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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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Shared and specific characteristics of regional cerebral blood flow and functional connectivity in unmedicated bipolar and major depressive disorders. J Affect Disord 2022; 309:77-84. [PMID: 35452757 DOI: 10.1016/j.jad.2022.04.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Identifying brain similarities and differences between bipolar disorder (BD) and major depressive disorder (MDD) can help us better understand their pathophysiological mechanisms and develop more effective treatments. However, the features of whole-brain regional cerebral blood flow (CBF) and intrinsic functional connectivity (FC) underlying BD and MDD have not been directly compared. METHODS Eighty-eight unmedicated BD II depression patients, 95 unmedicated MDD patients, and 96 healthy controls (HCs) underwent three-dimensional arterial spin labeling (3D ASL) and resting-state functional MRI (rs-fMRI). The functional properties of whole brain CBF and seed-based resting-state FC further performed based on those regions with changed CBF were analyzed between the three groups. RESULTS The patients with BD and MDD showed commonly increased CBF in the left posterior lobe of the cerebellum and the left middle temporal gyrus (MTG) compared with HCs. The CBF of the left MTG was positively associated with 24-items Hamilton Depression Rating Scale scores in MDD patients. Decreased FC between the left posterior lobe of the cerebellum and the left inferior frontal gyrus (IFG) was observed only in patients with BD compared with HCs. CONCLUSION Patients with BD and those with MDD shared common features of CBF in the posterior lobe of the cerebellum and the MTG. The altered posterior lobe of the cerebellum-IFG FC can be considered as a potential biomarker for the differentiation of patients with BD from those with MDD.
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Zheng T, Lai X, Lu J, Chen Q, Wei D. Three Dimensional-Arterial Spin Labeling Evaluation of Improved Cerebral Perfusion After Limb Remote Ischemic Preconditioning in a Rat Model of Focal Ischemic Stroke. Front Neuroanat 2022; 16:893953. [PMID: 35847828 PMCID: PMC9280338 DOI: 10.3389/fnana.2022.893953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the application value of 3D arterial spin labeling (3D-ASL) for evaluating distal limb ischemic preconditioning to improve acute ischemic stroke (AIS) perfusion. Materials and Methods A total of 40 patients with AISs treated in our hospital from January 2020 to December 2020 were recruited, and 15 healthy individuals who were examined in our hospital during the same period were included as the control group; all of these participants were scored on the National Institutes of Health Stroke Scale (NIHSS) and examined by MRI. Sequences included conventional sequences, diffusion-weighted imaging (DWI), magnetic resonance angiography (MRA), and 3D-ASL, and cerebral infarct volume and cerebral blood flow (CBF) in the area of the infarct lesion were measured. After 3 months of treatment, patients with AIS were scored on the modified Rankin Scale (mRS) and divided into good prognosis and poor prognosis groups. In total, 55 adult male Sprague–Dawley rats were divided randomly into three groups: 20 in the middle cerebral artery occlusion (MCAO) group, 20 in the MCAO + limb remote ischemic preconditioning (LRP) group, and 15 in the sham group. In total, 48 h after the procedures, conventional MRI, DWI, and 3D-ASL sequence data were collected, and 2,3,5-trphenyltetrazolium chloride monohydrate (TTC) staining and behavioral scoring were performed. CBF was recorded in the infarct lesion area and the corresponding contralateral area, and the affected/contralateral relative values (rCBF) were calculated to compare the differences in rCBF between different groups. The pathological changes in brain tissues were observed by HE staining, and the expression of vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31) in brain tissues was detected by immunofluorescence and real-time quantitative polymerase chain reaction (RT-qPCR). The protein expression of VEGF was detected by western blotting. Results Hypertension and internal carotid atherosclerosis are high-risk factors for ischemic stroke, and CBF values in the infarct area are significantly lower than those in the corresponding areas on the contralateral side. NIHSS and mRS scores and CBF values have higher specificity and sensitivity for the prognosis of patients with AIS. LRP significantly reduces the infarct area, improves behavioral deficits in rats with cerebral ischemia, reduces neurological injury and histological damage, protects vascular structures, and promotes neovascularization. In addition, 3D-ASL showed a significant increase in brain tissue perfusion in the ischemic area after LRP, and the expression of VEGF and CD31 showed a significant positive correlation with CBF values. Conclusion Three dimensional (3D) ASL can be used to evaluate LRP to improve stroke perfusion, and its protective effect may be closely related to LRP-induced vascular regeneration.
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Affiliation(s)
- Tianxiu Zheng
- Department of Radiology, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, China
| | - Xiaolan Lai
- Department of Hematology, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, China
| | - Jiaojiao Lu
- Department of Central Laboratory, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, China
| | - Qiuyan Chen
- Department of Radiology, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, China
| | - Dingtai Wei
- Department of Radiology, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, China
- *Correspondence: Dingtai Wei,
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Bohara M, Nakajo M, Kamimura K, Yoneyama T, Ayukawa T, Yoshiura T. Visualization of incidentally imaged pituitary gland on three-dimensional arterial spin labeling of the brain. Br J Radiol 2021; 94:20201311. [PMID: 33914621 DOI: 10.1259/bjr.20201311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the visualization of incidentally imaged normal pituitary gland on three-dimensional (3D) pseudo continuous arterial spin labeling (PCASL) perfusion imaging of the brain. METHODS Ninety-three patients with a normal pituitary gland who underwent 3D PCASL for suspected brain diseases were retrospectively included. Visualization of the pituitary gland on PCASL cerebral blood flow (CBF) maps was assessed independently by two observers using a three-point grading system: Grade 1, pituitary CBF ≤ CBF of the cerebral white matter (WM); Grade 2, CBF of WM < pituitary CBF ≤ CBF of the cortical gray matter (GM); and Grade 3, CBF of GM < pituitary CBF. The interobserver agreement of visual grading was determined using weighted κ statistic. The associations of visual grades with age, sex, and pituitary volume were assessed using multivariate logistic regression. Pituitary glands were divided equally into three groups (small, medium, and large) according to their volume for categorization. RESULTS The interobserver agreement for visual rating was excellent (weighted κ = 0.823). Of the 93 cases, Grades 1, 2, and 3 included 17 (18.3%), 41 (44.1%), and 35 cases (37.6%), respectively. Medium and large pituitary volume were significantly associated with Grade 3 visualization (p = 0.0153, OR = 4.8323; 95% CI: 1.3525, 17.2649 and p = 0.0009; OR = 9.0299; 95% CI: 2.4663, 33.0614, respectively), whereas there was no significant association for age or sex. CONCLUSION The normal pituitary gland is often visualized with higher CBF than cortical GM on 3D PCASL, especially in individuals with larger pituitary volume. ADVANCES IN KNOWLEDGE Appearance of the normal pituitary gland on 3D PCASL has been documented for the first time.
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Affiliation(s)
- Manisha Bohara
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masanori Nakajo
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kiyohisa Kamimura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tomohide Yoneyama
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takuro Ayukawa
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Wang C, Dong H. Ki-67 labeling index and the grading of cerebral gliomas by using intravoxel incoherent motion diffusion-weighted imaging and three-dimensional arterial spin labeling magnetic resonance imaging. Acta Radiol 2020; 61:1057-1063. [PMID: 31830431 DOI: 10.1177/0284185119891694] [Citation(s) in RCA: 10] [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
BACKGROUND Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and three-dimensional arterial spin labeling (3D-ASL) have been applied to brain tumors; however, the relationship between their parameters and the Ki-67 labeling index (Ki-67 LI) for the grading of gliomas have yet to be investigated. PURPOSE The aim of this study is to compare multiple parameters obtained from IVIM-DWI and 3D-ASL with the Ki-67 LI when grading gliomas. MATERIAL AND METHODS Fifty-two patients with pathologically confirmed gliomas had undergone magnetic resonance imaging (MRI), including IVIM-DWI and 3D-ASL imaging. Mann-Whitney U tests were conducted and receiver operating characteristic (ROC) curves were generated to determine parameters for distinguishing high-grade gliomas (HGGs) from low-grade gliomas (LGGs). These parameters included the apparent diffusion coefficient (ADC), true diffusivity (D), pseudo diffusivity (D*), perfusion fraction (f), cerebral blood flow (CBF), and their relative values (rADC, rD, rD*, rf, and rCBF). Spearman correlation analysis was used to assess the correlations of the parameters of MRI with the Ki-67 LI. RESULTS The rADC, rD, and rf were significantly lower in HGGs than in LGGs (P < 0.005 for all). The rD had a significantly greater area under the ROC curve than that of the other parameters in the differentiation of HGGs from LGGs (P < 0.05). Both the rD and rf were moderately negatively correlated with the Ki-67 LI. CONCLUSION Both the rD and rf can be used for the quantitative prediction of the Ki-67 LI. Among the extracted parameters, the rD had the significantly greatest diagnostic efficacy.
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Affiliation(s)
- Chaochao Wang
- Department of Radiology, Lihuili Hospital of Ningbo Medical Center, Ningbo, Zhejiang, PR China
| | - Haibo Dong
- Department of Radiology, Lihuili Hospital of Ningbo Medical Center, Ningbo, Zhejiang, PR China
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Parikh D, Afshari FT, Sherlala K, Ahmed S, Shad A. Utility of Arterial Spin Labeling Magnetic Resonance Imaging in Differentiating Sellar Region Meningiomas from Pituitary Adenomas. World Neurosurg 2020; 142:e407-e412. [PMID: 32673801 DOI: 10.1016/j.wneu.2020.07.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Differentiating sellar region meningiomas from pituitary adenomas on standard magnetic resonance imaging (MRI) sequences can be difficult. Arterial spin labeling (ASL) is a noninvasive technique of magnetic resonance perfusion imaging. The range of applications of ASL in neurosurgery has increased, and the information provided can be unique and complementary to other MRI sequences. Here we investigate the utility of ASL MRI in differentiating between sellar region meningiomas and pituitary adenomas. METHODS This was a retrospective comparison of quantitative assessments on absolute and normalized tumor blood flow in histologically proven meningiomas versus pituitary adenomas. RESULTS A total of 15 patients with sellar region lesions were identified, including 9 meningiomas and 6 pituitary adenomas. Mean absolute tumor blood flow and normalized tumor blood flow were significantly higher in meningiomas (131 mL/100 g/min and 2.22) than adenomas (47 mL/100 g/min and 0.92; P < 0.05). CONCLUSIONS ASL MRI is a useful adjunct sequence in differentiating sellar region meningiomas, which exhibit high perfusion, from pituitary adenomas, which exhibit relatively low perfusion.
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Affiliation(s)
- Dhruv Parikh
- Department of Neurosurgery, University Hospital of Coventry and Warwickshire, Coventry, United Kingdom
| | - Fardad T Afshari
- Department of Neurosurgery, University Hospital of Coventry and Warwickshire, Coventry, United Kingdom.
| | - Khaled Sherlala
- Department of Radiology, University Hospital of Coventry and Warwickshire, Coventry, United Kingdom
| | - Shahzada Ahmed
- Department of Ear, Nose, and Throat, University Hospital Birmingham, Birmingham, United Kingdom
| | - Amjad Shad
- Department of Neurosurgery, University Hospital of Coventry and Warwickshire, Coventry, United Kingdom
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Geerts B, Law Ye B, Galanaud D, Dormont D, Pyatigorskaya N. Potential effect of fetal origin of posterior cerebral artery on the arterial spin labeling sequence. J Neuroradiol 2019; 47:238-241. [PMID: 31705918 DOI: 10.1016/j.neurad.2019.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 04/12/2019] [Accepted: 08/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Bert Geerts
- Department of Radiology, AZ Sint-Jan Brugge-Oostende AV, Ruddershove 10, 8000 Bruges, Belgium.
| | - Bruno Law Ye
- Service de neuroradiologie, hôpital Pitié-Salpêtrière, Assistance publique Hôpitaux de Paris, 75013 Paris, France
| | - Damien Galanaud
- Service de neuroradiologie, hôpital Pitié-Salpêtrière, Assistance publique Hôpitaux de Paris, 75013 Paris, France
| | - Didier Dormont
- Service de neuroradiologie, hôpital Pitié-Salpêtrière, Assistance publique Hôpitaux de Paris, 75013 Paris, France
| | - Nadya Pyatigorskaya
- Service de neuroradiologie, hôpital Pitié-Salpêtrière, Assistance publique Hôpitaux de Paris, 75013 Paris, France
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Park H, Lee J, Park SH, Choi SH. Evaluation of Tumor Blood Flow Using Alternate Ascending/Descending Directional Navigation in Primary Brain Tumors: A Comparison Study with Dynamic Susceptibility Contrast Magnetic Resonance Imaging. Korean J Radiol 2019; 20:275-282. [PMID: 30672167 PMCID: PMC6342753 DOI: 10.3348/kjr.2018.0300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/04/2018] [Indexed: 11/23/2022] Open
Abstract
Objective Alternate ascending/descending directional navigation (ALADDIN) is a novel arterial spin labeling technique that does not require a separate spin preparation pulse. We sought to compare the normalized cerebral blood flow (nCBF) values obtained by ALADDIN and dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging (MRI) in patients with primary brain tumors. Materials and Methods Sixteen patients with primary brain tumors underwent MRI scans including contrast-enhanced T1-weighted imaging, DSC perfusion MRI, and ALADDIN. The nCBF values of normal gray matter (GM) and tumor areas were measured by both DSC perfusion MRI and ALADDIN, which were compared by the Wilcoxon signed rank test. Subgroup analyses according to pathology were performed with the Wilcoxon signed rank test. Results Higher mean nCBF values of GM regions in the bilateral frontal lobe, temporal lobe, and caudate were detected by ALADDIN than by DSC perfusion MRI (p <0.05). In terms of the mean or median nCBF values and the mean of the top 10% nCBF values from tumors, DSC perfusion MRI and ALADDIN did not statistically significantly differ either overall or in each tumor group. Conclusion ALADDIN tended to detect higher nCBF values in normal GM, as well as higher perfusion portions of primary brain tumors, than did DSC perfusion MRI. We believe that the high perfusion signal on ALADDIN can be beneficial in lesion detection and characterization.
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Affiliation(s)
- Hyeree Park
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Joonhyuk Lee
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Hong Park
- Magnetic Resonance Imaging Laboratory, Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul, Korea.
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Cassidy CM, Zucca FA, Girgis RR, Baker SC, Weinstein JJ, Sharp ME, Bellei C, Valmadre A, Vanegas N, Kegeles LS, Brucato G, Kang UJ, Sulzer D, Zecca L, Abi-Dargham A, Horga G. Neuromelanin-sensitive MRI as a noninvasive proxy measure of dopamine function in the human brain. Proc Natl Acad Sci U S A 2019; 116:5108-5117. [PMID: 30796187 PMCID: PMC6421437 DOI: 10.1073/pnas.1807983116] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Neuromelanin-sensitive MRI (NM-MRI) purports to detect the content of neuromelanin (NM), a product of dopamine metabolism that accumulates with age in dopamine neurons of the substantia nigra (SN). Interindividual variability in dopamine function may result in varying levels of NM accumulation in the SN; however, the ability of NM-MRI to measure dopamine function in nonneurodegenerative conditions has not been established. Here, we validated that NM-MRI signal intensity in postmortem midbrain specimens correlated with regional NM concentration even in the absence of neurodegeneration, a prerequisite for its use as a proxy for dopamine function. We then validated a voxelwise NM-MRI approach with sufficient anatomical sensitivity to resolve SN subregions. Using this approach and a multimodal dataset of molecular PET and fMRI data, we further showed the NM-MRI signal was related to both dopamine release in the dorsal striatum and resting blood flow within the SN. These results suggest that NM-MRI signal in the SN is a proxy for function of dopamine neurons in the nigrostriatal pathway. As a proof of concept for its clinical utility, we show that the NM-MRI signal correlated to severity of psychosis in schizophrenia and individuals at risk for schizophrenia, consistent with the well-established dysfunction of the nigrostriatal pathway in psychosis. Our results indicate that noninvasive NM-MRI is a promising tool that could have diverse research and clinical applications to investigate in vivo the role of dopamine in neuropsychiatric illness.
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Affiliation(s)
- Clifford M Cassidy
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032;
- University of Ottawa Institute of Mental Health Research, affiliated with The Royal, Ottawa, ON K1Z 8N3, Canada
| | - Fabio A Zucca
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, 20090 Milan, Italy
| | - Ragy R Girgis
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
| | - Seth C Baker
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
| | - Jodi J Weinstein
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794
| | - Madeleine E Sharp
- Department of Neurology, Columbia University Medical Center, New York, NY 10032
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 2B4, Canada
| | - Chiara Bellei
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, 20090 Milan, Italy
| | - Alice Valmadre
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, 20090 Milan, Italy
| | - Nora Vanegas
- Department of Neurology, Columbia University Medical Center, New York, NY 10032
| | - Lawrence S Kegeles
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
| | - Gary Brucato
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
| | - Un Jung Kang
- Department of Neurology, Columbia University Medical Center, New York, NY 10032
| | - David Sulzer
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
- Department of Neurology, Columbia University Medical Center, New York, NY 10032
| | - Luigi Zecca
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, 20090 Milan, Italy
| | - Anissa Abi-Dargham
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794
| | - Guillermo Horga
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032;
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Chen CY, Li CW, Mak HKF, Lin MF, Chan WP. Combined native magnetic resonance angiography, flow-quantifying, and perfusion-imaging for impending second-stroke assessment. Quant Imaging Med Surg 2019; 9:521-529. [PMID: 31032198 DOI: 10.21037/qims.2019.03.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This special report introduces native flow quantitative imaging for evaluating stroke risk. Moreover, the advantage of combining three imaging techniques [magnetic resonance angiography (MRA), phase-contrast (PC) flow imaging, and arterial spin-labeling imaging] is shown to be beneficial for responding to ischemia and preserving viable neurons. These quantitative imaging techniques provide authoritative information for diagnosing impending stroke and selecting appropriate treatment.
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Affiliation(s)
- Chia-Yuen Chen
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Wei Li
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Henry Ka Fung Mak
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong SAR, China
| | - Ming-Fang Lin
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Medical Imaging and Radiological Technology, Yuanpei University, Hsinchu, Taiwan
| | - Wing P Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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11
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Doucette J, Wei L, Hernández-Torres E, Kames C, Forkert ND, Aamand R, Lund TE, Hansen B, Rauscher A. Rapid solution of the Bloch-Torrey equation in anisotropic tissue: Application to dynamic susceptibility contrast MRI of cerebral white matter. Neuroimage 2019; 185:198-207. [DOI: 10.1016/j.neuroimage.2018.10.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 11/30/2022] Open
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12
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Schertz M, Benzakoun J, Pyatigorskaya N, Belkacem S, Sahli-Amor M, Navarro V, Cholet C, Leclercq D, Dormont D, Law-Ye B. Specificities of arterial spin labeling (ASL) abnormalities in acute seizure. J Neuroradiol 2018; 47:20-26. [PMID: 30500358 DOI: 10.1016/j.neurad.2018.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/10/2018] [Accepted: 11/19/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE Arterial spin labeling (ASL) is a non-invasive tool measuring cerebral blood flow (CBF) and is useful to assess acute neurological deficit. While acute stroke presents as hypoperfused vascular territory, epileptic activity causes cortical hyperperfusion. Other neurological conditions exhibit hyperperfusion, like migraine or secondary "luxury perfusion" in strokes. Our objectives were to evaluate the usefulness and potential specificities of ASL in acute seizure and correlate it with electroencephalogram. MATERIALS AND METHODS Amongst a cohort of patients with neurological deficit, addressed for suspicion of stroke, we retrospectively reviewed 25 consecutive patients with seizures who underwent magnetic resonance imaging (MRI) with ASL and electroencephalography (EEG). We compared them with a control group of patients with migraine and stroke secondary re-perfusion, exhibiting ASL hyperperfusion. RESULTS Lateralized cortical hyperperfusion (high relative CBF) was observed in all patients. Good topographic correlation with EEG was found in 18 patients (72%). Eight (32%) had hyperperfusion of ipsilateral pulvinar, 5 (20%) had hyperperfused contralateral cerebellar hemisphere, 16 (64%) presented diffusion abnormalities and 20 (80%) had underlying epileptogenic lesions. Pulvinar hyperperfusion was not observed in the control group, nor were diffusion abnormalities in migrainous patients. Contralateral cerebellar hyperperfusion was observed in two migrainous patient, without associated pulvinar activation, whereas all patients with cerebellar hyperperfusion in the study group had associated pulvinar activation. CONCLUSIONS Elevated CBF can be observed in the epileptogenic zone, ipsilateral pulvinar and contralateral cerebellum (diaschisis) in seizure. These abnormalities seem specific when compared with other causes of hyperperfusion. Arterial spin labeling can be highly effective in the differential diagnosis of strokes.
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Affiliation(s)
- Mathieu Schertz
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Joseph Benzakoun
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Nadya Pyatigorskaya
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France; Sorbonne universités, Pierre and Marie-Curie faculty of medicine, 75013 Paris, France
| | - Samia Belkacem
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Melika Sahli-Amor
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Vincent Navarro
- AP-HP, groupe hospitalier Pitié-Salpêtrière, epileptology department, 75013 Paris, France
| | - Clément Cholet
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Delphine Leclercq
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Didier Dormont
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France; Sorbonne universités, Pierre and Marie-Curie faculty of medicine, 75013 Paris, France
| | - Bruno Law-Ye
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France.
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13
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Lin T, Lyu Y, Qu J, Cheng X, Fan X, Zhang Y, Hou B, You H, Ma W, Feng F. Crossed cerebellar diaschisis in post-treatment glioma patients: A comparative study of arterial spin labelling and dynamic susceptibility contrast. Eur J Radiol 2018; 107:70-75. [PMID: 30292276 DOI: 10.1016/j.ejrad.2018.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess crossed cerebellar diaschisis (CCD) in post-treatment glioma patients, and to compare the performance of arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) in detecting CCD. METHODS AND MATERIALS This retrospective study included 130 patients who had both DSC and ASL. Among them, 16 had underwent fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). We investigated the relationship between CCD and the location and size of supratentorial lesions, and compared PET diagnostic performance with that of ASL and DSC. We assessed the inter-methods agreement for ASL and DSC, and performed quantitative analysis by calculating the asymmetry index (AI) between bilateral cerebellum and exploring how the AI values for ASL-CBF, DSC-rCBF, and DSC-rCBV maps correlated with each other. RESULT Supratentorial lesions affecting the corona radiata (P < 0.001), basal ganglia (P < 0.001), and insula (P = 0.046) were significantly associated with the occurrence of CCD. Lesion size was significantly larger (P = 0.005) in the CCD positive group. With PET as a reference, ASL-CBF and DSC-rCBF maps exhibited the best diagnostic performance compared with the other DSC-generated maps (diagnostic accuracy = 83.3% for both, area under curve (AUC) of ASL = 0.967, AUC of rCBF = 0.983), although differences were not statistically significant. The κ value for the inter-methods (ASL and DSC) agreement in detecting CCD was 0.893, while the degree of perfusion asymmetry was more significant in ASL- than DSC-generated maps. Bland-Altman plots showed that the AI for ASL-CBF was moderately correlated with those for DSC-rCBF and DSC-rCBV. CONCLUSIONS CCD can present in post-treatment glioma patients and is detectable on MR-perfusion images including ASL-CBF, DSC-rCBF, and DSC-rCBV maps.
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Affiliation(s)
- Tianye Lin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuelei Lyu
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Xin Cheng
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyuan Fan
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yiwei Zhang
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Hou
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
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Wong AMC, Yeh CH, Lin JJ, Liu HL, Chou IJ, Lin KL, Wang HS. Arterial spin-labeling perfusion imaging of childhood encephalitis: correlation with seizure and clinical outcome. Neuroradiology 2018; 60:961-970. [PMID: 30046856 DOI: 10.1007/s00234-018-2062-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/17/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE In childhood encephalitis, perfusion abnormalities have been infrequently reported to associate with clinical status. We investigated whether perfusion abnormalities correlated with seizure and clinical outcome in encephalitis. METHODS We retrospectively analyzed the MR studies of 77 pediatric patients with encephalitis. Pseudo-continuous arterial spin-labeling (ASL) imaging was performed on a 3-T scanner. The patients were divided into five groups according to ASL perfusion imaging pattern: normal perfusion (NP), focal hypoperfusion (Lf), extreme global hypoperfusion (LE), focal hyperperfusion (Hf), and extreme global hyperperfusion (HE). Clinical outcome at 3 weeks was dichotomized to unfavorable or favorable outcome according to the Glasgow outcome scale. Multivariate logistic regression was conducted to predict unfavorable outcome and presence of seizure separately, based on explanatory variables including age, sex, and ASL pattern. RESULTS Twenty-seven (35%) patients were designated as in group Hf, five (7%) in group Lf, 11 (14%) in group LE, none in group HE, and 34 (44%) in group NP. Multivariate logistic regression analysis showed that ASL pattern was significantly associated with unfavorable outcome (P = 0.005) and with presence of seizure (P = 0.005). For ASL pattern, group LE was 17.31 times as likely to have an unfavorable outcome as group NP (odds ratio confidence interval [CI] 3.084, 97.105; P = 0.001). Group Hf was 6.383 times as likely to have seizure as group NP (CI 1.765, 23.083; P = 0.005). CONCLUSIONS In childhood encephalitis, patients with extreme global hypoperfusion had poor neurological outcome and those with focal hypoperfusion were more likely to have seizure.
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Affiliation(s)
- Alex Mun-Ching Wong
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan.
| | - Chih-Hua Yeh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan
| | - Jainn-Jim Lin
- Division of Pediatric Critical Care Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - I-Jun Chou
- Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan
| | - Kuang-Lin Lin
- Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan
| | - Huei-Shyong Wang
- Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan
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15
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Geerts B, Leclercq D, Tezenas du Montcel S, Law-ye B, Gerber S, Bernardeschi D, Galanaud D, Dormont D, Pyatigorskaya N. Characterization of Skull Base Lesions Using Pseudo-Continuous Arterial Spin Labeling. Clin Neuroradiol 2017; 29:75-86. [DOI: 10.1007/s00062-017-0623-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/19/2017] [Indexed: 10/18/2022]
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16
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Wan CC, Chen DYT, Tseng YC, Yan FX, Lee KY, Chiang CH, Chen CJ. Fluid-attenuated inversion recovery vascular hyperintensities in predicting cerebral hyperperfusion after intracranial arterial stenting. Neuroradiology 2017; 59:791-796. [PMID: 28689257 DOI: 10.1007/s00234-017-1863-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE No reliable imaging sign predicting cerebral hyperperfusion after intracranial arterial stenting (IAS) had been described in the literature. This study evaluated the effect of fluid-attenuated inversion recovery vascular hyperintensities (FVHs), also called hyperintense vessel sign on T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) MR images, in predicting significant increase in cerebral blood flow (CBF) defined by arterial spin labeling (ASL) after IAS. METHODS We reviewed ASL CBF images and T2-FLAIR MR images before (D0), 1 day after (D1), and 3 days after (D3) IAS of 16 patients. T1-weighted MR images were used as cerebral maps for calculating CBF. The changes in CBF values after IAS were calculated in and compared among stenting and nonstenting vascular territories. An increase more than 50% of CBF was considered as hyperperfusion. The effect of FVHs in predicting hyperperfusion was calculated. RESULTS The D1 CBF value was significantly higher than the D0 CBF value in stenting vascular, contralateral anterior cerebral artery, contralateral middle cerebral artery, and contralateral posterior cerebral artery (PCA) territories (all P < .05). The D1 and D3 CBF values were significantly higher than the D0 CBF value in overall vascular (P < .001), overall nonstenting vascular (P < .001), and ipsilateral PCA (P < .05) territories. The rate of more than 50% increases in CBF was significantly higher in patients who exhibited asymmetric FVHs than in those who did not exhibit these findings. CONCLUSION FVHs could be a critical predictor of a significant increase in CBF after IAS.
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Affiliation(s)
- Chih-Cheng Wan
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 235, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei, 110, Taiwan
| | - David Yen-Ting Chen
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 235, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei, 110, Taiwan
| | - Ying-Chi Tseng
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 235, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei, 110, Taiwan
| | - Feng-Xian Yan
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 235, Taiwan
| | - Kun-Yu Lee
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 235, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei, 110, Taiwan
| | - Chen-Hua Chiang
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 235, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei, 110, Taiwan
| | - Chi-Jen Chen
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 235, Taiwan. .,School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei, 110, Taiwan.
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17
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Arterial spin-labeling perfusion imaging of children with subdural hemorrhage: Perfusion abnormalities in abusive head trauma. J Neuroradiol 2017; 44:281-287. [DOI: 10.1016/j.neurad.2017.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/09/2016] [Accepted: 02/12/2017] [Indexed: 11/17/2022]
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18
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Hernández-Torres E, Kassner N, Forkert ND, Wei L, Wiggermann V, Daemen M, Machan L, Traboulsee A, Li D, Rauscher A. Anisotropic cerebral vascular architecture causes orientation dependency in cerebral blood flow and volume measured with dynamic susceptibility contrast magnetic resonance imaging. J Cereb Blood Flow Metab 2017; 37:1108-1119. [PMID: 27259344 PMCID: PMC5363485 DOI: 10.1177/0271678x16653134] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Measurements of cerebral perfusion using dynamic susceptibility contrast magnetic resonance imaging rely on the assumption of isotropic vascular architecture. However, a considerable fraction of vessels runs in parallel with white matter tracts. Here, we investigate the effects of tissue orientation on dynamic susceptibility contrast magnetic resonance imaging. Tissue orientation was measured using diffusion tensor imaging and dynamic susceptibility contrast was performed with gradient echo planar imaging. Perfusion parameters and the raw dynamic susceptibility contrast signals were correlated with tissue orientation. Additionally, numerical simulations were performed for a range of vascular volumes of both the isotropic vascular bed and anisotropic vessel components, as well as for a range of contrast agent concentrations. The effect of the contrast agent was much larger in white matter tissue perpendicular to the main magnetic field compared to white matter parallel to the main magnetic field. In addition, cerebral blood flow and cerebral blood volume were affected in the same way with angle-dependent variations of up to 130%. Mean transit time and time to maximum of the residual curve exhibited weak orientation dependency of 10%. Numerical simulations agreed with the measured data, showing that one-third of the white matter vascular volume is comprised of vessels running in parallel with the fibre tracts.
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Affiliation(s)
- Enedino Hernández-Torres
- 1 Department of Pediatrics, Division of Neurology, University of British Columbia, Vancouver, Canada.,2 UBC MRI Research Centre, University of British Columbia, Vancouver, Canada
| | - Nora Kassner
- 3 Department of Physics, University of Heidelberg, Heidelberg, Germany
| | - Nils Daniel Forkert
- 4 Department of Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Luxi Wei
- 2 UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.,5 Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - Vanessa Wiggermann
- 1 Department of Pediatrics, Division of Neurology, University of British Columbia, Vancouver, Canada.,2 UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.,5 Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - Madeleine Daemen
- 6 Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Lindsay Machan
- 7 Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Anthony Traboulsee
- 8 Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - David Li
- 2 UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.,7 Department of Radiology, University of British Columbia, Vancouver, Canada.,8 Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Alexander Rauscher
- 1 Department of Pediatrics, Division of Neurology, University of British Columbia, Vancouver, Canada.,2 UBC MRI Research Centre, University of British Columbia, Vancouver, Canada
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Armitage PA, Skipper N, Connolly DJA, Griffiths PD. A qualitative comparison of arterial spin labelling and dynamic susceptibility contrast MRI in 52 children with a range of neurological conditions. Br J Radiol 2017; 90:20160495. [PMID: 27858468 PMCID: PMC5605026 DOI: 10.1259/bjr.20160495] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 11/11/2016] [Accepted: 11/15/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the usefulness of arterial spin labelling (ASL) compared with dynamic susceptibility contrast (DSC) perfusion MRI for typical paediatric neuroimaging applications at 1.5 T. METHODS 52 children (age: 4 months-17 years) with a variety of neurological disorders were scanned using three-dimensional ASL and echoplanar imaging DSC sequences. All images were reviewed by an experienced neuroradiologist; image quality was recorded as "good", "acceptable" or "poor" and diagnostic value was noted as being "greater", "similar" or "less" for ASL when compared with DSC. RESULTS ASL cerebral blood flow (CBF) images were judged to be acceptable in 89% of cases, poor in 11% of cases and good in 0% of cases, while DSC CBF images were acceptable in 88% of cases, poor in 12% of cases and good in 0% of cases. ASL images were judged to have better diagnostic value than DSC images in 28% of cases, about the same in 58% of cases and worse in 14% of cases. CONCLUSION The results of this study suggest that ASL offers a realistic alternative to DSC in the paediatric setting for the majority of cases encountered in this study. However, there are some situations where DSC outperforms ASL; so, care is required to choose the most appropriate technique for the pathology under investigation. A larger study is required to corroborate these preliminary findings. Advances in knowledge: ASL is a relatively new perfusion imaging technique whose use has not been explored extensively in the paediatric setting. This work is a preliminary study to evaluate its usefulness in paediatric neuroimaging.
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Affiliation(s)
- Paul A Armitage
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Nicholas Skipper
- Department of Radiology, Sheffield Children's Hospital, Sheffield, UK
| | | | - Paul D Griffiths
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
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Wong AMC, Yeh CH, Liu HL, Lin KL, Wang HS, Toh CH. Arterial spin-labeling perfusion imaging of childhood meningitis: a case series. Childs Nerv Syst 2016; 32:563-7. [PMID: 26248672 DOI: 10.1007/s00381-015-2858-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 07/26/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Conventional magnetic resonance imaging (MRI), which is mainly used to detect complications, is ineffective in determining the neurological status of patients with meningitis. Hemodynamic change in the brain may be more indicative of the neurological status but few imaging studies have verified this. Arterial spin-labeling (ASL) perfusion, a noninvasive MR method requiring no contrast agent injection, can be used to measure cerebral blood flow (CBF). CASE REPORTS We describe three pediatric patients with meningitis, who all showed regions of increased CBF on perfusion imaging. One patient, presenting with headache and conscious disturbance, had CBF changes in the frontal, temporal, and occipital regions. The other two patients, presenting with hallucinations, memory deficits, and seizures, had CBF changes in the frontal and temporal regions. CONCLUSION ASL perfusion imaging may be helpful in assessing patients with meningitis, demonstrating CBF changes more strongly correlating with the neurological status, and detecting active brain abnormalities.
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Affiliation(s)
- Alex Mun-Ching Wong
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelong, Linkou Medical Center and Chang Gung University, 5 Fu-Hsing Street, Tao Yuan, 333, Taiwan
| | - Chih-Hua Yeh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelong, Linkou Medical Center and Chang Gung University, 5 Fu-Hsing Street, Tao Yuan, 333, Taiwan
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Kuang-Lin Lin
- Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan
| | - Huei-Shyong Wang
- Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan
| | - Cheng-Hong Toh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelong, Linkou Medical Center and Chang Gung University, 5 Fu-Hsing Street, Tao Yuan, 333, Taiwan.
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Lin CM, Tseng YC, Hsu HL, Chen CJ, Chen DYT, Yan FX, Chiu WT. Arterial Spin Labeling Perfusion Study in the Patients with Subacute Mild Traumatic Brain Injury. PLoS One 2016; 11:e0149109. [PMID: 26871696 PMCID: PMC4752493 DOI: 10.1371/journal.pone.0149109] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/27/2016] [Indexed: 11/19/2022] Open
Abstract
Background This study uses a MRI technique, three-dimension pulse continuous arterial spin labeling (3D-PCASL), to measure the patient’s cerebral blood flow (CBF) at the subacute stage of mild traumatic brain injury (MTBI) in order to analyze the relationship between cerebral blood flow and neurocognitive deficits. Objective To provide the relationship between cortical CBF and neuropsychological dysfunction for the subacute MTBI patients. Methods After MTBI, perfusion MR imaging technique (3D-PCASL) measures the CBF of MTBI patients (n = 23) within 1 month and that of normal controls (n = 22) to determine the quantity and location of perfusion defect. The correlation between CBF abnormalities and cognitive deficits was elucidated by combining the results of the neuropsychological tests of the patients. Result We observed a substantial reduction in CBF in the bilateral frontal and left occipital cortex as compared with the normal persons. In addition, there were correlation between post concussive symptoms (including dizziness and simulator sickness) and CBF in the hypoperfused areas. The more severe symptom was correlated with higher CBF in bilateral frontal and left occipital lobes. Conclusion First, this study determined that despite no significant abnormality detected on conventional CT and MRI studies, hypoperfusion was observed in MTBI group using 3D-PCASL technique in subacute stage, which suggested that this approach may increase sensitivity to MTBI. Second, the correlation between CBF and the severity of post concussive symptoms suggested that changes in cerebral hemodynamics may play a role in pathophysiology underlies the symptoms.
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Affiliation(s)
- Che-Ming Lin
- Department of Diagnostic Radiology and Brain and Consciousness Research Center, Taipei Medical University Shuang-Ho Hospital, New Taipei City, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Ying-Chi Tseng
- Department of Diagnostic Radiology and Brain and Consciousness Research Center, Taipei Medical University Shuang-Ho Hospital, New Taipei City, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Hui-Ling Hsu
- Department of Diagnostic Radiology and Brain and Consciousness Research Center, Taipei Medical University Shuang-Ho Hospital, New Taipei City, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
- * E-mail:
| | - Chi-Jen Chen
- Department of Diagnostic Radiology and Brain and Consciousness Research Center, Taipei Medical University Shuang-Ho Hospital, New Taipei City, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
- Chia-Yi Hospital, Ministry of Health and Welfare, Chiayi City, Taiwan
| | - David Yen-Ting Chen
- Department of Diagnostic Radiology and Brain and Consciousness Research Center, Taipei Medical University Shuang-Ho Hospital, New Taipei City, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Feng-Xian Yan
- Department of Diagnostic Radiology and Brain and Consciousness Research Center, Taipei Medical University Shuang-Ho Hospital, New Taipei City, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
| | - Wen-Ta Chiu
- Department of Diagnostic Radiology and Brain and Consciousness Research Center, Taipei Medical University Shuang-Ho Hospital, New Taipei City, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
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22
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Yoo RE, Yun TJ, Cho YD, Rhim JH, Kang KM, Choi SH, Kim JH, Kim JE, Kang HS, Sohn CH, Park SW, Han MH. Utility of arterial spin labeling perfusion magnetic resonance imaging in prediction of angiographic vascularity of meningiomas. J Neurosurg 2016; 125:536-43. [PMID: 26824378 DOI: 10.3171/2015.8.jns151211] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Arterial spin labeling perfusion-weighted imaging (ASL-PWI) enables quantification of tissue perfusion without contrast media administration. The aim of this study was to explore whether cerebral blood flow (CBF) from ASL-PWI can reliably predict angiographic vascularity of meningiomas. METHODS Twenty-seven patients with intracranial meningiomas, who had undergone preoperative ASL-PWI and digital subtraction angiography prior to resection, were included. Angiographic vascularity was assessed using a 4-point grading scale and meningiomas were classified into 2 groups: low vascularity (Grades 0 and 1; n = 11) and high vascularity (Grades 2 and 3; n = 16). Absolute CBF, measured at the largest section of the tumor, was normalized to the contralateral gray matter. Correlation between the mean normalized CBF (nCBF) and angiographic vascularity was determined and the mean nCBF values of the 2 groups were compared. Diagnostic performance of the nCBF for differentiating between the 2 groups was assessed. RESULTS The nCBF had a significant positive correlation with angiographic vascularity (ρ = 0.718; p < 0.001). The high-vascularity group had a significantly higher nCBF than the low-vascularity group (3.334 ± 2.768 and 0.909 ± 0.468, respectively; p = 0.003). At the optimal nCBF cutoff value of 1.733, sensitivity and specificity for the differential diagnosis of the 2 groups were 69% (95% CI 41%-89%) and 100% (95% CI 72%-100%), respectively. The area under the receiver operating characteristic curve was 0.875 (p < 0.001). CONCLUSIONS ASL-PWI may provide a reliable and noninvasive means of predicting angiographic vascularity of meningiomas. It may thus assist in selecting potential candidates for preoperative digital subtraction angiography and embolization in clinical practice.
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Affiliation(s)
- Roh-Eul Yoo
- Departments of 1 Radiology and.,Department of Radiology, Seoul National University College of Medicine
| | - Tae Jin Yun
- Departments of 1 Radiology and.,Department of Radiology, Seoul National University College of Medicine
| | - Young Dae Cho
- Departments of 1 Radiology and.,Department of Radiology, Seoul National University College of Medicine
| | | | - Koung Mi Kang
- Departments of 1 Radiology and.,Department of Radiology, Seoul National University College of Medicine
| | - Seung Hong Choi
- Departments of 1 Radiology and.,Department of Radiology, Seoul National University College of Medicine;,Institute of Radiation Medicine, Seoul National University Medical Research Center; and
| | - Ji-Hoon Kim
- Departments of 1 Radiology and.,Department of Radiology, Seoul National University College of Medicine
| | | | | | - Chul-Ho Sohn
- Departments of 1 Radiology and.,Department of Radiology, Seoul National University College of Medicine;,Institute of Radiation Medicine, Seoul National University Medical Research Center; and
| | - Sun-Won Park
- Department of Radiology, Seoul National University College of Medicine;,Department of Radiology, Boramae Medical Center, Seoul, Korea
| | - Moon Hee Han
- Departments of 1 Radiology and.,Department of Radiology, Seoul National University College of Medicine;,Institute of Radiation Medicine, Seoul National University Medical Research Center; and
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23
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Zhang J, Liu T, Gupta A, Spincemaille P, Nguyen TD, Wang Y. Quantitative mapping of cerebral metabolic rate of oxygen (CMRO2 ) using quantitative susceptibility mapping (QSM). Magn Reson Med 2015; 74:945-52. [PMID: 25263499 PMCID: PMC4375095 DOI: 10.1002/mrm.25463] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/17/2014] [Accepted: 08/20/2014] [Indexed: 12/29/2022]
Abstract
PURPOSE To quantitatively map cerebral metabolic rate of oxygen ( CMRO2) and oxygen extraction fraction ( OEF) in human brains using quantitative susceptibility mapping (QSM) and arterial spin labeling-measured cerebral blood flow (CBF) before and after caffeine vasoconstriction. METHODS Using the multiecho, three-dimensional gradient echo sequence and an oral bolus of 200 mg caffeine, whole brain CMRO2 and OEF were mapped at 3-mm isotropic resolution on 13 healthy subjects. The QSM-based CMRO2 was compared with an R2*-based CMRO2 to analyze the regional consistency within cortical gray matter (CGM) with the scaling in the R2* method set to provide same total CMRO2 as the QSM method for each subject. RESULTS Compared to precaffeine, susceptibility increased (5.1 ± 1.1 ppb; P < 0.01) and CBF decreased (-23.6 ± 6.7 ml/100 g/min; P < 0.01) at 25-min postcaffeine in CGM. This corresponded to a CMRO2 of 153.0 ± 26.4 μmol/100 g/min with an OEF of 33.9 ± 9.6% and 54.5 ± 13.2% (P < 0.01) pre- and postcaffeine, respectively, at CGM, and a CMRO2 of 58.0 ± 26.6 μmol/100 g/min at white matter. CMRO2 from both QSM- and R2*-based methods showed good regional consistency (P > 0.05), but quantitation of R2*-based CMRO2 required an additional scaling factor. CONCLUSION QSM can be used with perfusion measurements pre- and postcaffeine vascoconstriction to map CMRO2 and OEF.
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Affiliation(s)
- Jingwei Zhang
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, United States Address: 301 Weill Hall, Cornell University, Ithaca, NY14853
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States Address: 515 East 71 St, Suite 104, New York, NY, 10021
| | - Tian Liu
- Medimagemetric, LLC, New York, NY, NY, United States Address: 455 Main Street, New York, NY, 10044
| | - Ajay Gupta
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States Address: 515 East 71 St, Suite 104, New York, NY, 10021
| | - Pascal Spincemaille
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States Address: 515 East 71 St, Suite 104, New York, NY, 10021
| | - Thanh D. Nguyen
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States Address: 515 East 71 St, Suite 104, New York, NY, 10021
| | - Yi Wang
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, United States Address: 301 Weill Hall, Cornell University, Ithaca, NY14853
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States Address: 515 East 71 St, Suite 104, New York, NY, 10021
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24
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Barrett TF, Sarkiss CA, Dyvorne HA, Lee J, Balchandani P, Shrivastava RK. Application of Ultrahigh Field Magnetic Resonance Imaging in the Treatment of Brain Tumors: A Meta-Analysis. World Neurosurg 2015; 86:450-65. [PMID: 26409071 DOI: 10.1016/j.wneu.2015.09.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is the imaging modality of choice for the clinical management of brain tumors, and the majority of scanners operate with static magnetic field strengths of 1.5 or 3.0 Tesla (T). During the past decade, ultrahigh field (UHF) MRI has been investigated for its clinical applicability. This meta-analysis evaluates studies pertaining to the application of UHF MRI to patients with brain tumors. METHODS The authors performed a systematic review of the literature. Articles relating to application of UHF MRI to brain anatomy and brain tumors with living subjects were included. Studies were grouped into 1 of 3 categories based on area of focus: "Anatomical Structures Involved with Brain Tumors," "Tumor characterization," and "Treatment Monitoring." Comparison studies with extractable outcomes measure data were analyzed for performance of UHF MRI versus clinical field strengths (1.5 T and 3 T). RESULTS Twenty-four studies (361 subjects) met inclusion criteria. The field of study was heterogeneous and rigorous statistical analysis was not possible. Overall, 279 patients with brain tumors scanned at UHF MRI have been reported. Of these, glioma and glioblastoma multiforme are the most commonly studied lesions (38.9% and 24.4%, respectively). In comparison studies between UHF MRI and clinical field strengths, 24 of 51 patients had outcome measures that were better with UHF MRI, 17 of 24 were equivalent at both field strengths, and 9 were worse at UHF MRI. The most common causes of a worse performance were susceptibility artifacts and magnetic field inhomogeneities (3 of 9). Imaging of the pituitary gland, pineal gland veins, cranial nerves, and tumor microvasculature were all shown to be feasible. CONCLUSIONS UHF MRI shows promise to improve detection and characterization of brain tumors, preoperative planning for neurosurgical resection, and longitudinal monitoring of the effects of radiation and antibody-based therapies. Technical innovations are needed to overcome field inhomogeneity and susceptibility artifacts in certain regions of the skull. Finally, larger studies comparing 1.5 T, 3.0 T, and 7.0 T or greater will determine whether UHF MRI gains acceptance as a clinical standard.
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Affiliation(s)
- Thomas F Barrett
- Department of Neurosurgery, The Mount Sinai Hospital, New York, New York, USA
| | | | - Hadrien A Dyvorne
- The Translational and Molecular Imaging Institute, Mount Sinai Health System, New York, New York, USA
| | - James Lee
- Department of Neurosurgery, The Mount Sinai Hospital, New York, New York, USA
| | - Priti Balchandani
- The Translational and Molecular Imaging Institute, Mount Sinai Health System, New York, New York, USA
| | - Raj K Shrivastava
- Department of Neurosurgery, The Mount Sinai Hospital, New York, New York, USA.
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25
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Zhang J. How far is arterial spin labeling MRI from a clinical reality? Insights from arterial spin labeling comparative studies in Alzheimer's disease and other neurological disorders. J Magn Reson Imaging 2015; 43:1020-45. [PMID: 26250802 DOI: 10.1002/jmri.25022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 07/16/2015] [Accepted: 07/19/2015] [Indexed: 12/26/2022] Open
Affiliation(s)
- Jing Zhang
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
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26
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Chronic cerebral hypoperfusion induces vascular plasticity and hemodynamics but also neuronal degeneration and cognitive impairment. J Cereb Blood Flow Metab 2015; 35:1249-59. [PMID: 25853908 PMCID: PMC4528009 DOI: 10.1038/jcbfm.2015.55] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 02/19/2015] [Accepted: 03/10/2015] [Indexed: 12/16/2022]
Abstract
Chronic cerebral hypoperfusion (CCH) induces cognitive impairment, but the compensative mechanism of cerebral blood flow (CBF) is not fully understood. The present study mainly investigated dynamic changes in CBF, angiogenesis, and cellular pathology in the cortex, the striatum, and the cerebellum, and also studied cognitive impairment of rats induced by bilateral common carotid artery occlusion (BCCAO). Magnetic resonance imaging (MRI) techniques, immunochemistry, and Morris water maze were employed to the study. The CBF of the cortex, striatum, and cerebellum dramatically decreased after right common carotid artery occlusion (RCCAO), and remained lower level at 2 weeks after BCCAO. It returned to the sham level from 3 to 6 weeks companied by the dilation of vertebral arteries after BCCAO. The number of microvessels declined at 2, 3, and 4 weeks but increased at 6 weeks after BCCAO. Neuronal degeneration occurred in the cortex and striatum from 2 to 6 weeks, but the number of glial cells dramatically increased at 4 weeks after BCCAO. Cognitive impairment of ischemic rats was directly related to ischemic duration. Our results suggest that CCH induces a compensative mechanism attempting to maintain optimal CBF to the brain. However, this limited compensation cannot prevent neuronal loss and cognitive impairment after permanent ischemia.
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27
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Liu HL, Chang TT, Yan FX, Li CH, Lin YS, Wong AM. Assessment of vessel permeability by combining dynamic contrast-enhanced and arterial spin labeling MRI. NMR IN BIOMEDICINE 2015; 28:642-649. [PMID: 25880892 DOI: 10.1002/nbm.3297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 02/19/2015] [Accepted: 03/05/2015] [Indexed: 06/04/2023]
Abstract
The forward volumetric transfer constant (K(trans)), a physiological parameter extracted from dynamic contrast-enhanced (DCE) MRI, is weighted by vessel permeability and tissue blood flow. The permeability × surface area product per unit mass of tissue (PS) in brain tumors was estimated in this study by combining the blood flow obtained through pseudo-continuous arterial spin labeling (PCASL) and K(trans) obtained through DCE MRI. An analytical analysis and a numerical simulation were conducted to understand how errors in the flow and K(trans) estimates would propagate to the resulting PS. Fourteen pediatric patients with brain tumors were scanned on a clinical 3-T MRI scanner. PCASL perfusion imaging was performed using a three-dimensional (3D) fast-spin-echo readout module to determine blood flow. DCE imaging was performed using a 3D spoiled gradient-echo sequence, and the K(trans) map was obtained with the extended Tofts model. The numerical analysis demonstrated that the uncertainty of PS was predominantly dependent on that of K(trans) and was relatively insensitive to the flow. The average PS values of the whole tumors ranged from 0.006 to 0.217 min(-1), with a mean of 0.050 min(-1) among the patients. The mean K(trans) value was 18% lower than the PS value, with a maximum discrepancy of 25%. When the parametric maps were compared on a voxel-by-voxel basis, the discrepancies between PS and K(trans) appeared to be heterogeneous within the tumors. The PS values could be more than two-fold higher than the K(trans) values for voxels with high K(trans) levels. This study proposes a method that is easy to implement in clinical practice and has the potential to improve the quantification of the microvascular properties of brain tumors.
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Affiliation(s)
- Ho-Ling Liu
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Imaging Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Ting-Ting Chang
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Feng-Xian Yan
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiology, Taipei Medical University/Shuang-Ho Hospital, New Taipei City, Taiwan
| | - Cheng-He Li
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Shi Lin
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Alex M Wong
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelong, Linkou Medical Center, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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28
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Multimodality MRI Findings in Patients with End-Stage Renal Disease. BIOMED RESEARCH INTERNATIONAL 2015; 2015:697402. [PMID: 26064943 PMCID: PMC4434172 DOI: 10.1155/2015/697402] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/15/2015] [Indexed: 01/17/2023]
Abstract
Patients with end-stage renal disease (ESRD) suffer from a number of complex neurological complications including vascular damage and cognitive dysfunction. It is of great significance to detect the neurological complications and improve the prognosis of ESRD patients. Many new noninvasive MRI techniques have been steadily used for the diagnosis of occult central nervous system complications in ESRD patients. This gives an opportunity to understand the pathophysiological mechanisms of these neurological disorders. This paper is a review that presents the MRI findings of occult brain damage in ESRD patients, outlines the applications of advanced MRI techniques, and introduces a brief perspective in this study field.
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29
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Guo X, Xu S, Wang G, Zhang Y, Guo L, Zhao B. Asymmetry of cerebral blood flow measured with three-dimensional pseudocontinuous arterial spin-labeling mr imaging in temporal lobe epilepsy with and without mesial temporal sclerosis. J Magn Reson Imaging 2015; 42:1386-97. [DOI: 10.1002/jmri.24920] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 04/01/2015] [Indexed: 11/09/2022] Open
Affiliation(s)
- Xiaoqin Guo
- Shandong Medical Imaging Research Institute; Shandong University; Jinan People's Republic of China
| | - Shangchen Xu
- Department of Neurosurgery; Shandong Provincial Hospital; Jinan People's Republic of China
| | - Guangbin Wang
- Shandong Medical Imaging Research Institute; Shandong University; Jinan People's Republic of China
| | - Yi Zhang
- Shandong Medical Imaging Research Institute; Shandong University; Jinan People's Republic of China
| | - Lingfei Guo
- Shandong Medical Imaging Research Institute; Shandong University; Jinan People's Republic of China
| | - Bin Zhao
- Shandong Medical Imaging Research Institute; Shandong University; Jinan People's Republic of China
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30
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Comparison of Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging and Arterial Spin Labeling MR Imaging in Gliomas. BIOMED RESEARCH INTERNATIONAL 2015; 2015:234245. [PMID: 25945328 PMCID: PMC4402183 DOI: 10.1155/2015/234245] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 03/14/2015] [Accepted: 03/21/2015] [Indexed: 11/18/2022]
Abstract
Gliomas grading is important for treatment plan; we aimed to investigate the application of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) in gliomas grading, by comparing with the three-dimensional pseudocontinuous arterial spin labeling (3D pCASL). 24 patients (13 high grade gliomas and 11 low grade gliomas) underwent IVIM DWI and 3D pCASL imaging before operation; maps of fast diffusion coefficient (D∗), slow diffusion coefficient (D), fractional perfusion-related volume (f), and apparent diffusion coefficient (ADC) as well as cerebral blood flow (CBF) were calculated and then coregistered to generate the corresponding parameter values. We found CBF and D∗ were higher in the high grade gliomas, whereas ADC, D, and f were lower (all P < 0.05). In differentiating the high from low grade gliomas, the maximum areas under the curves (AUC) of D∗, CBF, and ADC were 0.857, 0.85, and 0.902, respectively. CBF was negatively correlated with f in tumor (r = −0.619, P = 0.001). ADC was positively correlated with D in both tumor and white matter (r = 0.887, P = 0.000 and r = 0.824, P = 0.000, resp.). There was no correlation between CBF and D∗ in both tumor and white matter (P > 0.05). IVIM DWI showed more efficiency than 3D pCASL but less validity than conventional DWI in differentiating the high from low grade gliomas.
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31
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Prognostic value of blood flow estimated by arterial spin labeling and dynamic susceptibility contrast-enhanced MR imaging in high-grade gliomas. J Neurooncol 2014; 120:557-66. [DOI: 10.1007/s11060-014-1586-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 08/10/2014] [Indexed: 10/24/2022]
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32
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Fujima N, Kudo K, Tsukahara A, Yoshida D, Sakashita T, Homma A, Tha KK, Shirato H. Measurement of tumor blood flow in head and neck squamous cell carcinoma by pseudo-continuous arterial spin labeling: comparison with dynamic contrast-enhanced MRI. J Magn Reson Imaging 2014; 41:983-91. [PMID: 24723251 DOI: 10.1002/jmri.24637] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/26/2014] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To investigate the feasibility of tumor blood flow (TBF) measurement in head and neck squamous cell carcinoma (HNSCC) using pseudo-continuous arterial spin labeling (pCASL) in a comparison with dynamic contrast-enhanced (DCE) perfusion. MATERIALS AND METHODS We prospectively scanned 18 patients with HNSCC using 3T magnetic resonance imaging (MRI) with both pCASL and DCE perfusion. Quantitative TBF value in the whole-tumor region of interest (ROI), and regional TBF in the ROIs of the central and peripheral areas in the tumor were respectively measured. Relative TBF value in the whole-tumor ROI was also calculated. We determined the correlation and agreement between each measured TBF by pCASL and DCE perfusion using Pearson's correlation coefficients, intraclass correlation coefficients (ICC), and Bland-Altman analysis. RESULTS In the whole-tumor ROIs, significant correlation was observed between the absolute TBF values (r = 0.72, P < 0.01), with an ICC of 0.72; moreover, higher correlation was observed in the relative TBF (r = 0.79). The correlation was higher in the peripheral ROI (r = 0.70) than the central ROI (r = 0.65), with an ICC of 0.62 and 0.54, respectively. Bland-Altman plots revealed the underestimation of TBF by pCASL in central ROIs. CONCLUSION TBF measurement by pCASL was feasible in patients with HNSCC.
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Affiliation(s)
- Noriyuki Fujima
- Department of Radiology, Hokkaido University Hospital, Sapporo, Japan
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33
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Huang D, Wu B, Shi K, Ma L, Cai Y, Lou X. Reliability of three-dimensional pseudo-continuous arterial spin labeling MR imaging for measuring visual cortex perfusion on two 3T scanners. PLoS One 2013; 8:e79471. [PMID: 24278137 PMCID: PMC3835829 DOI: 10.1371/journal.pone.0079471] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/30/2013] [Indexed: 11/18/2022] Open
Abstract
Cerebral blood flow (CBF) in the human primary visual cortex is correlated with the loss of visual function in neuro-ophthalmological diseases. Advanced three-dimensional pseudo-continuous arterial spin labeling (3D pCASL), as a non-invasive method to access the CBF, can be a novel measurement to detect the visual cortex. The objective of the study was to assess the intra- and inter-scanner reliability of 3D pCASL of the visual cortex in healthy adults and suggest the selection of different post-labeling delay times (PLDs). For this reason, 3D pCASL was conducted in two 3.0T MR three times with twelve healthy volunteers at an interval of 10–15 days. The 1st and 3rd tests were performed on scanner-1, and the 2nd test was performed on scanner-2. The value of the CBF was abstracted from the visual cortex with two PLDs. The intra- and inter-scanner reliability and reproducibility were evaluated with the intraclass correlation coefficient (ICC) and Bland-Altman plots. By estimating the mean value of the CBF in the visual cortex, the intra-scanner results demonstrated the higher reliability (ICC for PLD = 1.5 second presented at 0.743 compared with 0.829 for PLD = 2.5 seconds), and the Bland-Altman plots showed the reproducibility at a longer PLD. We conclude that the calibrated 3D pCASL approach provides a highly reproducible measurement of the CBF of the visual cortex that can serve as a useful quantitative probe for research conducted at multiple centers and for the long-term observation of the clinical effects of neuro-opthalmological diseases.
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Affiliation(s)
- Diandian Huang
- Department of Radiology, PLA General Hospital, Beijing, China
| | - Bing Wu
- Department of Radiology, Beijing Military General Hospital, Beijing, China
| | - Kaining Shi
- MR Research (China), General Electric Company GE (China) Co., Ltd.-Healthcare, Beijing, China
| | - Lin Ma
- Department of Radiology, PLA General Hospital, Beijing, China
| | - Youquan Cai
- Department of Radiology, PLA General Hospital, Beijing, China
| | - Xin Lou
- Department of Radiology, PLA General Hospital, Beijing, China
- * E-mail:
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