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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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Sánchez-Catasús CA, Sanabria-Diaz G, Willemsen A, Martinez-Montes E, Samper-Noa J, Aguila-Ruiz A, Boellaard R, De Deyn PP, Dierckx RAJO, Melie-Garcia L. Subtle alterations in cerebrovascular reactivity in mild cognitive impairment detected by graph theoretical analysis and not by the standard approach. NEUROIMAGE-CLINICAL 2017; 15:151-160. [PMID: 28529871 PMCID: PMC5429238 DOI: 10.1016/j.nicl.2017.04.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 03/10/2017] [Accepted: 04/19/2017] [Indexed: 01/07/2023]
Abstract
There is growing support that cerebrovascular reactivity (CVR) in response to a vasodilatory challenge, also defined as the cerebrovascular reserve, is reduced in Alzheimer's disease dementia. However, this is less clear in patients with mild cognitive impairment (MCI). The current standard analysis may not reflect subtle abnormalities in CVR. In this study, we aimed to investigate vasodilatory-induced changes in the topology of the cerebral blood flow correlation (CBFcorr) network to study possible network-related CVR abnormalities in MCI. For this purpose, four CBFcorr networks were constructed: two using CBF SPECT data at baseline and under the vasodilatory challenge of acetazolamide (ACZ), obtained from a group of 26 MCI patients; and two equivalent networks from a group of 26 matched cognitively normal controls. The mean strength of association (SA) and clustering coefficient (C) were used to evaluate ACZ-induced changes on the topology of CBFcorr networks. We found that cognitively normal adults and MCI patients show different patterns of C and SA changes. The observed differences included the medial prefrontal cortices and inferior parietal lobe, which represent areas involved in MCI's cognitive dysfunction. In contrast, no substantial differences were detected by standard CVR analysis. These results suggest that graph theoretical analysis of ACZ-induced changes in the topology of the CBFcorr networks allows the identification of subtle network-related CVR alterations in MCI, which couldn't be detected by the standard approach. Subtle alterations in cerebrovascular reactivity in MCI by graph theoretical analysis. Graph theoretical analysis seems to be sensitive to subtle abnormalities. The standard approach could be insufficient for capturing subtle abnormal changes.
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Affiliation(s)
- Carlos A Sánchez-Catasús
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Nuclear Medicine, Center for Neurological Restoration (CIREN), Havana, Cuba.
| | - Gretel Sanabria-Diaz
- Laboratoire de Recherche en Neuroimagerie (LREN), Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Neuroinformatics Department, Cuban Neuroscience Center, Havana, Cuba
| | - Antoon Willemsen
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, The Netherlands
| | | | - Juan Samper-Noa
- Neuroinformatics Department, Cuban Neuroscience Center, Havana, Cuba; Hospital Carlos J. Finlay, Havana, Cuba
| | - Angel Aguila-Ruiz
- Department of Nuclear Medicine, Center for Neurological Restoration (CIREN), Havana, Cuba
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Peter P De Deyn
- Department of Neurology and Alzheimer Research Center, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Rudi A J O Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Lester Melie-Garcia
- Laboratoire de Recherche en Neuroimagerie (LREN), Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Neuroinformatics Department, Cuban Neuroscience Center, Havana, Cuba
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The diagnosis and evaluation of dementia and mild cognitive impairment with emphasis on SPECT perfusion neuroimaging. CNS Spectr 2012; 17:176-206. [PMID: 22929226 DOI: 10.1017/s1092852912000636] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
As the world population ages, the incidence of dementing illnesses will dramatically increase. The number of people afflicted with dementia is expected to quadruple in the next 50 years. Since the neuropathology of the dementias precedes clinical symptoms often by several years, earlier detection and intervention could be key steps to mitigating the progression and burden of these diseases. This review will explore methods of evaluating, differentiating, and diagnosing the multiple forms of dementia. Particular emphasis will be placed on the diagnosis of mild cognitive impairment-the precursor to dementia. Anatomical imaging; cerebrospinal fluid markers; functional neuroimaging, such as positron emission tomography and single photon emission tomography; and molecular imaging, such as amyloid marker imaging, will be assessed in terms of sensitivity and specificity. Cost will also be a consideration, as the growing population afflicted with dementia represents an increasingly large financial encumbrance to the healthcare systems of every nation. In the face of expensive new markers and limited availability of cyclotrons, single photon emission computer tomography (SPECT) provides relatively high sensitivity and specificity at a comparatively low overall cost.
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Takasawa M, Murase K, Oku N, Kawamata M, Nagayoshi M, Imaizumi M, Yoshikawa T, Osaki Y, Kimura Y, Kajimoto K, Kitagawa K, Hori M, Hatazawa J. Spectral analysis of 99mTc-HMPAO for estimating cerebral blood flow: a comparison with H2(15)O PET. Ann Nucl Med 2004; 18:243-9. [PMID: 15233286 DOI: 10.1007/bf02985006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cerebral blood flow (CBF) can be quantified non-invasively using the brain perfusion index (BPI), which is determined using radionuclide angiographic data obtained through the use of technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO). The BPI is generally calculated using graphical analysis (GA). In this study, BPI was measured using spectral analysis (SA), and the usefulness of SA was compared with that of GA. Thirteen patients with various brain diseases and four healthy male volunteers were examined using radionuclide angiography with 99mTc-HMPAO. The BPI was measured for each subject using both SA and GA. In the four healthy volunteers, the BPI was examined at rest and after the intravenous administration of 1 g of acetazolamide (ACZ). An H2(15)O PET examination was also performed in the 13 patients; the BPIS and BPIG values were compared with the CBF measurements obtained using H2(15)O PET (CBFPET). The BPI values obtained by SA (BPIS) (x) and by GA (BPIG) (y) were correlated (y = 0.568x + 0.055, r = 0.901) in the 13 patients and four healthy volunteers at rest, although the BPIG values were underestimated by 36.1 +/- 7.5% (mean +/- SD) compared with the BPIS values. The degree of underestimation tended to increase with increasing BPIS values. The increase in the BPIS was 32.1 +/- 8.0% after the intravenous administration of ACZ, while the increase in BPIG was only 8.1 +/- 2.8%. This discrepancy was considered to be the result of the BPIG values being affected by the first-pass extraction fraction of the tracer. Although both BPIS and BPIG values were significantly correlated with the CBFPET values, the correlation coefficient for BPIS was higher than that for BPIG (BPIS: r = 0.881; BPIG: r = 0.832). These results suggest that SA produces a more reliable BPI for quantifying CBF using 99mTc-HMPAO than the conventional method using GA. The SA method should be especially useful for activation studies involving pharmacological intervention and/or clinical cases with an increased CBF.
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Affiliation(s)
- Masashi Takasawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Japan.
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Boles Ponto LL, Schultz SK, Leonard Watkins G, Hichwa RD. Technical issues in the determination of cerebrovascular reserve in elderly subjects using 15O-water PET imaging. Neuroimage 2004; 21:201-10. [PMID: 14741657 DOI: 10.1016/j.neuroimage.2003.09.044] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The accurate determination of cerebrovascular reserve (CVR), especially in elderly subjects, entails several technical issues. From a review of the literature, the optimal technique employs quantitative 15O-water PET imaging determinations of cerebral blood flow (CBF) and acetazolamide (ACZ) (1 g iv with measurements at 10- to 20-min post-administration) as the vasodilating agent. CBF and CVR measurements were made using this methodology on 12 elderly subjects (3 males, 9 females, 66-84 years of age) meeting criteria for mild cognitive impairment (MCI) without other significant medical problems. Applying this quantitative technique, the cognitive and emotional status of the subject during the imaging procedure influenced the magnitude of the measurements. The semiquantitative measures resulted in even more pronounced subject state influences. The conditions under which CBF or CVR measurements are made should be controlled and reported. If semiquantitative techniques (e.g., single-photon emission-computed tomography [SPECT] imaging) must be employed for the determination of CVR, the validity of any measurement is dependent on the careful control of the general physiological status (e.g., heart rate, blood pressure, level of anxiety) of the patient.
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Affiliation(s)
- Laura L Boles Ponto
- Positron Emission Tomography Imaging Center, Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
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Abstract
This review article describes the principle and clinical applications of spectral analysis. Spectral analysis provides a spectrum of the kinetic components which are involved in the regional uptake and partitioning of tracer from the blood to the tissue. This technique allows the tissue impulse response function to be derived with minimal modeling assumptions. Spectral analysis makes no a priori assumptions regarding the number of compartments or components required to describe the time course of tracer in the tissue. Spectral analysis can be applied to various dynamic data acquired by planar scintigraphy, single photon emission computed tomography (SPECT) or positron emission tomography (PET) as an alternative approach to compartment analysis. This analysis appears to be clinically useful, because it not only facilitates the interpretation of dynamic scintigraphic, SPECT or PET data, but also simplifies comparisons between regions and between subjects.
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Affiliation(s)
- Kenya Murase
- Department of Medical Physics and Engineering, Division of Medical Technology and Science, Course of Health Science, Graduate School of Medicine, Osaka University, Suita, Japan.
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