region variations supporting its clinical utility.
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Affiliation(s)
- Feng Xu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University, Baltimore, MD 21205, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA.
| | - Dapeng Liu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University, Baltimore, MD 21205, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA
| | - Dan Zhu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University, Baltimore, MD 21205, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Arnold Bakker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Doris D M Lin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University, Baltimore, MD 21205, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA
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14
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Percie du Sert O, Unrau J, Gauthier CJ, Chakravarty M, Malla A, Lepage M, Raucher-Chéné D. Cerebral blood flow in schizophrenia: A systematic review and meta-analysis of MRI-based studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 121:110669. [PMID: 36341843 DOI: 10.1016/j.pnpbp.2022.110669] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 10/19/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Schizophrenia-spectrum disorders (SSD) represent one of the leading causes of disability worldwide and are usually underpinned by neurodevelopmental brain abnormalities observed on a structural and functional level. Nuclear medicine imaging studies of cerebral blood flow (CBF) have already provided insights into the pathophysiology of these disorders. Recent developments in non-invasive MRI techniques such as arterial spin labeling (ASL) have allowed broader examination of CBF across SSD prompting us to conduct an updated literature review of MRI-based perfusion studies. In addition, we conducted a focused meta-analysis of whole brain studies to provide a complete picture of the literature on the topic. METHODS A systematic OVID search was performed in Embase, MEDLINEOvid, and PsycINFO. Studies eligible for inclusion in the review involved: 1) individuals with SSD, first-episode psychosis or clinical-high risk for psychosis, or; 2) had healthy controls for comparison; 3) involved MRI-based perfusion imaging methods; and 4) reported CBF findings. No time span was specified for the database queries (last search: 08/2022). Information related to participants, MRI techniques, CBF analyses, and results were systematically extracted. Whole-brain studies were then selected for the meta-analysis procedure. The methodological quality of each included studies was assessed. RESULTS For the systematic review, the initial Ovid search yielded 648 publications of which 42 articles were included, representing 3480 SSD patients and controls. The most consistent finding was that negative symptoms were linked to cortical fronto-limbic hypoperfusion while positive symptoms seemed to be associated with hyperperfusion, notably in subcortical structures. The meta-analysis integrated results from 13 whole-brain studies, across 426 patients and 401 controls, and confirmed the robustness of the hypoperfusion in the left superior and middle frontal gyri and right middle occipital gyrus while hyperperfusion was found in the left putamen. CONCLUSION This updated review of the literature supports the implication of hemodynamic correlates in the pathophysiology of psychosis symptoms and disorders. A more systematic exploration of brain perfusion could complete the search of a multimodal biomarker of SSD.
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Affiliation(s)
- Olivier Percie du Sert
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Joshua Unrau
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Claudine J Gauthier
- Concordia University, Montreal, QC, Canada; Montreal Heart Institute, Montreal, QC, Canada
| | - Mallar Chakravarty
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Ashok Malla
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Martin Lepage
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada.
| | - Delphine Raucher-Chéné
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada; University of Reims Champagne-Ardenne, Cognition, Health, and Society Laboratory (EA 6291), Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
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15
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Wang Y, Bartels HM, Nelson LD. A Systematic Review of ASL Perfusion MRI in Mild TBI. Neuropsychol Rev 2023; 33:160-191. [PMID: 32808244 PMCID: PMC7889778 DOI: 10.1007/s11065-020-09451-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 08/06/2020] [Indexed: 01/06/2023]
Abstract
Mild traumatic brain injury (mTBI) is a major public health concern. Cerebrovascular alterations play a significant role in the evolution of injury sequelae and in the process of post-traumatic brain repair. Arterial spin labeling (ASL) is an advanced perfusion magnetic resonance imaging technique that permits noninvasive quantification of cerebral blood flow (CBF). This is the first systematic review of ASL research findings in patients with mTBI. Our approach followed the American Academy of Neurology (AAN) and PRISMA guidelines. We searched Ovid/MEDLINE, Web of Science, Scopus, and the Cochrane Index for relevant articles published as of February 20, 2020. Full-text results were combined into Rayyan software for further evaluation. Data extraction, including risk of bias ratings, was performed using American Academy of Neurology's four-tiered classification scheme. Twenty-three articles met inclusion criteria comprising data on up to 566 mTBI patients and 654 control subjects. Of the 23 studies, 18 reported some type of regional CBF abnormality in mTBI patients at rest or during a cognitive task, with more findings of decreased than increased CBF. The evidence supports the conclusion that mTBI likely causes ASL-derived CBF anomalies. However, synthesis of findings was challenging due to substantial methodological variations across studies and few studies with low risk of bias. Thus, larger-scale prospective cohort studies are needed to more definitively chart the course of CBF changes in humans after mTBI and to understand how individual difference factors contribute to post-injury CBF changes.
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Affiliation(s)
- Yang Wang
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| | - Hannah M Bartels
- Department of Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA
| | - Lindsay D Nelson
- Department of Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA
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Wang X, Bishop C, O'Callaghan J, Gayhoor A, Albani J, Theriault W, Chappell M, Golay X, Wang D, Becerra L. MRI assessment of cerebral perfusion in clinical trials. Drug Discov Today 2023; 28:103506. [PMID: 36690177 DOI: 10.1016/j.drudis.2023.103506] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
Neurodegenerative mechanisms affect the brain through a variety of processes that are reflected as changes in brain structure and physiology. Although some biomarkers for these changes are well established, others are at different stages of development for use in clinical trials. One of the most challenging biomarkers to harmonize for clinical trials is cerebral blood flow (CBF). There are several magnetic resonance imaging (MRI) methods for quantifying CBF without the use of contrast agents, in particular arterial spin labeling (ASL) perfusion MRI, which has been increasingly applied in clinical trials. In this review, we present ASL MRI techniques, including strategies for implementation across multiple imaging centers, levels of confidence in assessing disease progression and treatment effects, and details of image analysis.
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Affiliation(s)
| | | | | | | | | | | | - Michael Chappell
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham
| | - Xavier Golay
- MR Neurophysics and Translational Neuroscience, Queen Square UCL Institute of Neurology, University College London; Gold Standard Phantoms
| | - Danny Wang
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California (USC)
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17
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Batail JM, Corouge I, Combès B, Conan C, Guillery-Sollier M, Vérin M, Sauleau P, Le Jeune F, Gauvrit JY, Robert G, Barillot C, Ferre JC, Drapier D. Apathy in depression: An arterial spin labeling perfusion MRI study. J Psychiatr Res 2023; 157:7-16. [PMID: 36427413 DOI: 10.1016/j.jpsychires.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/28/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Apathy, as defined as a deficit in goal-directed behaviors, is a critical clinical dimension in depression associated with chronic impairment. Little is known about its cerebral perfusion specificities in depression. To explore neurovascular mechanisms underpinning apathy in depression by pseudo-continuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI). METHODS Perfusion imaging analysis was performed on 90 depressed patients included in a prospective study between November 2014 and February 2017. Imaging data included anatomical 3D T1-weighted and perfusion pCASL sequences. A multiple regression analysis relating the quantified cerebral blood flow (CBF) in different regions of interest defined from the FreeSurfer atlas, to the Apathy Evaluation Scale (AES) total score was conducted. RESULTS After confound adjustment (demographics, disease and clinical characteristics) and correction for multiple comparisons, we observed a strong negative relationship between the CBF in the left anterior cingulate cortex (ACC) and the AES score (standardized beta = -0.74, corrected p value = 0.0008). CONCLUSION Our results emphasized the left ACC as a key region involved in apathy severity in a population of depressed participants. Perfusion correlates of apathy in depression evidenced in this study may contribute to characterize different phenotypes of depression.
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Affiliation(s)
- J M Batail
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France; Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France; Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France.
| | - I Corouge
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France
| | - B Combès
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France
| | - C Conan
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France
| | - M Guillery-Sollier
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France; Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France; Univ Rennes, LP3C (Laboratoire de Psychologie: Cognition, Comportement, Communication) - EA 1285, CC5000, Rennes, France
| | - M Vérin
- Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France; CHU Rennes, Department of Neurology, F-35033, Rennes, France
| | - P Sauleau
- Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France; CHU Rennes, Department of Neurophysiology, F-35033, Rennes, France
| | - F Le Jeune
- Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France; Centre Eugène Marquis, Department of Nuclear Medicine, F-35062, Rennes, France
| | - J Y Gauvrit
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France; CHU Rennes, Department of Radiology, F-35033, Rennes, France
| | - G Robert
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France; Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France; Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France
| | - C Barillot
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France
| | - J C Ferre
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France; CHU Rennes, Department of Radiology, F-35033, Rennes, France
| | - D Drapier
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France; Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France
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18
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Knudsen LV, Sheldrick AJ, Vafaee MS, Michel TM. Diversifying autism neuroimaging research: An arterial spin labeling review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221137230. [DOI: 10.1177/13623613221137230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cognition and brain homeostasis depends on cerebral blood flow to secure adequate oxygen and nutrient distribution to the brain tissue. Altered cerebral blood flow has previously been reported in individuals diagnosed with autism spectrum condition in comparison to non-autistics. This phenomenon might suggest cerebral blood flow as a potential biomarker for autism spectrum condition. Major technological advancement enables the non-invasive and quantitative measurement of cerebral blood flow via arterial spin labeling magnetic resonance imaging. However, most neuroimaging studies in autistic individuals exploit the indirect blood oxygen level dependent functional magnetic resonance imaging signal instead. Therefore, this review examines the use of arterial spin labeling to further investigate the neurobiology of the autism spectrum condition. Followed by a comparison of results from molecular imaging and arterial spin labeling studies and a discussion concerning the future direction and potential of arterial spin labeling in this context. We found that arterial spin labeling study results are consistent with those of molecular imaging, especially after considering the effect of age and sex. Arterial spin labeling has numerous application possibilities besides the quantification of cerebral blood flow, including assessment of functional connectivity and arterial transit time. Therefore, we encourage researchers to explore and consider the application of arterial spin labeling for future scientific studies in the quest to better understand the neurobiology of autism spectrum condition. Lay abstract Brain function and health depend on cerebral blood flow to secure the necessary delivery of oxygen and nutrients to the brain tissue. However, cerebral blood flow appears to be altered in autistic compared to non-autistic individuals, potentially suggesting this difference to be a cause and potential identification point of autism. Recent technological development enables precise and non-invasive measurement of cerebral blood flow via the magnetic resonance imaging method referred to as arterial spin labeling. However, most neuroimaging studies still prefer using the physiologically indirect measure derived from functional magnetic resonance imaging. Therefore, this review examines the use of arterial spin labeling to further investigate the neurobiology of autism. Furthermore, the review includes a comparison of results from molecular imaging and arterial spin labeling followed by a discussion concerning the future direction and potential of arterial spin labeling. We found that arterial spin labeling study results are consistent with those of molecular imaging, especially after considering the effect of age and sex. In addition, arterial spin labeling has numerous application possibilities besides the quantification of cerebral blood flow. Therefore, we encourage researchers to explore and consider the application of arterial spin labeling for future scientific studies in the quest to better understand the neurobiology of autism.
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Liu Y, Huo R, Xu H, Zhou G, Wang T, Yuan H, Zhao X. Associations Between Carotid Plaque Characteristics and Perioperative Cerebral Blood Flow Determined by Arterial Spin Labeling Imaging in Patients With Moderate-to-Severe Stenosis Undergoing Carotid Endarterectomy. Front Neurol 2022; 13:899957. [PMID: 35865645 PMCID: PMC9295123 DOI: 10.3389/fneur.2022.899957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To examine the associations between carotid plaque characteristics and perioperative cerebral blood flow (CBF) by arterial spin labeling (ASL) imaging. Materials and Methods Patients with unilateral moderate-to-severe carotid stenosis referred for carotid endarterectomy (CEA) were recruited and underwent carotid vessel wall and brain ASL magnetic resonance imaging. The following imaging features were measured: relative CBF (rCBF = CBFindex−hemisphere/CBFcontralateral−hemisphere) in the middle cerebral artery territory; plaque burden and the presence of lipid-rich necrotic core; intraplaque hemorrhage (IPH); calcification; ulcer and fibrous-cap rupture; and the volume and maximum plaque components' area percentages. The associations between plaque characteristics and perioperative CBF were analyzed. Results Sixty-one patients (mean age, 66.6 ± 7.8 years; 55 males) were included. Univariate linear regression showed that rCBFpre−CEA was associated with stenosis [β, −0.462; 95% confidence interval (CI), from −0.797 to −0.126; p = 0.008], calcification (β, 0.103; 95% CI, 0.005–0.201; p = 0.040), maximum IPH area percentage (β, −0.127; 95% CI, from −0.223 to −0.030; p = 0.012), and ulcer (β, 0.069; 95% CI, 0.025–0.113; p = 0.005); rCBFpost−CEA was associated with the IPH volume (β, −0.060; 95% CI, from −0.107 to −0.014; p = 0.013). After adjusting for the confounding factors, the associations of calcification with rCBFpre−CEA (β, 0.099; 95% CI, from 0.004 to −0.194; p = 0.042) and IPH volume with rCBFpost−CEA (β, −0.060; 95% CI, from −0.109 to −0.011; p = 0.020) remained statistically significant, while those of rCBFpre−CEA with maximum IPH area percentage (β, −0.089; 95% CI, from −0.188 to 0.011; p = 0.080) and ulcer (β, 0.050; 95% CI, from −0.012 to 0.112; p = 0.100) did not remain statistically significant. Conclusion The compositional characteristics of carotid atherosclerotic plaques, particularly IPH, were associated with perioperative CBF in patients with unilateral moderate-to-severe carotid stenosis undergoing CEA. Our findings indicated that the patients with larger carotid IPH could expect smaller improvement in CBF following CEA.
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Affiliation(s)
- Ying Liu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Ran Huo
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Huimin Xu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Guangjin Zhou
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Tao Wang
- Department of Neurosurgery, Peking University Third Hospital, Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Beijing, China
- *Correspondence: Huishu Yuan
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
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20
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Zhu Z, Gong G, Wang L, Su Y, Lu J, Yin Y. Three-Dimensional Arterial Spin Labeling-Guided Sub-Volume Segmentation of Radiotherapy in Adult Non-Enhancing Low-Grade Gliomas. Front Oncol 2022; 12:914507. [PMID: 35860561 PMCID: PMC9291222 DOI: 10.3389/fonc.2022.914507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The present study aimed to evaluate the feasibility of sub-volume segmentation for radiotherapy planning of adult non-enhancing low-grade gliomas (NE-LGGs) guided by three-dimensional arterial spin labeling (3D-ASL). The differences in high- and low-perfusion areas of NE-LGGs were analyzed using multi-sequence magnetic resonance imaging (MRI) radiomics. Methods Fifteen adult patients with NE-LGGs were included in the study. MR images, including T1-weighted imaging (T1WI), T2 Propeller, T2 fluid-attenuated inversion recovery (T2 Flair), 3D-ASL, and contrast-enhanced T1WI (CE-T1WI), were obtained. The gross tumor volume (GTV) was delineated according to the hyperintensity on T2 Flair. The GTV was divided into high- and low-perfusion areas, namely GTV-ASL and GTV-SUB, respectively, based on the differences in cerebral blood flow (CBF) value. The volumes and CBF values of high- and low-perfusion areas were measured and compared. The least absolute shrinkage and selection operator (LASSO) regression was used to select the optimal features of all MR maps. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic accuracy of the absolute CBFmean (aCBFmean), relative CBFmean (rCBFmean, normalized by the CBF value of the normal gray matter), and screened features in differentiating high- and low-perfusion areas. Results Among the enrolled patients, three (20%) patients with NE-LGGs showed focal intra- and post-radiotherapy contrast enhancement within a prior high-perfusion area of 3D-ASL. The volume ratio of the GTV-ASL to the GTV was (37.08% ± 17.88)% (46.26 ± 44.51 vs. 167.46 ± 209.64 cm3, P = 0.000). The CBFmean in the high-perfusion area was approximately two times of that in the edema area or normal gray matter (66.98 ± 18.03 vs. 35.19 ± 7.75 or 33.92 ± 8.48 ml/100g/min, P = 0.000). Thirteen features were screened, seven of which were extracted from 3D-ASL. The area undercurve (AUC) values of aCBFmean, rCBFmean, and firstorder_10Percentile from 3D-ASL were more than 0.9, of which firstorder_10Percentile was the highest. Their cut-off values were 44.16 ml/100 g/min, 1.49 and 31, respectively. Conclusion The difference in blood perfusion in the GTV can be quantified and analyzed based on 3D-ASL images for NE-LGGs, which could guide the sub-volume segmentation of the GTV. 3D-ASL should become a routine method for NE-LGGs during simulation and radiotherapy.
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Affiliation(s)
- Zihong Zhu
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Guanzhong Gong
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Lizhen Wang
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Ya Su
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Jie Lu
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Yong Yin
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
- *Correspondence: Yong Yin,
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21
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Pavel DG, Henderson TA, DeBruin S, Cohen PF. The Legacy of the TTASAAN Report - Premature Conclusions and Forgotten Promises About SPECT Neuroimaging: A Review of Policy and Practice Part II. Front Neurol 2022; 13:851609. [PMID: 35655621 PMCID: PMC9152128 DOI: 10.3389/fneur.2022.851609] [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: 01/10/2022] [Accepted: 02/28/2022] [Indexed: 11/29/2022] Open
Abstract
Brain perfusion single photon emission computed tomography (SPECT) scans were initially developed in 1970s. A key radiopharmaceutical, hexamethylpropyleneamine oxime (HMPAO), was not stabilized until 1993 and most early SPECT scans were performed on single-head gamma cameras. These early scans were of inferior quality. In 1996, the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology (TTASAAN) issued a report regarding the use of SPECT in the evaluation of neurological disorders. This two-part series explores the policies and procedures related to perfusion SPECT functional neuroimaging. In Part I, the comparison between the quality of the SPECT scans and the depth of the data for key neurological and psychiatric indications at the time of the TTASAAN report vs. the intervening 25 years were presented. In Part II, the technical aspects of perfusion SPECT neuroimaging and image processing will be explored. The role of color scales will be reviewed and the process of interpreting a SPECT scan will be presented. Interpretation of a functional brain scans requires not only anatomical knowledge, but also technical understanding on correctly performing a scan, regardless of the scanning modality. Awareness of technical limitations allows the clinician to properly interpret a functional brain scan. With this foundation, four scenarios in which perfusion SPECT neuroimaging, together with other imaging modalities and testing, lead to a narrowing of the differential diagnoses and better treatment. Lastly, recommendations for the revision of current policies and practices are made.
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Affiliation(s)
- Dan G Pavel
- PathFinder Brain SPECT, Deerfield, IL, United States.,The International Society of Applied Neuroimaging (ISAN), Denver, CO, United States
| | - Theodore A Henderson
- The International Society of Applied Neuroimaging (ISAN), Denver, CO, United States.,The Synaptic Space, Inc., Denver, CO, United States.,Neuro-Luminance, Inc., Denver, CO, United States.,Dr. Theodore Henderson, Inc., Denver, CO, United States.,Neuro-Laser Foundation, Denver, CO, United States
| | - Simon DeBruin
- The International Society of Applied Neuroimaging (ISAN), Denver, CO, United States.,Good Lion Imaging, Baltimore, MD, United States
| | - Philip F Cohen
- The International Society of Applied Neuroimaging (ISAN), Denver, CO, United States.,Nuclear Medicine, Lions Gate Hospital, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
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22
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Kitajima M, Uetani H. Arterial Spin Labeling for Pediatric Central Nervous System Diseases: Techniques and Clinical Applications. Magn Reson Med Sci 2022; 22:27-43. [PMID: 35321984 PMCID: PMC9849418 DOI: 10.2463/mrms.rev.2021-0118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL) are techniques used to evaluate brain perfusion using MRI. DSC requires dynamic image acquisition with a rapid administration of gadolinium-based contrast agent. In contrast, ASL obtains brain perfusion information using magnetically labeled blood water as an endogenous tracer. For the evaluation of brain perfusion in pediatric neurological diseases, ASL has a significant advantage compared to DSC, CT, and single-photon emission CT/positron emission tomography because of the lack of radiation exposure and contrast agent administration. However, in ASL, optimization of several parameters, including the type of labeling, image acquisition, background suppression, and postlabeling delay, is required, because they have a significant effect on the quantification of cerebral blood flow (CBF).In this article, we first review recent technical developments of ASL and age-dependent physiological characteristics in pediatric brain perfusion. We then review the clinical implementation of ASL in pediatric neurological diseases, including vascular diseases, brain tumors, acute encephalopathy with biphasic seizure and late reduced diffusion (AESD), and migraine. In moyamoya disease, ASL can be used for brain perfusion and vessel assessment in pre- and post-treatment. In arteriovenous malformations, ASL is sensitive to detect small degrees of shunt. Furthermore, in vascular diseases, the implementation of ASL-based time-resolved MR angiography is described. In neoplasms, ASL-derived CBF has a high diagnostic accuracy for differentiation between low- and high-grade pediatric brain tumors. In AESD and migraine, ASL may allow for accurate early diagnosis and provide pathophysiological information.
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Affiliation(s)
- Mika Kitajima
- Department of Medical Imaging Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan,Corresponding author: 4-24-1, Kuhonji, Chuo-ku, Kumamoto, Kumamoto 862-0976, Japan. Phone: +81-373-5483, Fax: +81-373-5519, E-mail:
| | - Hiroyuki Uetani
- Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
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23
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Testud B, Delacour C, El Ahmadi AA, Brun G, Girard N, Duhamel G, Heesen C, Häußler V, Thaler C, Has Silemek AC, Stellmann JP. Brain grey matter perfusion in primary progressive multiple sclerosis: Mild decrease over years and regional associations with cognition and hand function. Eur J Neurol 2022; 29:1741-1752. [PMID: 35167161 DOI: 10.1111/ene.15289] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/11/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Extend and dynamic of neurodegeneration in progressive Multiple Sclerosis (MS) might be reflected by global and regional brain perfusion, an outcome at the intercept between structure and function. Here, we provide a first insight in the evolution of brain perfusion and its association with disability in primary progressive MS (PPMS) over several years. METHODS 77 persons with PPMS were followed over up to 5 years. Visits included a 3T MRI with pulsed Arterial spin labelling (ASL) perfusion, the Timed-25-Foot-Walk, 9-Hole-Peg-Test (NHPT), Symbol-Digit-Modalities-Test (SDMT) and Expanded Disability Status Scale (EDSS). We extracted regional cerebral blood flow surrogates and compared them to 11 controls. Analyses focused in cortical and deep gray matter, the change over time and associations with disability on regional and global level. RESULTS Baseline brain perfusion of patients and controls was comparable for the cortex (p=0.716) and deep grey matter (p=0.095). EDSS disability increased mildly (p=0.023) while brain perfusion decreased during follow up (p<0.001) and with disease duration (p=0.009). Lower global perfusion correlated with higher disability as indicated by EDSS, NHPT and Timed-25-Foot-Walk (p<0.001). The motor task NHPT showed associations with twenty gray matter regions. In contrast, better SDMT performance correlated with lower perfusion (p<0.001) in seven predominantly frontal regions indicating a functional maladaptation. CONCLUSION Decreasing perfusion indicates a putative association with MS disease mechanisms such as neurodegeneration, reduced metabolism, and loss of resilience. A low alteration rate limits its use in clinical practice, but regional association patterns might provide a snapshot of adaptive and maladaptive functional reorganization.
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Affiliation(s)
- Benoit Testud
- APHM La Timone, CEMEREM, Marseille, France.,Aix-Marseille Univ, CNRS, CRMBM, UMR 7339, Marseille, France.,APHM La Timone, Department of Neuroradiology, Marseille, France
| | - Clara Delacour
- APHM La Timone, Department of Neuroradiology, Marseille, France
| | | | - Gilles Brun
- APHM La Timone, Department of Neuroradiology, Marseille, France
| | - Nadine Girard
- Aix-Marseille Univ, CNRS, CRMBM, UMR 7339, Marseille, France.,APHM La Timone, Department of Neuroradiology, Marseille, France
| | - Guillaume Duhamel
- APHM La Timone, CEMEREM, Marseille, France.,Aix-Marseille Univ, CNRS, CRMBM, UMR 7339, Marseille, France
| | - Christoph Heesen
- Institute of Neuroimmunology and MS (INIMS), University Medical Centre Hamburg-Eppendorf, Germany.,Department of Neurology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Vivien Häußler
- Institute of Neuroimmunology and MS (INIMS), University Medical Centre Hamburg-Eppendorf, Germany.,Department of Neurology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Christian Thaler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Arzu Ceylan Has Silemek
- Institute of Neuroimmunology and MS (INIMS), University Medical Centre Hamburg-Eppendorf, Germany
| | - Jan-Patrick Stellmann
- APHM La Timone, CEMEREM, Marseille, France.,Aix-Marseille Univ, CNRS, CRMBM, UMR 7339, Marseille, France.,Institute of Neuroimmunology and MS (INIMS), University Medical Centre Hamburg-Eppendorf, Germany.,Department of Neurology, University Medical Centre Hamburg-Eppendorf, Germany
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24
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Alsaedi AF, Thomas DL, De Vita E, Panovska-Griffiths J, Bisdas S, Golay X. Repeatability of perfusion measurements in adult gliomas using pulsed and pseudo-continuous arterial spin labelling MRI. MAGMA (NEW YORK, N.Y.) 2022; 35:113-125. [PMID: 34817780 DOI: 10.1007/s10334-021-00975-4] [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: 06/29/2021] [Revised: 10/30/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To investigate the repeatability of perfusion measures in gliomas using pulsed- and pseudo-continuous-arterial spin labelling (PASL, PCASL) techniques, and evaluate different regions-of-interest (ROIs) for relative tumour blood flow (rTBF) normalisation. MATERIALS AND METHODS Repeatability of cerebral blood flow (CBF) was measured in the Contralateral Normal Appearing Hemisphere (CNAH) and in brain tumours (aTBF). rTBF was normalised using both large/small ROIs from the CNAH. Repeatability was evaluated with intra-class-correlation-coefficient (ICC), Within-Coefficient-of-Variation (WCoV) and Coefficient-of-Repeatability (CR). RESULTS PASL and PCASL demonstrated high reliability (ICC > 0.9) for CNAH-CBF, aTBF and rTBF. PCASL demonstrated a more stable signal-to-noise ratio (SNR) with a lower WCoV of the SNR than that of PASL (10.9-42.5% vs. 12.3-29.2%). PASL and PCASL showed higher WCoV in aTBF and rTBF than in CNAH CBF in WM and GM but not in the caudate, and higher WCoV for rTBF than for aTBF when normalised using a small ROI (PASL 8.1% vs. 4.7%, PCASL 10.9% vs. 7.9%, respectively). The lowest CR was observed for rTBF normalised with a large ROI. DISCUSSION PASL and PCASL showed similar repeatability for the assessment of perfusion parameters in patients with primary brain tumours as previous studies based on volunteers. Both methods displayed reasonable WCoV in the tumour area and CNAH. PCASL's more stable SNR in small areas (caudate) is likely to be due to the longer post-labelling delays.
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Affiliation(s)
- Amirah Faisal Alsaedi
- Department of Radiology Technology, Taibah University, Medina, Kingdom of Saudi Arabia.
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK.
| | - David Lee Thomas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
- Leonard Wolfson Experimental Neurology Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Enrico De Vita
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK
| | - Jasmina Panovska-Griffiths
- Nuffield Department of Medicine, The Big Data Institute, University of Oxford, Oxford, UK
- The Queen's College, University of Oxford, Oxford, UK
| | - Sotirios Bisdas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK
| | - Xavier Golay
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK
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25
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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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26
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Jiang D, Koehler RC, Liu X, Kulikowicz E, Lee JK, Lu H, Liu P. Quantitative validation of MRI mapping of cerebral venous oxygenation with direct blood sampling: A graded-O 2 study in piglets. Magn Reson Med 2021; 86:1445-1453. [PMID: 33755253 PMCID: PMC8184598 DOI: 10.1002/mrm.28786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/12/2021] [Accepted: 03/08/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To validate two neonatal cerebral venous oxygenation (Yv ) MRI techniques, T2 relaxation under phase contrast (TRUPC) and accelerated TRUPC (aTRUPC) MRI, with oxygenation measured with direct blood sampling. METHODS In vivo experiments were performed on seven healthy newborn piglets. For each piglet, a catheter was placed in the superior sagittal sinus to obtain venous blood samples for blood gas oximetry measurement as a gold standard. During the MRI experiment, three to five venous oxygenation levels were achieved in each piglet by varying inhaled O2 content and breathing rate. Under each condition, Yv values of the superior sagittal sinus measured by TRUPC, aTRUPC, and blood gas oximetry were obtained. The Yv quantification in TRUPC and aTRUPC used a standard bovine blood calibration model. The aTRUPC scan was repeated twice to assess its reproducibility. Agreements among TRUPC Yv , aTRUPC Yv , and blood gas oximetry were evaluated by intraclass correlation coefficient (ICC) and paired Student's t-test. RESULTS The mean hematocrit was 23.6 ± 6.5% among the piglets. Across all measurements, Yv values were 51.9 ± 21.3%, 54.1 ± 18.8%, and 53.7 ± 19.2% for blood gas oximetry, TRUPC and aTRUPC, respectively, showing no significant difference between any two methods (P > .3). There were good correlations between TRUPC and blood gas Yv (ICC = 0.801; P < .0001), between aTRUPC and blood gas Yv (ICC = 0.809; P < .0001), and between aTRUPC and TRUPC Yv (ICC = 0.887; P < .0001). The coefficient of variation of aTRUPC Yv was 8.1 ± 9.9%. CONCLUSION The values of Yv measured by TRUPC and aTRUPC were in good agreement with blood gas oximetry. These findings suggest that TRUPC and aTRUPC can provide accurate quantifications of Yv in major cerebral veins.
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Affiliation(s)
- Dengrong Jiang
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Raymond C. Koehler
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Xiuyun Liu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ewa Kulikowicz
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer K. Lee
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & 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
| | - Peiying Liu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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27
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Amemiya S, Watanabe Y, Takei N, Ueyama T, Miyawaki S, Koizumi S, Kato S, Takao H, Abe O, Saito N. Arterial Transit Time-Based Multidelay Combination Strategy Improves Arterial Spin Labeling Cerebral Blood Flow Measurement Accuracy in Severe Steno-Occlusive Diseases. J Magn Reson Imaging 2021; 55:178-187. [PMID: 34263988 DOI: 10.1002/jmri.27823] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although perfusion imaging plays a key role in the management of steno-occlusive diseases, the clinical usefulness of arterial spin labeling (ASL) is limited by technical issues. PURPOSE To examine the effect of arterial transit time (ATT) prolongation on cerebral blood flow (CBF) measurement accuracy and identify the best CBF measurement protocol for steno-occlusive diseases. STUDY TYPE Prospective. POPULATION Moyamoya (n = 10) and atherosclerotic diseases (n = 8). FIELD STRENGTH/SEQUENCE A 3.0T/3DT1 -weighted and ASL. ASSESSMENT Hadamard-encoded multidelay ASL scans with/without vessel suppression (VS) and single-delay ASL scans with long-label duration (LD) and long postlabeling delay (PLD), referred to as long-label long-delay (LLLD), were acquired. CBF measurement accuracy and its ATT dependency, measured as the correlation between the relative CBF measurement difference (ASL-single-photon emission computed tomography [SPECT]) and ATT, were compared among 1) Combo (incorporating multidelay and LLLD data based on ATT), 2) standard (LD/PLD = 1333/2333 msec), and 3) LLLD (LD/PLD = 4000/4000 msec) protocols, using whole-brain voxel-wise correlation with reference standard SPECT CBF. The effect of VS on CBF measurement accuracy was also assessed. STATISTICAL TESTS Pearson's correlation coefficient, repeated-measures analysis of variance, t-test. P< 0.05 was considered significant. RESULTS Pearson's correlation coefficients between ASL and SPECT CBF measurements were as follows: Combo = 0.55 ± 0.09; standard = 0.52 ± 0.12; LLLD = 0.41 ± 0.10. CBF measurement was least accurate in LLLD and most accurate in Combo. VS significantly improved overall CBF measurement accuracy in the standard protocol and in moyamoya patients for the Combo. ATT dependency analysis revealed that, compared with Combo, the standard and LLLD protocols showed significantly lower and negative and significantly higher and positive correlations, respectively (standard = -0.12 ± 0.04, Combo = -0.04 ± 0.03, LLLD = 0.17 ± 0.03). DATA CONCLUSION By using ATT-corrected CBF derived from LD/PLD = 1333/2333 msec as a base and by compensating underestimation in delayed regions using multidelay scans, the ATT-based Combo strategy improves CBF measurement accuracy compared with single-delay protocols in severe steno-occlusive diseases. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Shiori Amemiya
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yusuke Watanabe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Naoyuki Takei
- MR Applications and Workflow, GE Healthcare, Tokyo, Japan
| | - Tsuyoshi Ueyama
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Satoru Miyawaki
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Satoshi Koizumi
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Seiji Kato
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Hidemasa Takao
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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28
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Domínguez-Vivero C, Wu L, Lee S, Manoochehri M, Cines S, Brickman AM, Rizvi B, Chesebro A, Gazes Y, Fallon E, Lynch T, Heidebrink JL, Paulson H, Goldman JS, Huey E, Cosentino S. Structural Brain Changes in Pre-Clinical FTD MAPT Mutation Carriers. J Alzheimers Dis 2021; 75:595-606. [PMID: 32310161 DOI: 10.3233/jad-190820] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Frontotemporal dementia (FTD) is the second most common cause of early-onset neurodegenerative dementia. Several studies have focused on early imaging changes in FTD patients, but once subjects meet full criteria for FTD diagnosis, structural changes are generally widespread. OBJECTIVE This study aims to determine the earliest structural brain changes in asymptomatic MAPT MUTATION carriers. METHODS This is a cross-sectional multicenter study comparing global and regional brain volume and white matter integrity in a group of MAPT mutation preclinical carriers and controls. Participants belong to multiple generations of six families with five MAPT mutations. All participants underwent a medical examination, neuropsychological tests, genetic analysis, and a magnetic resonance scan (3T, scout, T1-weighted image followed by EPI (BOLD), MPRAGE, DTI, FLAIR, and ASL sequences). RESULTS Volumes of five cortical and subcortical areas were strongly correlated with mutation status: temporal lobe (left amygdala, left temporal pole), cingulate cortex (left rostral anterior cingulate gyrus, right posterior cingulate), and the lingual gyrus in the occipital lobe. We did not find significant differences in whole brain volume, white matter hyperintensities volume, and white matter integrity using DTI analysis. CONCLUSION Temporal lobe, cingulate cortex and the lingual gyrus seem to be early targets of the disease and may serve as biomarkers for FTD prior to overt symptom onset.
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Affiliation(s)
- Clara Domínguez-Vivero
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA
| | - Liwen Wu
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Seonjoo Lee
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Masood Manoochehri
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA
| | - Sarah Cines
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA.,Fairleigh Dickinson University, Teaneck, NJ, USA
| | - Adam M Brickman
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA
| | - Batool Rizvi
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA
| | - Anthony Chesebro
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA
| | - Yunglin Gazes
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA
| | - Emer Fallon
- Dublin Neurological Institute, Dublin, Ireland
| | | | | | - Henry Paulson
- Department of Neurology, The University of Michigan, Ann Arbor, MI, USA
| | - Jill S Goldman
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA
| | - Edward Huey
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA.,Department of Psychiatry & New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Stephanie Cosentino
- Department of Neurology, Columbia University, Cognitive Neuroscience Division of the Taub Institute, G.H. Sergievsky Center, New York, NY, USA
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Hu Y, Liu R, Gao F. Arterial Spin Labeling Magnetic Resonance Imaging in Healthy Adults: Mathematical Model Fitting to Assess Age-Related Perfusion Pattern. Korean J Radiol 2021; 22:1194-1202. [PMID: 33856130 PMCID: PMC8236374 DOI: 10.3348/kjr.2020.0716] [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: 04/08/2020] [Revised: 01/01/2021] [Accepted: 01/08/2021] [Indexed: 02/05/2023] Open
Abstract
Objective To investigate the age-dependent changes in regional cerebral blood flow (CBF) in healthy adults by fitting mathematical models to imaging data. Materials and Methods In this prospective study, 90 healthy adults underwent pseudo-continuous arterial spin labeling imaging of the brain. Regional CBF values were extracted from the arterial spin labeling images of each subject. Multivariable regression with the Akaike information criterion, link test, and F test (Ramsey's regression equation specification error test) was performed for 7 models in every brain region to determine the best mathematical model for fitting the relationship between CBF and age. Results Of all 87 brain regions, 68 brain regions were best fitted by cubic models, 9 brain regions were best fitted by quadratic models, and 10 brain regions were best fitted by linear models. In most brain regions (global gray matter and the other 65 brain regions), CBF decreased nonlinearly with aging, and the rate of CBF reduction decreased with aging, gradually approaching 0 after approximately 60. CBF in some regions of the frontal, parietal, and occipital lobes increased nonlinearly with aging before age 30, approximately, and decreased nonlinearly with aging for the rest of life. Conclusion In adults, the age-related perfusion patterns in most brain regions were best fitted by the cubic models, and age-dependent CBF changes were nonlinear.
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Affiliation(s)
- Ying Hu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Rongbo Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Fabao Gao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
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30
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Lin Z, Jiang D, Liu D, Li Y, Uh J, Hou X, Pillai JJ, Qin Q, Ge Y, Lu H. Noncontrast assessment of blood-brain barrier permeability to water: Shorter acquisition, test-retest reproducibility, and comparison with contrast-based method. Magn Reson Med 2021; 86:143-156. [PMID: 33559214 DOI: 10.1002/mrm.28687] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/28/2020] [Accepted: 12/24/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Assessment of the blood-brain barrier (BBB) permeability without the need for contrast agent is desirable, and the ability to measure the permeability to small molecules such as water may further increase the sensitivity in detecting diseases. This study proposed a time-efficient, noncontrast method to measure BBB permeability to water, evaluated its test-retest reproducibility, and compared it with a contrast agent-based method. METHODS A single-delay water extraction with phase-contrast arterial spin tagging (WEPCAST) method was devised in which spatial profile of the signal along the superior sagittal sinus was used to estimate bolus arrival time, and the WEPCAST signal at the corresponding location was used to compute water extraction fraction, which was combined with global cerebral blood flow to estimate BBB permeability surface area product to water. The reliability of WEPCAST sequence was examined in terms of intrasession, intersession, and inter-vendor (Philips [Ingenia, Best, the Netherlands] and Siemens [Prisma, Erlangen, Germany]) reproducibility. Finally, we compared this new technique to a contrast agent-based method. RESULTS Single-delay WEPCAST reduced the scan duration from approximately 20 min to 5 min. Extract fraction values estimated from single-delay WEPCAST showed good consistency with the multi-delay method (R = 0.82, P = .004). Group-averaged permeability surface area product values were found to be 137.5 ± 9.3 mL/100 g/min. Intrasession, intersession, and inter-vendor coefficient of variation of the permeability surface area product values were 6.6 ± 4.5%, 6.9 ± 3.7%, and 8.9 ± 3.0%, respectively. Finally, permeability surface area product obtained from WEPCAST MRI showed a significant correlation with that from the contrast-based method (R = .73, P = .02). CONCLUSION Single-delay WEPCAST MRI can measure BBB permeability to water within 5 min with an intrasession, intersession, and inter-vendor test-retest reproducibility of 6% to 9%. This method may provide a useful marker of BBB breakdown in clinical studies.
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Affiliation(s)
- Zixuan Lin
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dengrong Jiang
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dapeng Liu
- The Russell H. Morgan Department of Radiology & Radiological Science, 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
| | - Yang Li
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jinsoo Uh
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Xirui Hou
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jay J Pillai
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Qin Qin
- The Russell H. Morgan Department of Radiology & Radiological Science, 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
| | - Yulin Ge
- Department of Radiology, New York University Langone Medical Center, New York, New York, USA
| | - Hanzhang Lu
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,The Russell H. Morgan Department of Radiology & Radiological Science, 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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31
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Lee H, Wehrli FW. Venous cerebral blood volume mapping in the whole brain using venous-spin-labeled 3D turbo spin echo. Magn Reson Med 2020; 84:1991-2003. [PMID: 32243708 DOI: 10.1002/mrm.28262] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/27/2020] [Accepted: 02/29/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE Venous cerebral blood volume (CBVv ) is a major contributor to BOLD contrast, and therefore is an important parameter for understanding the underlying mechanism. Here, we propose a velocity-selective venous spin labeling (VS-VSL)-prepared 3D turbo spin echo pulse sequence for whole-brain baseline CBVv mapping. METHODS Unlike previous CBVv measurement techniques that exploit the interrelationship between BOLD signals and CBVv , in the proposed VS-VSL technique both arterial blood and cerebrospinal fluid (CSF) signals were suppressed before the VS pulse train for exclusive labeling of venous blood, while a single-slab 3D turbo spin echo readout was used because of its relative immunity to magnetic field variations. Furthermore, two approximations were made to the VS-VSL signal model for simplified derivation of CBVv . In vivo studies were performed at 3T field strength in 8 healthy subjects. The performance of the proposed VS-VSL method in baseline CBVv estimation was first evaluated in comparison to the existing, hyperoxia-based method. Then, data were also acquired using VS-VSL under hypercapnic and hyperoxic gas breathing challenges for further validation of the technique. RESULTS The proposed technique yielded physiologically plausible baseline CBVv values, and when compared with the hyperoxia-based method, showed no statistical difference. Furthermore, data acquired using VS-VSL yielded average CBVv of 2.89%/1.78%, 3.71%/2.29%, and 2.88%/1.76% for baseline, hypercapnia, and hyperoxia, respectively, in gray/white matter regions. As expected, hyperoxia had negligible effect (P > .8), whereas hypercapnia demonstrated vasodilation (P << .01). CONCLUSION Upon further validation of the quantification model, the method is expected to have merit for 3D CBVv measurements across the entire brain.
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Affiliation(s)
- Hyunyeol Lee
- Laboratory for Structural, Physiologic, and Functional Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Felix W Wehrli
- Laboratory for Structural, Physiologic, and Functional Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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32
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Mutsaerts HJMM, Petr J, Groot P, Vandemaele P, Ingala S, Robertson AD, Václavů L, Groote I, Kuijf H, Zelaya F, O'Daly O, Hilal S, Wink AM, Kant I, Caan MWA, Morgan C, de Bresser J, Lysvik E, Schrantee A, Bjørnebekk A, Clement P, Shirzadi Z, Kuijer JPA, Wottschel V, Anazodo UC, Pajkrt D, Richard E, Bokkers RPH, Reneman L, Masellis M, Günther M, MacIntosh BJ, Achten E, Chappell MA, van Osch MJP, Golay X, Thomas DL, De Vita E, Bjørnerud A, Nederveen A, Hendrikse J, Asllani I, Barkhof F. ExploreASL: An image processing pipeline for multi-center ASL perfusion MRI studies. Neuroimage 2020; 219:117031. [PMID: 32526385 DOI: 10.1016/j.neuroimage.2020.117031] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 01/01/2023] Open
Abstract
Arterial spin labeling (ASL) has undergone significant development since its inception, with a focus on improving standardization and reproducibility of its acquisition and quantification. In a community-wide effort towards robust and reproducible clinical ASL image processing, we developed the software package ExploreASL, allowing standardized analyses across centers and scanners. The procedures used in ExploreASL capitalize on published image processing advancements and address the challenges of multi-center datasets with scanner-specific processing and artifact reduction to limit patient exclusion. ExploreASL is self-contained, written in MATLAB and based on Statistical Parameter Mapping (SPM) and runs on multiple operating systems. To facilitate collaboration and data-exchange, the toolbox follows several standards and recommendations for data structure, provenance, and best analysis practice. ExploreASL was iteratively refined and tested in the analysis of >10,000 ASL scans using different pulse-sequences in a variety of clinical populations, resulting in four processing modules: Import, Structural, ASL, and Population that perform tasks, respectively, for data curation, structural and ASL image processing and quality control, and finally preparing the results for statistical analyses on both single-subject and group level. We illustrate ExploreASL processing results from three cohorts: perinatally HIV-infected children, healthy adults, and elderly at risk for neurodegenerative disease. We show the reproducibility for each cohort when processed at different centers with different operating systems and MATLAB versions, and its effects on the quantification of gray matter cerebral blood flow. ExploreASL facilitates the standardization of image processing and quality control, allowing the pooling of cohorts which may increase statistical power and discover between-group perfusion differences. Ultimately, this workflow may advance ASL for wider adoption in clinical studies, trials, and practice.
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Affiliation(s)
- Henk J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands; Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Radiology, University Medical Center Utrecht, Utrecht, the Netherlands; Kate Gleason College of Engineering, Rochester Institute of Technology, NY, USA; Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium.
| | - Jan Petr
- Kate Gleason College of Engineering, Rochester Institute of Technology, NY, USA; Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Paul Groot
- Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Pieter Vandemaele
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
| | - Andrew D Robertson
- Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada
| | - Lena Václavů
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Inge Groote
- Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
| | - Hugo Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore; Memory Aging and Cognition Center, National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Alle Meije Wink
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
| | - Ilse Kant
- Radiology, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Intensive Care, University Medical Centre, Utrecht, the Netherlands
| | - Matthan W A Caan
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Catherine Morgan
- School of Psychology and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Jeroen de Bresser
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Elisabeth Lysvik
- Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
| | - Anouk Schrantee
- Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway
| | - Patricia Clement
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Zahra Shirzadi
- Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Joost P A Kuijer
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
| | - Viktor Wottschel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
| | - Udunna C Anazodo
- Department of Medical Biophysics, University of Western Ontario, London, Canada; Imaging Division, Lawson Health Research Institute, London, Canada
| | - Dasja Pajkrt
- Department of Pediatric Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centre, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Edo Richard
- Department of Neurology, Donders Institute for Brain, Behavior and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Neurology, Amsterdam University Medical Center, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinoud P H Bokkers
- Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Liesbeth Reneman
- Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Mario Masellis
- Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Matthias Günther
- Fraunhofer MEVIS, Bremen, Germany; University of Bremen, Bremen, Germany; Mediri GmbH, Heidelberg, Germany
| | | | - Eric Achten
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Michael A Chappell
- Institute of Biomedical Engineering, Department of Engineering Science & Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Xavier Golay
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - David L Thomas
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Enrico De Vita
- Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, SE1 7EH, UK
| | - Atle Bjørnerud
- Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Norway
| | - Aart Nederveen
- Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jeroen Hendrikse
- Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Iris Asllani
- Kate Gleason College of Engineering, Rochester Institute of Technology, NY, USA; Clinical Imaging Sciences Centre, Department of Neuroscience, Brighton and Sussex Medical School, Brighton, UK
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands; UCL Queen Square Institute of Neurology, University College London, London, UK; Centre for Medical Image Computing (CMIC), Faculty of Engineering Science, University College London, London, UK
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Cohen AD, Agarwal M, Jagra AS, Nencka AS, Meier TB, Lebel RM, McCrea MA, Wang Y. Longitudinal Reproducibility of MR Perfusion Using 3D Pseudocontinuous Arterial Spin Labeling With Hadamard-Encoded Multiple Postlabeling Delays. J Magn Reson Imaging 2020; 51:1846-1853. [PMID: 31785062 PMCID: PMC10063372 DOI: 10.1002/jmri.27007] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Arterial spin labeling (ASL) can be confounded by varying arterial transit times (ATT) across the brain and with disease. Hadamard encoding schemes can be applied to 3D pseudocontinuous ASL (pCASL) to acquire ASL data with multiple postlabeling delays (PLDs) to estimate ATT and then correct cerebral blood flow (CBF). PURPOSE To assess the longitudinal reproducibility of 3D pCASL with Hadamard-encoded multiple PLDs. STUDY TYPE Prospective, longitudinal. POPULATION Fifty-two healthy, right-handed male subjects who underwent imaging at four timepoints over 45 days. FIELD STRENGTH/SEQUENCE A Hadamard-encoded 3D pCASL sequence was acquired at 3.0T with seven PLDs from 1.0-3.7 sec. ASSESSMENT ATT and corrected CBF (cCBF) were computed. Conventional uncorrected CBF (unCBF) was also estimated. Within- and between-subject coefficient of variation (wCV and bCV, respectively) and intraclass correlation coefficient (ICC) were evaluated across four time intervals: 7, 14, 30, and 45 days, in gray matter and 17 independent regions of interest (ROIs). A power analysis was also conducted. STATISTICAL TESTS A repeated-measures analysis of variance (ANOVA) was used to compare ATT, cCBF, and unCBF across the four scan sessions. A paired two-sample t-test was used to compare cCBF and unCBF. Pearson's correlation was used to examine the relationship between the cCBF and unCBF difference and ATT. Power calculations were completed using both the cCBF and unCBF variances. RESULTS ATT showed the lowest wCV and bCV (3.3-4.4% and 6.0-6.3%, respectively) compared to both cCBF (10.5-11.7% and 20.6-22.2%, respectively) and unCBF (12.0-13.6% and 22.7-23.7%, respectively). wCV and bCV were lower for cCBF vs. unCBF. A significant difference between cCBF and unCBF was found in most regions (P = 5.5 × 10-5 -3.8 × 10-4 in gray matter) that was highly correlated with ATT (R2 = 0.79-0.86). A power analysis yielded acceptable power at feasible sample sizes using cCBF. DATA CONCLUSION ATT and ATT-corrected CBF were longitudinally stable, indicating that ATT and CBF changes can be reliably evaluated with Hadamard-encoded 3D pCASL with multiple PLDs. LEVEL OF EVIDENCE 1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1846-1853.
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Affiliation(s)
- Alexander D Cohen
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mohit Agarwal
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amritpal S Jagra
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew S Nencka
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Bladt P, van Osch MJP, Clement P, Achten E, Sijbers J, den Dekker AJ. Supporting measurements or more averages? How to quantify cerebral blood flow most reliably in 5 minutes by arterial spin labeling. Magn Reson Med 2020; 84:2523-2536. [PMID: 32424947 PMCID: PMC7402018 DOI: 10.1002/mrm.28314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/19/2020] [Accepted: 04/17/2020] [Indexed: 11/29/2022]
Abstract
Purpose To determine whether sacrificing part of the scan time of pseudo‐continuous arterial spin labeling (PCASL) for measurement of the labeling efficiency and blood
T1 is beneficial in terms of CBF quantification reliability. Methods In a simulation framework, 5‐minute scan protocols with different scan time divisions between PCASL data acquisition and supporting measurements were evaluated in terms of CBF estimation variability across both noise and ground truth parameter realizations taken from the general population distribution. The entire simulation experiment was repeated for a single‐post‐labeling delay (PLD), multi‐PLD, and free‐lunch time‐encoded (te‐FL) PCASL acquisition strategy. Furthermore, a real data study was designed for preliminary validation. Results For the considered population statistics, measuring the labeling efficiency and the blood
T1 proved beneficial in terms of CBF estimation variability for any distribution of the 5‐minute scan time compared to only acquiring ASL data. Compared to single‐PLD PCASL without support measurements as recommended in the consensus statement, a 26%, 33%, and 42% reduction in relative CBF estimation variability was found for optimal combinations of supporting measurements with single‐PLD, free‐lunch, and multi‐PLD PCASL data acquisition, respectively. The benefit of taking the individual variation of blood
T1 into account was also demonstrated in the real data experiment. Conclusions Spending time to measure the labeling efficiency and the blood
T1 instead of acquiring more averages of the PCASL data proves to be advisable for robust CBF quantification in the general population.
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Affiliation(s)
- Piet Bladt
- imec - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
| | - Matthias J P van Osch
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute of Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Patricia Clement
- Department of Radiology and Nuclear Medicine, Ghent University, Ghent, Belgium
| | - Eric Achten
- Department of Radiology and Nuclear Medicine, Ghent University, Ghent, Belgium
| | - Jan Sijbers
- imec - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
| | - Arnold J den Dekker
- imec - Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
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Pinto J, Chappell MA, Okell TW, Mezue M, Segerdahl AR, Tracey I, Vilela P, Figueiredo P. Calibration of arterial spin labeling data-potential pitfalls in post-processing. Magn Reson Med 2020; 83:1222-1234. [PMID: 31605558 PMCID: PMC6972489 DOI: 10.1002/mrm.28000] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 07/24/2019] [Accepted: 08/27/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess the impact of the different post-processing options in the calibration of arterial spin labeling (ASL) data on perfusion quantification and its reproducibility. THEORY AND METHODS Absolute quantification of perfusion measurements is one of the promises of ASL techniques. However, it is highly dependent on a calibration procedure that involves a complex processing pipeline for which no standardized procedure has been fully established. In this work, we systematically compare the main ASL calibration methods as well as various post-processing calibration options, using 2 data sets acquired with the most common sequences, pulsed ASL and pseudo-continuous ASL. RESULTS Significant and sometimes large discrepancies in ASL perfusion quantification were obtained when using different post-processing calibration options. Nevertheless, when using a set of theoretically based and carefully chosen options, only small differences were observed for both reference tissue and voxelwise methods. The voxelwise and white matter reference tissue methods were less sensitive to post-processing options than the cerebrospinal fluid reference tissue method. However, white matter reference tissue calibration also produced poorer reproducibility results. Moreover, it may also not be an appropriate reference in case of white matter pathology. CONCLUSION Poor post-processing calibration options can lead to large errors in perfusion quantification, and a complete description of the calibration procedure should therefore be reported in ASL studies. Overall, our results further support the voxelwise calibration method proposed by the ASL white paper, particularly given the advantage of being relatively simple to implement and intrinsically correcting for the coil sensitivity profile.
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Affiliation(s)
- Joana Pinto
- Institute for Systems and Robotics and Department of BioengineeringInstituto Superior TécnicoUniversidade de LisboaLisbonPortugal
| | - Michael A. Chappell
- Wellcome Centre for Integrative NeuroimagingFMRIBNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Institute of Biomedical EngineeringDepartment of Engineering ScienceUniversity of OxfordOxfordUnited Kingdom
| | - Thomas W. Okell
- Wellcome Centre for Integrative NeuroimagingFMRIBNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Melvin Mezue
- Wellcome Centre for Integrative NeuroimagingFMRIBNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Andrew R. Segerdahl
- Wellcome Centre for Integrative NeuroimagingFMRIBNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Irene Tracey
- Wellcome Centre for Integrative NeuroimagingFMRIBNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Nuffield Division of AnaestheticsNuffield Department of Clinical NeuroscienceUniversity of OxfordOxfordUnited Kingdom
| | | | - Patrícia Figueiredo
- Institute for Systems and Robotics and Department of BioengineeringInstituto Superior TécnicoUniversidade de LisboaLisbonPortugal
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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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Melzer TR, Keenan RJ, Leeper GJ, Kingston-Smith S, Felton SA, Green SK, Henderson KJ, Palmer NJ, Shoorangiz R, Almuqbel MM, Myall DJ. Test-retest reliability and sample size estimates after MRI scanner relocation. Neuroimage 2020; 211:116608. [PMID: 32032737 DOI: 10.1016/j.neuroimage.2020.116608] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Many factors can contribute to the reliability and robustness of MRI-derived metrics. In this study, we assessed the reliability and reproducibility of three MRI modalities after an MRI scanner was relocated to a new hospital facility. METHODS Twenty healthy volunteers (12 females, mean age (standard deviation) = 41 (11) years, age range [25-66]) completed three MRI sessions. The first session (S1) was one week prior to the 3T GE HDxt scanner relocation. The second (S2) occurred nine weeks after S1 and at the new location; a third session (S3) was acquired 4 weeks after S2. At each session, we acquired structural T1-weighted, pseudo-continuous arterial spin labelled, and diffusion tensor imaging sequences. We used longitudinal processing streams to create 12 summary MRI metrics, including total gray matter (GM), cortical GM, subcortical GM, white matter (WM), and lateral ventricle volume; mean cortical thickness; total surface area; average gray matter perfusion, and average diffusion tensor metrics along principal white matter pathways. We compared mean MRI values and variance at the old scanner location to multiple sessions at the new location using Bayesian multi-level regression models. K-fold cross validation allowed identification of important predictors. Whole-brain analyses were used to investigate any regional differences. Furthermore, we calculated within-subject coefficient of variation (wsCV), intraclass correlation coefficient (ICC), and dice similarity index (SI) of cortical segmentations across scanner relocation and within-site. Additionally, we estimated sample sizes required to robustly detect a 4% difference between two groups across MRI metrics. RESULTS All global MRI metrics exhibited little mean difference and small variability (bar cortical gray matter perfusion) both across scanner relocation and within-site repeat. T1- and DTI-derived tissue metrics showed < |0.3|% mean difference and <1.2% variance across scanner location and <|0.4|% mean difference and <0.8% variance within the new location, with between-site intraclass correlation coefficient (ICC) > 0.80 and within-subject coefficient of variation (wsCV) < 1.4%. Mean cortical gray matter perfusion had the highest between-session variability (6.7% [0.3, 16.7], estimate [95% uncertainty interval]), and hence the smallest ICC (0.71 [0.44,0.92]) and largest wsCV (13.4% [5.4, 18.1]). No global metric exhibited evidence of a meaningful mean difference between scanner locations. However, surface area showed evidence of a mean difference within-site repeat (between S2 and S3). Whole-brain analyses revealed no significant areas of difference between scanner relocation or within-site. For all metrics, we found no support for a systematic difference in variance across relocation sites compared to within-site test-retest reliability. Necessary sample sizes to detect a 4% difference between two independent groups varied from a maximum of n = 362 per group (cortical gray matter perfusion), to total gray matter volume (n = 114), average fractional anisotropy (n = 23), total gray matter volume normalized by intracranial volume (n = 19), and axial diffusivity (n = 3 per group). CONCLUSION Cortical gray matter perfusion was the most variable metric investigated (necessitating large sample sizes to identify group differences), with other metrics showing substantially less variability. Scanner relocation appeared to have a negligible effect on variability of the global MRI metrics tested. This manuscript reports within-site test-retest variability to act as a tool for calculating sample size in future investigations. Our results suggest that when all other parameters are held constant (e.g., sequence parameters and MRI processing), the effect of scanner relocation is indistinguishable from within-site variability, but may need to be considered depending on the question being investigated.
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Affiliation(s)
- Tracy R Melzer
- Department of Medicine, University of Otago, Christchurch, New Zealand; New Zealand Brain Research Institute, Christchurch, New Zealand; Brain Research New Zealand - Rangahau Roro Aotearoa Centre of Research Excellence, New Zealand.
| | - Ross J Keenan
- New Zealand Brain Research Institute, Christchurch, New Zealand; Department of Radiology, Christchurch Hospital, Christchurch, New Zealand; Pacific Radiology Group, Christchurch, New Zealand.
| | | | | | | | | | | | | | - Reza Shoorangiz
- New Zealand Brain Research Institute, Christchurch, New Zealand; Department of Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand.
| | - Mustafa M Almuqbel
- Department of Medicine, University of Otago, Christchurch, New Zealand; New Zealand Brain Research Institute, Christchurch, New Zealand; Pacific Radiology Group, Christchurch, New Zealand.
| | - Daniel J Myall
- New Zealand Brain Research Institute, Christchurch, New Zealand.
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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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de la Peña MJ, Peña IC, García PGP, Gavilán ML, Malpica N, Rubio M, González RA, de Vega VM. Early perfusion changes in multiple sclerosis patients as assessed by MRI using arterial spin labeling. Acta Radiol Open 2019; 8:2058460119894214. [PMID: 32002192 PMCID: PMC6964247 DOI: 10.1177/2058460119894214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 11/19/2019] [Indexed: 01/01/2023] Open
Abstract
Background Gadolinium-perfusion magnetic resonance (MR) identifies gray matter abnormalities in early multiple sclerosis (MS), even in the absence of structural differences. These perfusion changes could be related to the cognitive disability of these patients, especially in the working memory. Arterial spin labeling (ASL) is a relatively recent perfusion technique that does not require intravenous contrast, making the technique especially attractive for clinical research. Purpose To verify the perfusion alterations in early MS, even in the absence of cerebral volume changes. To introduce the ASL sequence as a suitable non-invasive method in the monitoring of these patients. Material and Methods Nineteen healthy controls and 28 patients were included. The neuropsychological test EDSS and SDMT were evaluated. Cerebral blood flow and bolus arrival time were collected from the ASL study. Cerebral volume and cortical thickness were obtained from the volumetric T1 sequence. Spearman's correlation analyzed the correlation between EDSS and SDMT tests and perfusion data. Differences were considered significant at a level of P < 0.05. Results Reduction of the cerebral blood flow and an increase in the bolus arrival time were found in patients compared to controls. A negative correlation between EDSS and thalamus transit time, and between EDSS and cerebral blood flow in the frontal cortex, was found. Conclusion ASL perfusion might detect changes in MS patients even in absent structural volumetric changes. More longitudinal studies are needed, but perfusion parameters could be biomarkers for monitoring these patients.
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Affiliation(s)
| | | | | | | | - Norberto Malpica
- Faculty of Biomedical Imaging, Universidad Rey Juan Carlos, Madrid, Spain
| | - Margarita Rubio
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
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Hormuth DA, Sorace AG, Virostko J, Abramson RG, Bhujwalla ZM, Enriquez-Navas P, Gillies R, Hazle JD, Mason RP, Quarles CC, Weis JA, Whisenant JG, Xu J, Yankeelov TE. Translating preclinical MRI methods to clinical oncology. J Magn Reson Imaging 2019; 50:1377-1392. [PMID: 30925001 PMCID: PMC6766430 DOI: 10.1002/jmri.26731] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/14/2019] [Accepted: 03/14/2019] [Indexed: 02/05/2023] Open
Abstract
The complexity of modern in vivo magnetic resonance imaging (MRI) methods in oncology has dramatically changed in the last 10 years. The field has long since moved passed its (unparalleled) ability to form images with exquisite soft-tissue contrast and morphology, allowing for the enhanced identification of primary tumors and metastatic disease. Currently, it is not uncommon to acquire images related to blood flow, cellularity, and macromolecular content in the clinical setting. The acquisition of images related to metabolism, hypoxia, pH, and tissue stiffness are also becoming common. All of these techniques have had some component of their invention, development, refinement, validation, and initial applications in the preclinical setting using in vivo animal models of cancer. In this review, we discuss the genesis of quantitative MRI methods that have been successfully translated from preclinical research and developed into clinical applications. These include methods that interrogate perfusion, diffusion, pH, hypoxia, macromolecular content, and tissue mechanical properties for improving detection, staging, and response monitoring of cancer. For each of these techniques, we summarize the 1) underlying biological mechanism(s); 2) preclinical applications; 3) available repeatability and reproducibility data; 4) clinical applications; and 5) limitations of the technique. We conclude with a discussion of lessons learned from translating MRI methods from the preclinical to clinical setting, and a presentation of four fundamental problems in cancer imaging that, if solved, would result in a profound improvement in the lives of oncology patients. Level of Evidence: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:1377-1392.
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Affiliation(s)
- David A. Hormuth
- Institute for Computational Engineering and Sciences,Livestrong Cancer Institutes, The University of Texas at Austin
| | - Anna G. Sorace
- Department of Biomedical Engineering, The University of Texas at Austin,Department of Diagnostic Medicine, The University of Texas at Austin,Department of Oncology, The University of Texas at Austin,Livestrong Cancer Institutes, The University of Texas at Austin
| | - John Virostko
- Department of Diagnostic Medicine, The University of Texas at Austin,Department of Oncology, The University of Texas at Austin,Livestrong Cancer Institutes, The University of Texas at Austin
| | - Richard G. Abramson
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
| | | | - Pedro Enriquez-Navas
- Departments of Cancer Imaging and Metabolism, Cancer Physiology, The Moffitt Cancer Center
| | - Robert Gillies
- Departments of Cancer Imaging and Metabolism, Cancer Physiology, The Moffitt Cancer Center
| | - John D. Hazle
- Imaging Physics, The University of Texas M.D. Anderson Cancer Center
| | - Ralph P. Mason
- Department of Radiology, The University of Texas Southwestern Medical Center
| | - C. Chad Quarles
- Department of NeuroImaging Research, The Barrow Neurological Institute
| | - Jared A. Weis
- Department of Biomedical Engineering Wake Forest School of Medicine
| | | | - Junzhong Xu
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center,Institute of Imaging Science, Vanderbilt University Medical Center
| | - Thomas E. Yankeelov
- Institute for Computational Engineering and Sciences,Department of Biomedical Engineering, The University of Texas at Austin,Department of Diagnostic Medicine, The University of Texas at Austin,Department of Oncology, The University of Texas at Austin,Livestrong Cancer Institutes, The University of Texas at Austin
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41
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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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42
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Waterton JC, Hines CDG, Hockings PD, Laitinen I, Ziemian S, Campbell S, Gottschalk M, Green C, Haase M, Hassemer K, Juretschke HP, Koehler S, Lloyd W, Luo Y, Mahmutovic Persson I, O'Connor JPB, Olsson LE, Pindoria K, Schneider JE, Sourbron S, Steinmann D, Strobel K, Tadimalla S, Teh I, Veltien A, Zhang X, Schütz G. Repeatability and reproducibility of longitudinal relaxation rate in 12 small-animal MRI systems. Magn Reson Imaging 2019; 59:121-129. [PMID: 30872166 PMCID: PMC6477178 DOI: 10.1016/j.mri.2019.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/29/2019] [Accepted: 03/08/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Many translational MR biomarkers derive from measurements of the water proton longitudinal relaxation rate R1, but evidence for between-site reproducibility of R1 in small-animal MRI is lacking. OBJECTIVE To assess R1 repeatability and multi-site reproducibility in phantoms for preclinical MRI. METHODS R1 was measured by saturation recovery in 2% agarose phantoms with five nickel chloride concentrations in 12 magnets at 5 field strengths in 11 centres on two different occasions within 1-13 days. R1 was analysed in three different regions of interest, giving 360 measurements in total. Root-mean-square repeatability and reproducibility coefficients of variation (CoV) were calculated. Propagation of reproducibility errors into 21 translational MR measurements and biomarkers was estimated. Relaxivities were calculated. Dynamic signal stability was also measured. RESULTS CoV for day-to-day repeatability (N = 180 regions of interest) was 2.34% and for between-centre reproducibility (N = 9 centres) was 1.43%. Mostly, these do not propagate to biologically significant between-centre error, although a few R1-based MR biomarkers were found to be quite sensitive even to such small errors in R1, notably in myocardial fibrosis, in white matter, and in oxygen-enhanced MRI. The relaxivity of aqueous Ni2+ in 2% agarose varied between 0.66 s-1 mM-1 at 3 T and 0.94 s-1 mM-1 at 11.7T. INTERPRETATION While several factors affect the reproducibility of R1-based MR biomarkers measured preclinically, between-centre propagation of errors arising from intrinsic equipment irreproducibility should in most cases be small. However, in a few specific cases exceptional efforts might be required to ensure R1-reproducibility.
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Affiliation(s)
- John C Waterton
- Bioxydyn Ltd, Manchester Science Park, Rutherford House, Pencroft Way, MANCHESTER M15 6SZ, United Kingdom; Centre for Imaging Sciences, Division of Informatics Imaging & Data Sciences, School of Health Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester Academic Health Sciences Centre, MANCHESTER M13 9PL, United Kingdom.
| | | | - Paul D Hockings
- Antaros Medical, BioVenture Hub, 43183 Mölndal, Sweden; MedTech West, Chalmers University of Technology, Gothenburg, Sweden.
| | - Iina Laitinen
- Sanofi-Aventis Deutschland GmbH, R&D TIM - Bioimaging Germany, Industriepark Höchst, D-65926 Frankfurt am Main, Germany.
| | - Sabina Ziemian
- Bayer AG, Research and Development, Pharmaceuticals, MR and CT Contrast Media Research, Müllerstraße 178, D-13353 Berlin, Germany.
| | - Simon Campbell
- In-Vivo Bioimaging UK, RD Platform Technology & Science, GSK Medicines Research Centre, Gunnels Wood Road, STEVENAGE, Hertfordshire, SG1 2NY, United Kingdom.
| | - Michael Gottschalk
- Lund University BioImaging Center, Klinikgatan 32, SE-222-42 Lund, Sweden.
| | - Claudia Green
- Bayer AG, Research and Development, Pharmaceuticals, MR and CT Contrast Media Research, Müllerstraße 178, D-13353 Berlin, Germany.
| | - Michael Haase
- In-Vivo Bioimaging UK, RD Platform Technology & Science, GSK Medicines Research Centre, Gunnels Wood Road, STEVENAGE, Hertfordshire, SG1 2NY, United Kingdom.
| | - Katja Hassemer
- Sanofi-Aventis Deutschland GmbH, R&D TIM - Bioimaging Germany, Industriepark Höchst, D-65926 Frankfurt am Main, Germany.
| | - Hans-Paul Juretschke
- Sanofi-Aventis Deutschland GmbH, R&D TIM - Bioimaging Germany, Industriepark Höchst, D-65926 Frankfurt am Main, Germany
| | - Sascha Koehler
- Bruker BioSpin MRI GmbH, Rudolf-Plank-Straße 23, D-76275 Ettlingen, Germany.
| | - William Lloyd
- Centre for Imaging Sciences, Division of Informatics Imaging & Data Sciences, School of Health Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester Academic Health Sciences Centre, MANCHESTER M13 9PL, United Kingdom.
| | - Yanping Luo
- iSAT Discovery, Abbvie, 1 North Waukegan Road, North Chicago, IL, 60064-1802, United States of America.
| | - Irma Mahmutovic Persson
- Department of Translational Sciences, Medical Radiation Physics, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden.
| | - James P B O'Connor
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester Academic Health Sciences Centre, MANCHESTER M20 4BX, United Kingdom. james.o'
| | - Lars E Olsson
- Department of Translational Sciences, Medical Radiation Physics, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden.
| | - Kashmira Pindoria
- In-Vivo Bioimaging UK, RD Platform Technology & Science, GSK Medicines Research Centre, Gunnels Wood Road, STEVENAGE, Hertfordshire, SG1 2NY, United Kingdom.
| | - Jurgen E Schneider
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, United Kingdom.
| | - Steven Sourbron
- Leeds Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, LIGHT Labs, Clarendon Way, LEEDS LS2 9JT, United Kingdom.
| | - Denise Steinmann
- Sanofi-Aventis Deutschland GmbH, R&D TIM - Bioimaging Germany, Industriepark Höchst, D-65926 Frankfurt am Main, Germany.
| | - Klaus Strobel
- Bruker BioSpin MRI GmbH, Rudolf-Plank-Straße 23, D-76275 Ettlingen, Germany.
| | - Sirisha Tadimalla
- Leeds Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, LIGHT Labs, Clarendon Way, LEEDS LS2 9JT, United Kingdom.
| | - Irvin Teh
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, United Kingdom.
| | - Andor Veltien
- Radboud university medical center, Radiology (766), P.O.Box 9101, 6500, HB, Nijmegen, the Netherlands.
| | - Xiaomeng Zhang
- iSAT Discovery, Abbvie, 1 North Waukegan Road, North Chicago, IL, 60064-1802, United States of America.
| | - Gunnar Schütz
- Bayer AG, Research and Development, Pharmaceuticals, MR and CT Contrast Media Research, Müllerstraße 178, D-13353 Berlin, Germany.
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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 2019; 187:17-31. [PMID: 29458187 PMCID: PMC6095829 DOI: 10.1016/j.neuroimage.2018.02.027] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [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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44
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Shirzadi Z, Stefanovic B, Mutsaerts HJMM, Masellis M, MacIntosh BJ. Classifying cognitive impairment based on the spatial heterogeneity of cerebral blood flow images. J Magn Reson Imaging 2019; 50:858-867. [PMID: 30666734 DOI: 10.1002/jmri.26650] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/28/2018] [Accepted: 12/29/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The spatial coefficient of variation (sCoV) of arterial spin-labeled (ASL) MRI can index cerebral blood flow spatial heterogeneity. This metric reflects delayed blood delivery-seen as a hyperintense ASL signal juxtaposed by hypointense regions. PURPOSE To investigate the use of ASL-sCoV in the classification of cognitively unimpaired (CU), mild cognitive impairment (MCI), and Alzheimer's disease (AD) cohorts. STUDY TYPE Prospective/cohort. POPULATION Baseline ASL images from AD neuroimaging initiative dataset in three groups of CU, MCI, and AD (N = 258). FIELD STRENGTH/SEQUENCE Pulsed ASL (PICORE QT2) images were acquired on 3 T Siemens systems (TE/TR = 12/3400 msec, TI1/2 = 700/1900 msec). ASSESSMENT ASL-sCoV was calculated in temporal, parietal, occipital, and frontal lobes as well as whole gray matter. STATISTICAL TESTS The primary analysis used an analysis of covariance to investigate sCoV and cognitive group (CU, MCI, AD) associations. We also evaluated the repeatability of sCoV by calculating within-subject agreement in a subgroup of CU participants with a repeat ASL. The secondary analyses assessed ventricular volume, amyloid burden, glucose uptake, ASL-sCoV, and regional CBF as cognitive group classifiers using logistic regression models and receiver operating characteristic analyses. RESULTS We found that global and temporal lobe sCoV differed between cognitive groups (P = 0.006). Post-hoc tests showed that temporal lobe sCoV was lower in CU than in MCI (Cohen's d = -0.36) or AD (Cohen's d = -1.36). We found that sCoV was moderately repeatable in CU (intersession intraclass correlation = 0.50; intrasession intraclass correlation = 0.88). Subsequent logistic regression analyses revealed that temporal lobe sCoV and amyloid uptake classified CU vs. MCI (P < 0.01; accuracy = 78%). Temporal lobe sCoV, amyloid, and glucose uptake classified CU vs. AD (P < 0.01; accuracy = 97%); glucose uptake significantly classified MCI vs. AD (P < 0.01; accuracy = 85%). DATA CONCLUSION We showed that ASL spatial heterogeneity can be used alongside AD neuroimaging markers to distinguish cognitive groups, in particular, cognitively unimpaired from cognitively impaired individuals. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:858-867.
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Affiliation(s)
- Zahra Shirzadi
- Department of Medical Biophysics, University of Toronto, ON, Canada.,Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, ON, Canada
| | - Bojana Stefanovic
- Department of Medical Biophysics, University of Toronto, ON, Canada.,Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, ON, Canada
| | - Henri J M M Mutsaerts
- Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, ON, Canada.,Department of Radiology, VU Medical Center, Amsterdam, The Netherlands
| | - Mario Masellis
- Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, ON, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, ON, Canada.,Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, ON, Canada
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45
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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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Shukla-Dave A, Obuchowski NA, Chenevert TL, Jambawalikar S, Schwartz LH, Malyarenko D, Huang W, Noworolski SM, Young RJ, Shiroishi MS, Kim H, Coolens C, Laue H, Chung C, Rosen M, Boss M, Jackson EF. Quantitative imaging biomarkers alliance (QIBA) recommendations for improved precision of DWI and DCE-MRI derived biomarkers in multicenter oncology trials. J Magn Reson Imaging 2018; 49:e101-e121. [PMID: 30451345 DOI: 10.1002/jmri.26518] [Citation(s) in RCA: 222] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 12/14/2022] Open
Abstract
Physiological properties of tumors can be measured both in vivo and noninvasively by diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging. Although these techniques have been used for more than two decades to study tumor diffusion, perfusion, and/or permeability, the methods and studies on how to reduce measurement error and bias in the derived imaging metrics is still lacking in the literature. This is of paramount importance because the objective is to translate these quantitative imaging biomarkers (QIBs) into clinical trials, and ultimately in clinical practice. Standardization of the image acquisition using appropriate phantoms is the first step from a technical performance standpoint. The next step is to assess whether the imaging metrics have clinical value and meet the requirements for being a QIB as defined by the Radiological Society of North America's Quantitative Imaging Biomarkers Alliance (QIBA). The goal and mission of QIBA and the National Cancer Institute Quantitative Imaging Network (QIN) initiatives are to provide technical performance standards (QIBA profiles) and QIN tools for producing reliable QIBs for use in the clinical imaging community. Some of QIBA's development of quantitative diffusion-weighted imaging and dynamic contrast-enhanced QIB profiles has been hampered by the lack of literature for repeatability and reproducibility of the derived QIBs. The available research on this topic is scant and is not in sync with improvements or upgrades in MRI technology over the years. This review focuses on the need for QIBs in oncology applications and emphasizes the importance of the assessment of their reproducibility and repeatability. Level of Evidence: 5 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;49:e101-e121.
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Affiliation(s)
- Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nancy A Obuchowski
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Thomas L Chenevert
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Sachin Jambawalikar
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Lawrence H Schwartz
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Dariya Malyarenko
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Wei Huang
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Susan M Noworolski
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Robert J Young
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mark S Shiroishi
- Division of Neuroradiology, Department of Radiology, University of Southern California, Los Angeles, California, USA
| | - Harrison Kim
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Catherine Coolens
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | | | - Caroline Chung
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Mark Rosen
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael Boss
- Applied Physics Division, National Institute of Standards and Technology, Boulder, Colorado, USA
| | - Edward F Jackson
- Departments of Medical Physics, Radiology, and Human Oncology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA
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47
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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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48
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van Osch MJ, Teeuwisse WM, Chen Z, Suzuki Y, Helle M, Schmid S. Advances in arterial spin labelling MRI methods for measuring perfusion and collateral flow. J Cereb Blood Flow Metab 2018; 38:1461-1480. [PMID: 28598243 PMCID: PMC6120125 DOI: 10.1177/0271678x17713434] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
With the publication in 2015 of the consensus statement by the perfusion study group of the International Society for Magnetic Resonance in Medicine (ISMRM) and the EU-COST action 'ASL in dementia' on the implementation of arterial spin labelling MRI (ASL) in a clinical setting, the development of ASL can be considered to have become mature and ready for clinical prime-time. In this review article new developments and remaining issues will be discussed, especially focusing on quantification of ASL as well as on new technological developments of ASL for perfusion imaging and flow territory mapping. Uncertainty of the achieved labelling efficiency in pseudo-continuous ASL (pCASL) as well as the presence of arterial transit time artefacts, can be considered the main remaining challenges for the use of quantitative cerebral blood flow (CBF) values. New developments in ASL centre around time-efficient acquisition of dynamic ASL-images by means of time-encoded pCASL and diversification of information content, for example by combined 4D-angiography with perfusion imaging. Current vessel-encoded and super-selective pCASL-methodology have developed into easily applied flow-territory mapping methods providing relevant clinical information with highly similar information content as digital subtraction angiography (DSA), the current clinical standard. Both approaches seem therefore to be ready for clinical use.
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Affiliation(s)
- Matthias Jp van Osch
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,2 Leiden Institute of Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Wouter M Teeuwisse
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,2 Leiden Institute of Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Zhensen Chen
- 3 Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Yuriko Suzuki
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael Helle
- 4 Philips GmbH Innovative Technologies, Research Laboratories, Hamburg, Germany
| | - Sophie Schmid
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,2 Leiden Institute of Brain and Cognition, Leiden University, Leiden, The Netherlands
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49
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Henriksen OM, Vestergaard MB, Lindberg U, Aachmann-Andersen NJ, Lisbjerg K, Christensen SJ, Rasmussen P, Olsen NV, Forman JL, Larsson HBW, Law I. Interindividual and regional relationship between cerebral blood flow and glucose metabolism in the resting brain. J Appl Physiol (1985) 2018; 125:1080-1089. [PMID: 29975605 DOI: 10.1152/japplphysiol.00276.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Studies of the resting brain measurements of cerebral blood flow (CBF) show large interindividual and regional variability, but the metabolic basis of this variability is not fully established. The aim of the present study was to reassess regional and interindividual relationships between cerebral perfusion and glucose metabolism in the resting brain. Regional quantitative measurements of CBF and cerebral metabolic rate of glucose (CMRglc) were obtained in 24 healthy young men using dynamic [15O]H2O and [18F]fluorodeoxyglucose positron emission tomography (PET). Magnetic resonance imaging measurements of global oxygen extraction fraction (gOEF) and metabolic rate of oxygen ([Formula: see text]) were obtained by combined susceptometry-based sagittal sinus oximetry and phase contrast mapping. No significant interindividual associations between global CBF, global CMRglc, and [Formula: see text] were observed. Linear mixed-model analysis showed a highly significant association of CBF with CMRglc regionally. Compared with neocortex significantly higher CBF values than explained by CMRglc were demonstrated in infratentorial structures, thalami, and mesial temporal cortex, and lower values were found in the striatum and cerebral white matter. The present study shows that absolute quantitative global CBF measurements appear not to be a valid surrogate measure of global cerebral glucose or oxygen consumption, and further demonstrates regionally variable relationship between perfusion and glucose metabolism in the resting brain that could suggest regional differences in energy substrate metabolism. NEW & NOTEWORTHY Using method-independent techniques the study cannot confirm direct interindividual correlations of absolute global values of perfusion with oxygen or glucose metabolism in the resting brain, and absolute global perfusion measurements appear not to be valid surrogate measures of cerebral metabolism. The ratio of both perfusion and oxygen delivery to glucose metabolism varies regionally, also when accounting for known methodological regional bias in quantification of glucose metabolism.
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Affiliation(s)
- Otto M Henriksen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen , Denmark
| | - Mark B Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Glostrup, Denmark
| | - Ulrich Lindberg
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Glostrup, Denmark
| | | | - Kristian Lisbjerg
- Department of Neuroanaesthesiology, The Neuroscience Centre, Rigshospitalet, Copenhagen , Denmark
| | - Søren J Christensen
- Department of Neuroanaesthesiology, The Neuroscience Centre, Rigshospitalet, Copenhagen , Denmark
| | - Peter Rasmussen
- Department of Neuroscience and Pharmacology, The Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Niels V Olsen
- Department of Neuroanaesthesiology, The Neuroscience Centre, Rigshospitalet, Copenhagen , Denmark.,Department of Neuroscience and Pharmacology, The Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Julie L Forman
- Section of Biostatistics, University of Copenhagen, The Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Henrik B W Larsson
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Glostrup, Denmark.,Institute of Clinical Medicine, The Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen , Denmark.,Institute of Clinical Medicine, The Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
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50
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Components of day-to-day variability of cerebral perfusion measurements - Analysis of phase contrast mapping magnetic resonance imaging measurements in healthy volunteers. PLoS One 2018; 13:e0197807. [PMID: 29879126 PMCID: PMC5991708 DOI: 10.1371/journal.pone.0197807] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/09/2018] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of the study was to investigate the components of day-to-day variability of repeated phase contrast mapping (PCM) magnetic resonance imaging measurements of global cerebral blood flow (gCBF). Materials and methods Two dataset were analyzed. In Dataset 1 duplicated PCM measurements of total brain flow were performed in 11 healthy young volunteers on two separate days applying a strictly standardized setup. For comparison PCM measurements obtained from a previously published study (Dataset 2) were analyzed in order to assess long-term variability in an aged population in a less strictly controlled setup. Global CBF was calculated by normalizing total brain flow to brain volume. On each day measurements of hemoglobin, caffeine and glucose were obtained. Linear mixed models were applied to estimate coefficients of variation (CV) of total (CVt), between-subject (CVb), within-subject day-to-day (CVw), and intra-session residual variability (CVr). Results In Dataset 1 CVt, CVb, CVw and CVr were estimated to be 11%, 9.4%, 4% and 4.2%, respectively, and to 8.8%, 7.2%, 2.7% and 4.3%, respectively, when adjusting for hemoglobin and plasma caffeine. In Dataset 2 CVt, CVb and CVw were estimated to be 25.4%, 19.2%, and 15.0%, respectively, and decreased to 16.6%, 8.2% and 12.5%, respectively, when adjusting for the same covariates. Discussion Our results suggest that short-term day-to-day variability of gCBF is relatively low compared to between-subject variability when studied in standardized conditions, whereas long-term variability in an aged population appears to be much larger when studied in less a standardized setup. The results further showed that from 20% to 35% of the total variability in gCBF can be attributed to the effects of hemoglobin and caffeine.
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