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Ishida S, Isozaki M, Fujiwara Y, Takei N, Kanamoto M, Kimura H, Tsujikawa T. Effects of the Training Data Condition on Arterial Spin Labeling Parameter Estimation Using a Simulation-Based Supervised Deep Neural Network. J Comput Assist Tomogr 2024; 48:459-471. [PMID: 38149628 DOI: 10.1097/rct.0000000000001566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE A simulation-based supervised deep neural network (DNN) can accurately estimate cerebral blood flow (CBF) and arterial transit time (ATT) from multidelay arterial spin labeling signals. However, the performance of deep learning depends on the characteristics of the training data set. We aimed to investigate the effects of the ground truth (GT) ranges of CBF and ATT on the performance of the DNN when training data were prepared using arterial spin labeling signal simulation. METHODS Deep neural networks were individually trained using 36 patterns of the training data sets. Simulation test data (1,000,000 points), 17 healthy volunteers, and 1 patient with moyamoya disease were included. The simulation test data were used to evaluate accuracy, precision, and noise immunity of the DNN. The best-performing DNN was determined by the normalized mean absolute error (NMAE), normalized root mean squared error (NRMSE), and normalized coefficient of variation over repeated training (CV Net ). Cerebral blood flow and ATT values and their histograms were compared between the GT and predicted values. For the in vivo data, the dependency of the predicted values on the GT ranges was visually evaluated by comparing CBF and ATT maps between the best-performing DNN and the other DNNs. Moreover, using the synthesized noisy images, noise immunity was compared between the best-performing DNN based on the simulation study and a conventional method. RESULTS The simulation study showed that a network trained by the GT of CBF and ATT in the ranges of 0 to 120 mL/100 g/min and 0 to 4500 milliseconds, respectively, had the highest performance (NMAE CBF , 0.150; NRMSE CBF , 0.231; CV NET CBF , 0.028; NMAE ATT , 0.158; NRMSE ATT , 0.257; and CV NET ATT , 0.028). Although the predicted CBF and ATT varied with the GT range of the training data sets, the appropriate settings preserved the accuracy, precision, and noise immunity of the DNN. In addition, the same results were observed in in vivo studies. CONCLUSIONS The GT ranges to prepare the training data affected the performance of the simulation-based supervised DNNs. The predicted CBF and ATT values depended on the GT range; inappropriate settings degraded the accuracy, whereas appropriate settings of the GT range provided accurate and precise estimates.
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Affiliation(s)
- Shota Ishida
- From the Department of Radiological Technology, Faculty of medical sciences, Kyoto College of Medical Science, Kyoto
| | - Makoto Isozaki
- Department of Neurosurgery, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto
| | | | | | | | - Tetsuya Tsujikawa
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Woods JG, Achten E, Asllani I, Bolar DS, Dai W, Detre JA, Fan AP, Fernández-Seara MA, 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 MJP, Wang DJJ, Warnert EAH, 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. [PMID: 38594906 DOI: 10.1002/mrm.30091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 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, Brighton, UK
- Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, New York, 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, New York, USA
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Audrey P Fan
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
- Department of Neurology, University of California Davis, Davis, California, USA
| | - María A 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, Sheffield, UK
| | - Matthias Günther
- Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- Department of Physics and Electrical Engineering, University of Bremen, Bremen, Germany
| | - Jia Guo
- Department of Bioengineering, University of California Riverside, Riverside, California, USA
| | | | - Mai-Lan Ho
- Department of Radiology, University of Missouri, Columbia, Missouri, USA
| | - 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, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, 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, Texas, USA
| | - Henk-Jan Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, 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, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Manchester, 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, The Netherlands
| | - 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 J J Wang
- Laboratory of FMRI Technology (LOFT), Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Esther A H Warnert
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, California, 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, California, USA
- Maternal & Child Health Research Institute, Stanford University, Stanford, California, 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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Fan H, Bunker L, Wang Z, Durfee AZ, Lin DDM, Yedavalli V, Ge Y, Zhou XJ, Hillis AE, Lu H. Simultaneous perfusion, diffusion, T 2 *, and T 1 mapping with MR fingerprinting. Magn Reson Med 2024; 91:558-569. [PMID: 37749847 PMCID: PMC10872728 DOI: 10.1002/mrm.29880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/27/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Quantitative mapping of brain perfusion, diffusion, T2 *, and T1 has important applications in cerebrovascular diseases. At present, these sequences are performed separately. This study aims to develop a novel MRI technique to simultaneously estimate these parameters. METHODS This sequence to measure perfusion, diffusion, T2 *, and T1 mapping with magnetic resonance fingerprinting (MRF) was based on a previously reported MRF-arterial spin labeling (ASL) sequence, but the acquisition module was modified to include different TEs and presence/absence of bipolar diffusion-weighting gradients. We compared parameters derived from the proposed method to those derived from reference methods (i.e., separate sequences of MRF-ASL, conventional spin-echo DWI, and T2 * mapping). Test-retest repeatability and initial clinical application in two patients with stroke were evaluated. RESULTS The scan time of our proposed method was 24% shorter than the sum of the reference methods. Parametric maps obtained from the proposed method revealed excellent image quality. Their quantitative values were strongly correlated with those from reference methods and were generally in agreement with values reported in the literature. Repeatability assessment revealed that ADC, T2 *, T1 , and B1 + estimation was highly reliable, with voxelwise coefficient of variation (CoV) <5%. The CoV for arterial transit time and cerebral blood flow was 16% ± 3% and 25% ± 9%, respectively. The results from the two patients with stroke demonstrated that parametric maps derived from the proposed method can detect both ischemic and hemorrhagic stroke. CONCLUSION The proposed method is a promising technique for multi-parametric mapping and has potential use in patients with stroke.
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Affiliation(s)
- Hongli Fan
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lisa Bunker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Zihan Wang
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Alexandra Zezinka Durfee
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Doris Da May Lin
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vivek Yedavalli
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yulin Ge
- Department of Radiology, New York University Grossman School of Medicine, New York, NY, Unites States
| | - Xiaohong Joe Zhou
- Center for Magnetic Resonance Research and Department of Radiology, University of Illinois at Chicago, Chicago, IL, United States
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hanzhang Lu
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
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Cabrera JÁ, Urmeneta Ulloa J, Jímenez de la Peña M, Rubio Alonso M, López Gavilán M, Bayona Horta S, Pizarro G, Simon K, Migoya T, Martínez de Vega V. White-Matter Lesions and Cortical Cerebral Blood Flow Evaluation by 3D Arterial Spin-Labeled Perfusion MRI in Asymptomatic Divers: Correlation with Patent Foramen Ovale Ocurrence. J Clin Med 2023; 12:jcm12082866. [PMID: 37109204 PMCID: PMC10141148 DOI: 10.3390/jcm12082866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Cerebral white-matter lesions (cWML) can be caused by dilation of Virchow-Robin spaces or may correspond to true lacunar ischemic lesions. The aim of our study was to evaluate in asymptomatic divers the relationship between the presence of patent foramen ovale (PFO) and cWML, as well as their possible effects on cortical cerebral blood flow (CBF) by magnetic resonance (MRI) through the arterial spin labeling (ASL) sequence. Transthoracic echocardiography was performed for the identification of PFO, and cerebral magnetic resonance including the 3D-ASL sequence for CBF quantification. Thirty-eight divers, with a mean age 45.8 ± 8.6 years, were included. Nineteen healthy volunteers, mean age 41 ± 15.2 years, served as the control group. A total of 28.9% of divers had completed more than 1000 dives. It was found that 26.3% of divers presented with PFO in the echocardiographic study. cWML was evidenced in 10.5% of diver MRI studies. There was no statistically significant relationship between the presence of PFO and cWML (p = 0.95). We observed a lower blood flow in all brain areas assessed by the 3D-ASL sequence in the group of divers, compared with the control group. We did not find statistical differences in CBF as a function of the presence or absence of PFO, number of dives, or cWML evidence.
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Affiliation(s)
- José Ángel Cabrera
- Cardiology Department, Hospital Universitario Quirónsalud Madrid, 28223 Madrid, Spain
| | - Javier Urmeneta Ulloa
- Cardiology Department, Hospital Universitario Quirónsalud Madrid, 28223 Madrid, Spain
- Radiology Department, Hospital Universitario Quirónsalud Madrid, 28223 Madrid, Spain
| | | | - Margarita Rubio Alonso
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | | | - Silvia Bayona Horta
- Cardiology Department, Hospital Universitario Quirónsalud Madrid, 28223 Madrid, Spain
| | - Gonzalo Pizarro
- Cardiology Department, Hospital Ruber Juan Bravo, Grupo Quirónsalud, 28006 Madrid, Spain
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Woods JG, Schauman SS, Chiew M, Chappell MA, Okell TW. Time-encoded pseudo-continuous arterial spin labeling: Increasing SNR in ASL dynamic angiography. Magn Reson Med 2023; 89:1323-1341. [PMID: 36255158 PMCID: PMC10091734 DOI: 10.1002/mrm.29491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/28/2022] [Accepted: 09/23/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE Dynamic angiography using arterial spin labeling (ASL) can provide detailed hemodynamic information. However, the long time-resolved readouts require small flip angles to preserve ASL signal for later timepoints, limiting SNR. By using time-encoded ASL to generate temporal information, the readout can be shortened. Here, the SNR improvements from using larger flip angles, made possible by the shorter readout, are quantitatively investigated. METHODS The SNR of a conventional protocol with nine Look-Locker readouts and a 4 × $$ \times $$ 3 time-encoded protocol with three Look-Locker readouts (giving nine matched timepoints) were compared using simulations and in vivo data. Both protocols were compared using readouts with constant flip angles (CFAs) and variable flip angles (VFAs), where the VFA scheme was designed to produce a consistent ASL signal across readouts. Optimization of the background suppression to minimize physiological noise across readouts was also explored. RESULTS The time-encoded protocol increased in vivo SNR by 103% and 96% when using CFAs or VFAs, respectively. Use of VFAs improved SNR compared with CFAs by 25% and 21% for the conventional and time-encoded protocols, respectively. The VFA scheme also removed signal discontinuities in the time-encoded data. Preliminary data suggest that optimizing the background suppression could improve in vivo SNR by a further 16%. CONCLUSIONS Time encoding can be used to generate additional temporal information in ASL angiography. This enables the use of larger flip angles, which can double the SNR compared with a non-time-encoded protocol. The shortened time-encoded readout can also lead to improved background suppression, reducing physiological noise and further improving SNR.
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Affiliation(s)
- Joseph G Woods
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
| | - S Sophie Schauman
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom.,Department of Radiology, Stanford University, Stanford, California, USA
| | - Mark Chiew
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
| | - Michael A Chappell
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom.,Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Thomas W Okell
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
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Ishida S, Isozaki M, Fujiwara Y, Takei N, Kanamoto M, Kimura H, Tsujikawa T. Estimation of Cerebral Blood Flow and Arterial Transit Time From Multi-Delay Arterial Spin Labeling MRI Using a Simulation-Based Supervised Deep Neural Network. J Magn Reson Imaging 2022; 57:1477-1489. [PMID: 36169654 DOI: 10.1002/jmri.28433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND An inherently poor signal-to-noise ratio (SNR) causes inaccuracy and less precision in cerebral blood flow (CBF) and arterial transit time (ATT) when using arterial spin labeling (ASL). Deep neural network (DNN)-based parameter estimation can solve these problems. PURPOSE To reduce the effects of Rician noise on ASL parameter estimation and compute unbiased CBF and ATT using simulation-based supervised DNNs. STUDY TYPE Retrospective. POPULATION One million simulation test data points, 17 healthy volunteers (five women and 12 men, 33.2 ± 14.6 years of age), and one patient with moyamoya disease. FIELD STRENGTH/SEQUENCE 3.0 T/Hadamard-encoded pseudo-continuous ASL with a three-dimensional fast spin-echo stack of spirals. ASSESSMENT Performances of DNN and conventional methods were compared. For test data, the normalized mean absolute error (NMAE) and normalized root mean squared error (NRMSE) between the ground truth and predicted values were evaluated. For in vivo data, baseline CBF and ATT and their relative changes with respect to SNR using artificial noise-added images were assessed. STATISTICAL TESTS One-way analysis of variance with post-hoc Tukey's multiple comparison test, paired t-test, and the Bland-Altman graphical analysis. Statistical significance was defined as P < 0.05. RESULTS For both CBF and ATT, NMAE and NRMSE were lower with DNN than with the conventional method. The baseline values were significantly smaller with DNN than with the conventional method (CBF in gray matter, 66 ± 10 vs. 71 ± 12 mL/100 g/min; white matter, 45 ± 6 vs. 46 ± 7 mL/100 g/min; ATT in gray matter, 1424 ± 201 vs. 1471 ± 154 msec). CBF and ATT increased with decreasing SNR; however, their change rates were smaller with DNN than were those with the conventional method. Higher CBF in the prolonged ATT region and clearer contrast in ATT were identified by DNN in a clinical case. DATA CONCLUSION DNN outperformed the conventional method in terms of accuracy, precision, and noise immunity. EVIDENCE LEVEL 3 Technical Efficacy: Stage 1.
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Affiliation(s)
- Shota Ishida
- Department of Radiological Technology, Faculty of Medical Sciences, Kyoto College of Medical Science, Kyoto, Japan
| | - Makoto Isozaki
- Department of Neurosurgery, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Naoyuki Takei
- GE Healthcare, Tokyo, Japan.,Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Hirohiko Kimura
- Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Radiology Section, National Health Insurance Echizen-cho Ota Hospital, Fukui, Japan
| | - Tetsuya Tsujikawa
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Golay X, Ho ML. Multidelay ASL of the pediatric brain. Br J Radiol 2022; 95:20220034. [PMID: 35451851 PMCID: PMC10996417 DOI: 10.1259/bjr.20220034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/22/2022] [Indexed: 11/05/2022] Open
Abstract
Arterial spin labeling (ASL) is a powerful noncontrast MRI technique for evaluation of cerebral blood flow (CBF). A key parameter in single-delay ASL is the choice of postlabel delay (PLD), which refers to the timing between the labeling of arterial free water and measurement of flow into the brain. Multidelay ASL (MDASL) utilizes several PLDs to improve the accuracy of CBF calculations using arterial transit time (ATT) correction. This approach is particularly helpful in situations where ATT is unknown, including young subjects and slow-flow conditions. In this article, we discuss the technical considerations for MDASL, including labeling techniques, quantitative metrics, and technical artefacts. We then provide a practical summary of key clinical applications with real-life imaging examples in the pediatric brain, including stroke, vasculopathy, hypoxic-ischemic injury, epilepsy, migraine, tumor, infection, and metabolic disease.
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Affiliation(s)
- Xavier Golay
- MR Neurophysics and Translational Neuroscience, UCL Queen
Square Institute of Neurology London, London,
England, UK
| | - Mai-Lan Ho
- Radiology, Nationwide Children’s Hospital and The Ohio
State University, Columbus, OH,
USA
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8
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Ishida S, Kimura H, Takei N, Fujiwara Y, Matsuda T, Kanamoto M, Matta Y, Kosaka N, Kidoya E. Separating spin compartments in arterial spin labeling using delays alternating with nutation for tailored excitation (DANTE) pulse: A validation study using T 2 -relaxometry and application to arterial cerebral blood volume imaging. Magn Reson Med 2021; 87:1329-1345. [PMID: 34687085 DOI: 10.1002/mrm.29052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/31/2021] [Accepted: 09/30/2021] [Indexed: 11/07/2022]
Abstract
PURPOSE To clarify the type of spin compartment in arterial spin labeling (ASL) that is eliminated by delays alternating with nutation for tailored excitation (DANTE) pulse using T2 -relaxometry, and to demonstrate the feasibility of arterial cerebral blood volume (CBVa ) imaging using DANTE-ASL in combination with a simplified two-compartment model. METHOD The DANTE and T2 -preparation modules were combined into a single ASL sequence. T2 values under the application of DANTE were determined to evaluate changes in T2 , along with the post-labeling delay (PLD) and the relationship between transit time without DANTE (TTnoVS ) and T2 . The reference tissue T2 (T2_ref ) was also obtained. Subsequently, the DANTE module was embedded into the Hadamard-encoded ASL. Cerebral blood flow (CBF) and CBVa were computed using two Hadamard-encoding datasets (with and without DANTE) in a rest and breath-holding (BH) task. RESULTS While T2 without DANTE (T2_noVS ) decreased as the PLD increased, T2 with DANTE (T2_DANTE ) was equivalent to T2_ref and did not change with the PLD. Although there was a significant positive correlation between TTnoVS and T2_noVS with short PLD, T2_DANTE was not correlated with TTnoVS nor PLD. Baseline CBVa values obtained at rest were 0.64 ± 0.12, 0.64 ± 0.11, and 0.58 ± 0.15 mL/100 g for anterior, middle, and posterior cerebral arteries, respectively. Significant CBF and CBVa elevations were observed in the BH task. CONCLUSION Microvascular compartment signals were eliminated from the total ASL signals by DANTE. CBVa can be measured using Hadamard-encoded DANTE-ASL in combination with a simplified two-compartment model.
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Affiliation(s)
- Shota Ishida
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Naoyuki Takei
- Global MR Applications and Workflow, GE Healthcare Japan, Hino, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tsuyoshi Matsuda
- Division of Ultra-high Field MRI, Institute for Biomedical Science, Iwate Medical University, Iwate, Japan
| | - Masayuki Kanamoto
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Yuki Matta
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Eiji Kidoya
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
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9
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Ssali T, Anazodo UC, Narciso L, Liu L, Jesso S, Richardson L, Günther M, Konstandin S, Eickel K, Prato F, Finger E, St Lawrence K. Sensitivity of arterial Spin labeling for characterization of longitudinal perfusion changes in Frontotemporal dementia and related disorders. NEUROIMAGE-CLINICAL 2021; 35:102853. [PMID: 34697009 PMCID: PMC9421452 DOI: 10.1016/j.nicl.2021.102853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
This study demonstrates the value of ASL for longitudinal monitoring of perfusion in FTD patients. Good agreement was found in repeat measures of CBF in patients and controls. Transit times were not a significant source of error for the selected post labeling delay (2 s).
Background Advances in the understanding of the pathophysiology of frontotemporal dementia (FTD) and related disorders, along with the development of novel candidate disease modifying treatments, have stimulated the need for tools to assess the efficacy of new therapies. While perfusion imaging by arterial spin labeling (ASL) is an attractive approach for longitudinal imaging biomarkers of neurodegeneration, sources of variability between sessions including arterial transit times (ATT) and fluctuations in resting perfusion can reduce its sensitivity. Establishing the magnitude of perfusion changes that can be reliably detected is necessary to delineate longitudinal perfusion changes related to disease processes from the effects of these sources of error. Purpose To assess the feasibility of ASL for longitudinal monitoring of patients with FTD by quantifying between-session variability of perfusion on a voxel-by-voxel basis. Methods and materials ASL data were collected in 13 healthy controls and 8 patients with FTD or progressive supra-nuclear palsy. Variability in cerebral blood flow (CBF) by single delay pseudo-continuous ASL (SD-pCASL) acquired one month apart were quantified by the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Additionally, CBF by SD-pCASL and ATT by low-resolution multiple inversion time ASL (LowRes-pCASL) were compared to Hadamard encoded sequences which are able to simultaneously measure CBF and ATT with improved time-efficiency. Results Agreement of grey-matter perfusion between sessions was found for both patients and controls (CV = 10.8% and 8.3% respectively) with good reliability for both groups (ICC > 0.6). Intensity normalization to remove day-to-day fluctuations in resting perfusion reduced the CV by 28%. Less than 5% of voxels had ATTs above the chosen post labelling delay (2 s), indicating that the ATT was not a significant source of error. Hadamard-encoded perfusion imaging yielded systematically higher CBF compared to SD-pCASL, but produced similar transit-time measurements. Power analysis revealed that SD-pCASL has the sensitivity to detect longitudinal changes as low as 10% with as few as 10 patient participants. Conclusion With the appropriate labeling parameters, SD-pCASL is a promising approach for assessing longitudinal changes in CBF associated with FTD.
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Affiliation(s)
- Tracy Ssali
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada.
| | - Udunna C Anazodo
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Lucas Narciso
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Linshan Liu
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Sarah Jesso
- Lawson Health Research Institute, London, Canada; St. Joseph's Health Care, London, Canada
| | - Lauryn Richardson
- Lawson Health Research Institute, London, Canada; St. Joseph's Health Care, London, Canada
| | - Matthias Günther
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany; University Bremen, Bremen, Germany
| | - Simon Konstandin
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany; Mediri GmbH, Heidelberg, Germany
| | | | - Frank Prato
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Elizabeth Finger
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada; Department of Clinical Neurological Sciences, Western University, London, Canada
| | - Keith St Lawrence
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
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10
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Neumann K, Schidlowski M, Günther M, Stöcker T, Düzel E. Reliability and Reproducibility of Hadamard Encoded Pseudo-Continuous Arterial Spin Labeling in Healthy Elderly. Front Neurosci 2021; 15:711898. [PMID: 34489631 PMCID: PMC8417446 DOI: 10.3389/fnins.2021.711898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
The perfusion parameters cerebral blood flow (CBF) and arterial transit time (ATT) measured with arterial spin labeling (ASL) magnetic resonance imaging (MRI) provide valuable essentials to assess the integrity of cerebral tissue. Brain perfusion changes, due to aging, an intervention, or neurodegenerative diseases for example, could be investigated in longitudinal ASL studies with reliable ASL sequences. Generally, pseudo-continuous ASL (pCASL) is preferred because of its larger signal-to-noise ratio (SNR) compared to pulsed ASL (PASL) techniques. Available pCASL versions differ regarding their feature details. To date only little is known about the reliability and reproducibility of CBF and ATT measures obtained with the innovative Hadamard encoded pCASL variant, especially if applied on participants in old age. Therefore, we investigated an in-house developed Hadamard encoded pCASL sequence on a group of healthy elderly at two different 3 Tesla Siemens MRI systems (Skyra and mMR Biograph) and evaluated CBF and ATT reliability and reproducibility for several regions-of-interests (ROI). Calculated within-subject coefficients of variation (wsCV) demonstrated an excellent reliability of perfusion measures, whereas ATT appeared to be even more reliable than CBF [e.g., wsCV(CBF) = 2.9% vs. wsCV(ATT) = 2.3% for a gray matter (GM) ROI on Skyra system]. Additionally, a substantial agreement of perfusion values acquired on both MRI systems with an inter-session interval of 78 ± 17.6 days was shown by high corresponding intra-class correlation (ICC) coefficients [e.g., ICC(CBF) = 0.704 and ICC(ATT) = 0.754 for a GM ROI]. The usability of this novel Hadamard encoded pCASL sequence might improve future follow-up perfusion studies of the aging and/or diseased brain.
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Affiliation(s)
- Katja Neumann
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Martin Schidlowski
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Epileptology, University of Bonn Medical Center, Bonn, Germany
| | - Matthias Günther
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany.,MR-Imaging and Spectroscopy, University of Bremen, Bremen, Germany
| | - Tony Stöcker
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department for Physics and Astronomy, University of Bonn, Bonn, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute of Cognitive Neurology and Dementia Research, Otto von Guericke University Magdeburg, Magdeburg, Germany.,Institute of Cognitive Neuroscience, University College London, London, United Kingdom.,Center for Behavioral Brain Science, Magdeburg, Germany
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11
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Kosaka N, Kimura H. Editorial for "Arterial Transit Time-Based Multidelay Combination Strategy Improves Arterial Spin Labeling MRI Cerebral Blood Flow Measurement Accuracy in Severe Steno-Occlusive Diseases". J Magn Reson Imaging 2021; 55:188-189. [PMID: 34431586 DOI: 10.1002/jmri.27901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 11/07/2022] Open
Affiliation(s)
- Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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12
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Meyer BP, Hirschler L, Lee S, Kurpad SN, Warnking JM, Barbier EL, Budde MD. Optimized cervical spinal cord perfusion MRI after traumatic injury in the rat. J Cereb Blood Flow Metab 2021; 41:2010-2025. [PMID: 33509036 PMCID: PMC8327111 DOI: 10.1177/0271678x20982396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 10/11/2020] [Accepted: 11/22/2020] [Indexed: 11/17/2022]
Abstract
Despite the potential to guide clinical management of spinal cord injury and disease, noninvasive methods of monitoring perfusion status of the spinal cord clinically remain an unmet need. In this study, we optimized pseudo-continuous arterial spin labeling (pCASL) for the rodent cervical spinal cord and demonstrate its utility in identifying perfusion deficits in an acute contusion injury model. High-resolution perfusion sagittal images with reduced imaging artifacts were obtained with optimized background suppression and imaging readout. Following moderate contusion injury, perfusion was clearly and reliably decreased at the site of injury. Implementation of time-encoded pCASL confirmed injury site perfusion deficits with blood flow measurements corrected for variability in arterial transit times. The noninvasive protocol of pCASL in the spinal cord can be utilized in future applications to examine perfusion changes after therapeutic interventions in the rat and translation to patients may offer critical implications for patient management.
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Affiliation(s)
- Briana P Meyer
- Department of Neurosurgery, Medical College of Wisconsin,
Milwaukee, WI, USA
- Biophysics Graduate Program, Medical College of Wisconsin,
Milwaukee, WI, USA
- Neuroscience Doctoral Program, Medical College of Wisconsin,
Milwaukee, WI, USA
| | - Lydiane Hirschler
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut des
Neurosciences, Grenoble, France
- Department of Radiology, C.J. Gorter Center for High Field MRI,
Leiden University Medical Center, Leiden, the Netherlands
| | - Seongtaek Lee
- Department of Neurosurgery, Medical College of Wisconsin,
Milwaukee, WI, USA
- Biomedical Engineering Graduate Program, Marquette University
& Medical College of Wisconsin, Milwaukee, WI, USA
| | - Shekar N Kurpad
- Department of Neurosurgery, Medical College of Wisconsin,
Milwaukee, WI, USA
| | - Jan M Warnking
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut des
Neurosciences, Grenoble, France
| | - Emmanuel L Barbier
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut des
Neurosciences, Grenoble, France
| | - Matthew D Budde
- Department of Neurosurgery, Medical College of Wisconsin,
Milwaukee, WI, USA
- Clement J Zablocki Veteran's Affairs Medical Center, Milwaukee,
WI, USA
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13
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Amemiya S, Watanabe Y, Takei N, Ueyama T, Miyawaki S, Koizumi S, Kato S, Takao H, Abe O, Saito N. Arterial Transit Time-Based Multidelay Combination Strategy Improves Arterial Spin Labeling Cerebral Blood Flow Measurement Accuracy in Severe Steno-Occlusive Diseases. J Magn Reson Imaging 2021; 55:178-187. [PMID: 34263988 DOI: 10.1002/jmri.27823] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although perfusion imaging plays a key role in the management of steno-occlusive diseases, the clinical usefulness of arterial spin labeling (ASL) is limited by technical issues. PURPOSE To examine the effect of arterial transit time (ATT) prolongation on cerebral blood flow (CBF) measurement accuracy and identify the best CBF measurement protocol for steno-occlusive diseases. STUDY TYPE Prospective. POPULATION Moyamoya (n = 10) and atherosclerotic diseases (n = 8). FIELD STRENGTH/SEQUENCE A 3.0T/3DT1 -weighted and ASL. ASSESSMENT Hadamard-encoded multidelay ASL scans with/without vessel suppression (VS) and single-delay ASL scans with long-label duration (LD) and long postlabeling delay (PLD), referred to as long-label long-delay (LLLD), were acquired. CBF measurement accuracy and its ATT dependency, measured as the correlation between the relative CBF measurement difference (ASL-single-photon emission computed tomography [SPECT]) and ATT, were compared among 1) Combo (incorporating multidelay and LLLD data based on ATT), 2) standard (LD/PLD = 1333/2333 msec), and 3) LLLD (LD/PLD = 4000/4000 msec) protocols, using whole-brain voxel-wise correlation with reference standard SPECT CBF. The effect of VS on CBF measurement accuracy was also assessed. STATISTICAL TESTS Pearson's correlation coefficient, repeated-measures analysis of variance, t-test. P< 0.05 was considered significant. RESULTS Pearson's correlation coefficients between ASL and SPECT CBF measurements were as follows: Combo = 0.55 ± 0.09; standard = 0.52 ± 0.12; LLLD = 0.41 ± 0.10. CBF measurement was least accurate in LLLD and most accurate in Combo. VS significantly improved overall CBF measurement accuracy in the standard protocol and in moyamoya patients for the Combo. ATT dependency analysis revealed that, compared with Combo, the standard and LLLD protocols showed significantly lower and negative and significantly higher and positive correlations, respectively (standard = -0.12 ± 0.04, Combo = -0.04 ± 0.03, LLLD = 0.17 ± 0.03). DATA CONCLUSION By using ATT-corrected CBF derived from LD/PLD = 1333/2333 msec as a base and by compensating underestimation in delayed regions using multidelay scans, the ATT-based Combo strategy improves CBF measurement accuracy compared with single-delay protocols in severe steno-occlusive diseases. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Shiori Amemiya
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yusuke Watanabe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Naoyuki Takei
- MR Applications and Workflow, GE Healthcare, Tokyo, Japan
| | - Tsuyoshi Ueyama
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Satoru Miyawaki
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Satoshi Koizumi
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Seiji Kato
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Hidemasa Takao
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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14
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Setta K, Matsuda T, Sasaki M, Chiba T, Fujiwara S, Kobayashi M, Yoshida K, Kubo Y, Suzuki M, Yoshioka K, Ogasawara K. Diagnostic Accuracy of Screening Arterial Spin-Labeling MRI Using Hadamard Encoding for the Detection of Reduced CBF in Adult Patients with Ischemic Moyamoya Disease. AJNR Am J Neuroradiol 2021; 42:1403-1409. [PMID: 34016589 DOI: 10.3174/ajnr.a7167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/11/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Adult patients with ischemic Moyamoya disease are advised to undergo selective revascularization surgery based on cerebral hemodynamics. The purpose of this study was to determine the diagnostic accuracy of arterial spin-labeling MR imaging using Hadamard-encoded multiple postlabeling delays for the detection of reduced CBF in such patients. MATERIALS AND METHODS Thirty-seven patients underwent brain perfusion SPECT and pseudocontinuous arterial spin-labeling MR imaging using standard postlabeling delay (1525 ms) and Hadamard-encoded multiple postlabeling delays. For Hadamard-encoded multiple postlabeling delays, based on data obtained from the 7 sub-boluses with combinations of different labeling durations and postlabeling delays, CBF corrected by the arterial transit time was calculated on a voxel-by-voxel basis. Using a 3D stereotaxic template, we automatically placed ROIs in the ipsilateral cerebellar hemisphere and 5 MCA territories in the symptomatic cerebral hemisphere; then, the ratio of the MCA to cerebellar ROI was calculated. RESULTS The area under the receiver operating characteristic curve for detecting reduced SPECT-CBF ratios (<0.686) was significantly greater for the Hadamard-encoded multiple postlabeling delays-CBF ratios (0.885) than for the standard postlabeling delay-CBF ratios (0.786) (P = .001). The sensitivity and negative predictive value for the Hadamard-encoded multiple postlabeling delays-CBF ratios were 100% (95% confidence interval, 100%-100%) and significantly higher than the sensitivity (95% CI, 44%-80%) and negative predictive value (95% CI, 88%-97%) for the standard postlabeling delay-CBF ratio, respectively. CONCLUSIONS ASL MR imaging using Hadamard-encoded multiple postlabeling delays may be applicable as a screening tool because it can detect reduced CBF on brain perfusion SPECT with 100% sensitivity and a 100% negative predictive value in adult patients with ischemic Moyamoya disease.
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Affiliation(s)
- K Setta
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - T Matsuda
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (T.M., M. Sasaki), Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - M Sasaki
- Department of Radiology (M. Suzuki, K. Yoshioka) Institute for Biomedical Sciences (TM, MS), Iwate Medical University School of Medicine, Yahaba-cho, Japan.,Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (T.M., M. Sasaki), Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - T Chiba
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - S Fujiwara
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - M Kobayashi
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - K Yoshida
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan.,Department of Radiology (M. Suzuki, K. Yoshioka) Institute for Biomedical Sciences (TM, MS), Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - Y Kubo
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | | | - K Yoshioka
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan.,Department of Radiology (M. Suzuki, K. Yoshioka) Institute for Biomedical Sciences (TM, MS), Iwate Medical University School of Medicine, Yahaba-cho, Japan
| | - K Ogasawara
- From the Department of Neurosurgery (K.S., T.C., S.F., M.K., K. Yoshida, Y. Kubo, K.O.), Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba-cho, Japan
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15
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Zhao MY, Fan AP, Chen DYT, Sokolska MJ, Guo J, Ishii Y, Shin DD, Khalighi MM, Holley D, Halbert K, Otte A, Williams B, Rostami T, Park JH, Shen B, Zaharchuk G. Cerebrovascular reactivity measurements using simultaneous 15O-water PET and ASL MRI: Impacts of arterial transit time, labeling efficiency, and hematocrit. Neuroimage 2021; 233:117955. [PMID: 33716155 PMCID: PMC8272558 DOI: 10.1016/j.neuroimage.2021.117955] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 12/19/2022] Open
Abstract
Cerebrovascular reactivity (CVR) reflects the capacity of the brain to meet changing physiological demands and can predict the risk of cerebrovascular diseases. CVR can be obtained by measuring the change in cerebral blood flow (CBF) during a brain stress test where CBF is altered by a vasodilator such as acetazolamide. Although the gold standard to quantify CBF is PET imaging, the procedure is invasive and inaccessible to most patients. Arterial spin labeling (ASL) is a non-invasive and quantitative MRI method to measure CBF, and a consensus guideline has been published for the clinical application of ASL. Despite single post labeling delay (PLD) pseudo-continuous ASL (PCASL) being the recommended ASL technique for CBF quantification, it is sensitive to variations to the arterial transit time (ATT) and labeling efficiency induced by the vasodilator in CVR studies. Multi-PLD ASL controls for the changes in ATT, and velocity selective ASL is in theory insensitive to both ATT and labeling efficiency. Here we investigate CVR using simultaneous 15O-water PET and ASL MRI data from 19 healthy subjects. CVR and CBF measured by the ASL techniques were compared using PET as the reference technique. The impacts of blood T1 and labeling efficiency on ASL were assessed using individual measurements of hematocrit and flow velocity data of the carotid and vertebral arteries measured using phase-contrast MRI. We found that multi-PLD PCASL is the ASL technique most consistent with PET for CVR quantification (group mean CVR of the whole brain = 42 ± 19% and 40 ± 18% respectively). Single-PLD ASL underestimated the CVR of the whole brain significantly by 15 ± 10% compared with PET (p<0.01, paired t-test). Changes in ATT pre- and post-acetazolamide was the principal factor affecting ASL-based CVR quantification. Variations in labeling efficiency and blood T1 had negligible effects.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, Stanford, CA, United States.
| | - Audrey P Fan
- Department of Biomedical Engineering, University of California Davis, Davis, CA, USA; Department of Neurology, University of California Davis, Davis, CA, USA
| | - David Yen-Ting Chen
- Department of Medical Imaging, Taipei Medical University - Shuan-Ho Hospital, New Taipei City, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Magdalena J Sokolska
- Medical Physics and Biomedical Engineering, University College London Hospitals, London, United Kingdom
| | - Jia Guo
- Department of Bioengineering, University of California Riverside, Riverside, CA, United States
| | - Yosuke Ishii
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | - Dawn Holley
- Department of Radiology, Stanford University, Stanford, CA, United States
| | - Kim Halbert
- Department of Radiology, Stanford University, Stanford, CA, United States
| | - Andrea Otte
- Department of Radiology, Stanford University, Stanford, CA, United States
| | - Brittney Williams
- Department of Radiology, Stanford University, Stanford, CA, United States
| | - Taghi Rostami
- Department of Bioengineering, Stanford University, Stanford, CA, United States
| | - Jun-Hyung Park
- Department of Radiology, Stanford University, Stanford, CA, United States
| | - Bin Shen
- Department of Radiology, Stanford University, Stanford, CA, United States
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA, United States.
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16
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Itagaki H, Kokubo Y, Kawanami K, Sato S, Yamada Y, Sato S, Sonoda Y. Arterial spin labeling magnetic resonance imaging at short post-labeling delay reflects cerebral perfusion pressure verified by oxygen-15-positron emission tomography in cerebrovascular steno-occlusive disease. Acta Radiol 2021; 62:225-233. [PMID: 32295388 DOI: 10.1177/0284185120917111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Arterial transit time correction by data acquisition with multiple post-labeling delays (PLDs) or relatively long PLDs is expected to obtain more accurate imaging in cases of the cerebrovascular steno-occlusive disease. However, there have so far been no reports describing the significance of arterial spin labeling (ASL) images at short PLDs regarding the evaluation of cerebral circulation in ischemic cerebrovascular disease. PURPOSE To clarify the role of short-PLD ASL in cerebrovascular steno-occlusive disease. MATERIAL AND METHODS Fifty-three patients with cerebrovascular steno-occlusive disease were included in this study. All patients underwent ASL magnetic resonance imaging and 15O-PET within two days of each modality. To compare the ASL findings with each parameter of PET, the right-to-left (R/L) ratio, defined as the right middle cerebral artery (MCA) value/left MCA value, was calculated. RESULTS There is a significant correlation between the ASL images at a short PLD and the ratio of cerebral blood flow and cerebral blood volume by 15O-PET, which may accurately reflect the cerebral perfusion pressure. A receiver operating characteristic curve analysis indicated that ASL images at PLD 1000 and 1500 ms were more accurate than at PLD 2000-3000 ms for the detection of a ≥10% change in the PET cerebral blood flow. CONCLUSION ASL images at shorter PLDs may be useful at least as a screening modality to detect the changes in the cerebral circulation in cerebrovascular steno-occlusive disease. We must evaluate ASL images at multiple PLDs while considering the arterial transit time of each case at present.
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Affiliation(s)
- Hiroshi Itagaki
- Department of Neurosurgery, Faculty of Medicine Yamagata University, Yamagata, Japan
| | - Yasuaki Kokubo
- Department of Neurosurgery, Faculty of Medicine Yamagata University, Yamagata, Japan
| | - Kanako Kawanami
- Department of Neurosurgery, Faculty of Medicine Yamagata University, Yamagata, Japan
| | - Shinji Sato
- Department of Neurosurgery, Faculty of Medicine Yamagata University, Yamagata, Japan
| | - Yuki Yamada
- Department of Neurosurgery, Faculty of Medicine Yamagata University, Yamagata, Japan
| | - Shinya Sato
- Department of Neurosurgery, Faculty of Medicine Yamagata University, Yamagata, Japan
| | - Yukihiko Sonoda
- Department of Neurosurgery, Faculty of Medicine Yamagata University, Yamagata, Japan
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17
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Woods JG, Chappell MA, Okell TW. Designing and comparing optimized pseudo-continuous Arterial Spin Labeling protocols for measurement of cerebral blood flow. Neuroimage 2020; 223:117246. [PMID: 32853814 PMCID: PMC7762814 DOI: 10.1016/j.neuroimage.2020.117246] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/03/2020] [Accepted: 08/05/2020] [Indexed: 01/24/2023] Open
Abstract
Arterial Spin Labeling (ASL) is a non-invasive, non-contrast, perfusion imaging technique which is inherently SNR limited. It is, therefore, important to carefully design scan protocols to ensure accurate measurements. Many pseudo-continuous ASL (PCASL) protocol designs have been proposed for measuring cerebral blood flow (CBF), but it has not yet been demonstrated which design offers the most accurate and repeatable CBF measurements. In this study, a wide range of literature PCASL protocols were first optimized for CBF accuracy and then compared using Monte Carlo simulations and in vivo experiments. The protocols included single-delay, sequential and time-encoded multi-timepoint protocols, and several novel protocol designs, which are hybrids of time-encoded and sequential multi-timepoint protocols. It was found that several multi-timepoint protocols produced more confident, accurate, and repeatable CBF estimates than the single-delay protocol, while also generating maps of arterial transit time. Of the literature protocols, the time-encoded protocol with T1-adjusted label durations gave the most confident and accurate CBF estimates in vivo (16% and 40% better than single-delay), while the sequential multi-timepoint protocol was the most repeatable (20% more repeatable than single-delay). One of the novel hybrid protocols, HybridT1-adj, was found to produce the most confident, accurate and repeatable CBF estimates out of all the protocols tested in both simulations and in vivo (24%, 47%, and 28% more confident, accurate, and repeatable than single-delay in vivo). The HybridT1-adj protocol makes use of the best aspects of both time-encoded and sequential multi-timepoint protocols and should be a useful tool for accurately and efficiently measuring CBF.
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Affiliation(s)
- Joseph G Woods
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
| | - Michael A Chappell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Institute of Biomedical Engineering, Department of Engineering, University of Oxford, Oxford, United Kingdom
| | - Thomas W Okell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Ishida S, Kimura H, Isozaki M, Takei N, Fujiwara Y, Kanamoto M, Kosaka N, Matsuda T, Kidoya E. Robust arterial transit time and cerebral blood flow estimation using combined acquisition of Hadamard-encoded multi-delay and long-labeled long-delay pseudo-continuous arterial spin labeling: a simulation and in vivo study. NMR IN BIOMEDICINE 2020; 33:e4319. [PMID: 32424992 DOI: 10.1002/nbm.4319] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 04/03/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
Arterial transit time (ATT) prolongation causes an error of cerebral blood flow (CBF) measurement during arterial spin labeling (ASL). To improve the accuracy of ATT and CBF in patients with prolonged ATT, we propose a robust ATT and CBF estimation method for clinical practice. The proposed method consists of a three-delay Hadamard-encoded pseudo-continuous ASL (H-pCASL) with an additional-encoding and single-delay with long-labeled long-delay (1dLLLD) acquisition. The additional-encoding allows for the reconstruction of a single-delay image with long-labeled short-delay (1dLLSD) in addition to the normal Hadamard sub-bolus images. Five different images (normal Hadamard 3 delay, 1dLLSD, 1dLLLD) were reconstructed to calculate ATT and CBF. A Monte Carlo simulation and an in vivo study were performed to access the accuracy of the proposed method in comparison to normal 7-delay (7d) H-pCASL with equally divided sub-bolus labeling duration (LD). The simulation showed that the accuracy of CBF is strongly affected by ATT. It was also demonstrated that underestimation of ATT and CBF by 7d H-pCASL was higher with longer ATT than with the proposed method. Consistent with the simulation, the 7d H-pCASL significantly underestimated the ATT compared to that of the proposed method. This underestimation was evident in the distal anterior cerebral artery (ACA; P = 0.0394) and the distal posterior cerebral artery (PCA; 2 P = 0.0255). Similar to the ATT, the CBF was underestimated with 7d H-pCASL in the distal ACA (P = 0.0099), distal middle cerebral artery (P = 0.0109), and distal PCA (P = 0.0319) compared to the proposed method. Improving the SNR of each delay image (even though the number of delays is small) is crucial for ATT estimation. This is opposed to acquiring many delays with short LD. The proposed method confers accurate ATT and CBF estimation within a practical acquisition time in a clinical setting.
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Affiliation(s)
- Shota Ishida
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Makoto Isozaki
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Naoyuki Takei
- Global MR Applications and Workflow, GE Healthcare Japan, Hino, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Masayuki Kanamoto
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Tsuyoshi Matsuda
- Division of Ultra-high Field MRI, Institute for Biomedical Science, Iwate Medical University, Yahaba-cho, Shiwa-gun, Iwate, Japan
| | - Eiji Kidoya
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
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19
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Cohen AD, Agarwal M, Jagra AS, Nencka AS, Meier TB, Lebel RM, McCrea MA, Wang Y. Longitudinal Reproducibility of MR Perfusion Using 3D Pseudocontinuous Arterial Spin Labeling With Hadamard-Encoded Multiple Postlabeling Delays. J Magn Reson Imaging 2020; 51:1846-1853. [PMID: 31785062 PMCID: PMC10063372 DOI: 10.1002/jmri.27007] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Arterial spin labeling (ASL) can be confounded by varying arterial transit times (ATT) across the brain and with disease. Hadamard encoding schemes can be applied to 3D pseudocontinuous ASL (pCASL) to acquire ASL data with multiple postlabeling delays (PLDs) to estimate ATT and then correct cerebral blood flow (CBF). PURPOSE To assess the longitudinal reproducibility of 3D pCASL with Hadamard-encoded multiple PLDs. STUDY TYPE Prospective, longitudinal. POPULATION Fifty-two healthy, right-handed male subjects who underwent imaging at four timepoints over 45 days. FIELD STRENGTH/SEQUENCE A Hadamard-encoded 3D pCASL sequence was acquired at 3.0T with seven PLDs from 1.0-3.7 sec. ASSESSMENT ATT and corrected CBF (cCBF) were computed. Conventional uncorrected CBF (unCBF) was also estimated. Within- and between-subject coefficient of variation (wCV and bCV, respectively) and intraclass correlation coefficient (ICC) were evaluated across four time intervals: 7, 14, 30, and 45 days, in gray matter and 17 independent regions of interest (ROIs). A power analysis was also conducted. STATISTICAL TESTS A repeated-measures analysis of variance (ANOVA) was used to compare ATT, cCBF, and unCBF across the four scan sessions. A paired two-sample t-test was used to compare cCBF and unCBF. Pearson's correlation was used to examine the relationship between the cCBF and unCBF difference and ATT. Power calculations were completed using both the cCBF and unCBF variances. RESULTS ATT showed the lowest wCV and bCV (3.3-4.4% and 6.0-6.3%, respectively) compared to both cCBF (10.5-11.7% and 20.6-22.2%, respectively) and unCBF (12.0-13.6% and 22.7-23.7%, respectively). wCV and bCV were lower for cCBF vs. unCBF. A significant difference between cCBF and unCBF was found in most regions (P = 5.5 × 10-5 -3.8 × 10-4 in gray matter) that was highly correlated with ATT (R2 = 0.79-0.86). A power analysis yielded acceptable power at feasible sample sizes using cCBF. DATA CONCLUSION ATT and ATT-corrected CBF were longitudinally stable, indicating that ATT and CBF changes can be reliably evaluated with Hadamard-encoded 3D pCASL with multiple PLDs. LEVEL OF EVIDENCE 1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1846-1853.
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Affiliation(s)
- Alexander D Cohen
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mohit Agarwal
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amritpal S Jagra
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew S Nencka
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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20
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Su P, Fan H, Liu P, Li Y, Qiao Y, Hua J, Lin D, Jiang D, Pillai JJ, Hillis AE, Lu H. MR fingerprinting ASL: Sequence characterization and comparison with dynamic susceptibility contrast (DSC) MRI. NMR IN BIOMEDICINE 2020; 33:e4202. [PMID: 31682305 PMCID: PMC7229700 DOI: 10.1002/nbm.4202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/12/2019] [Accepted: 09/26/2019] [Indexed: 06/03/2023]
Abstract
MR Fingerprinting (MRF)-based Arterial-Spin-Labeling (ASL) has the potential to measure multiple parameters such as cerebral blood flow (CBF), bolus arrival time (BAT), and tissue T1 in a single scan. However, the previous reports have only demonstrated a proof-of-principle of the technique but have not examined the performance of the sequence in the context of key imaging parameters. Furthermore, there has not been a study to directly compare the technique to clinically used perfusion method of dynamic-susceptibility-contrast (DSC) MRI. The present report consists of two studies. In the first study (N = 8), we examined the dependence of MRF-ASL sequence on TR time pattern. Ten different TR patterns with a range of temporal characteristics were examined by both simulations and experiments. The results revealed that there was a significance dependence of the sequence performance on TR pattern (p < 0.001), although there was not a single pattern that provided dramatically improvements. Among the TR patterns tested, a sinusoidal pattern with a period of 125 TRs provided an overall best estimation in terms of spatial consistency. These experimental observations were consistent with those of numerical simulations. In the second study (N = 8), we compared MRF-ASL results with those of DSC MRI. It was found that MRF-ASL and DSC MRI provided highly comparable maps of cerebral blood flow (CBF) and bolus-arrival-time (BAT), with spatial correlation coefficients of 0.79 and 0.91, respectively. However, in terms of quantitative values, BAT obtained with MRF-ASL was considerably lower than that from DSC (p < 0.001), presumably because of the differences in tracer characteristics in terms of diffusible versus intravascular tracers. Test-retest assessment of MRF-ASL MRI revealed that the spatial correlations of parametric maps were 0.997, 0.962, 0.746 and 0.863 for B1+ , T1 , CBF, and BAT, respectively. MRF-ASL is a promising technique for assessing multiple perfusion parameters simultaneously without contrast agent.
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Affiliation(s)
- Pan Su
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hongli Fan
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peiying Liu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yang Li
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ye Qiao
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jun Hua
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
| | - Doris Lin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dengrong Jiang
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jay J. Pillai
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Cognitive Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
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21
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Application of a 3D pseudocontinuous arterial spin-labeled perfusion MRI scan combined with a postlabeling delay value in the diagnosis of neonatal hypoxic-ischemic encephalopathy. PLoS One 2019; 14:e0219284. [PMID: 31283776 PMCID: PMC6613698 DOI: 10.1371/journal.pone.0219284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/20/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Currently, there are many studies on the application of the 3D pseudocontinuous arterial spin-labeled (3D-pcASL) perfusion MRI technique for adult brain examinations, but few studies exist on the application of the technique for child brain examinations. PURPOSE To explore the application of a 3D-pcASL perfusion MRI scan combined with postlabeling delay (PLD) for assessing neonatal hypoxic-ischemic encephalopathy (HIE). MATERIALS AND METHODS Two-hundred neonates diagnosed with neonatal HIE were equally divided into five groups (40/group): 0- to <24-hour-old HIE group, 1- to <3-day-old HIE group, 3- to <7-day-old HIE group, 7- to <15-day-old HIE group and 15- to 28-day-old HIE group; 200 healthy neonates were equivalently divided. All 10 groups received a conventional and a 3D-pcASL perfusion MRI scan. For groups <3 days old, PLD values for the 3D-pcASL cerebral perfusion MRI scan were preset at 1025 ms; in all other groups, PLD values were preset at 1525 ms. CBF values for the 3D-pcASL cerebral perfusion MRI were compared between the HIE and corresponding control groups to determine the distinguishing characteristics of CBF values in HIE neonates. RESULTS On the 3D-pcASL cerebral perfusion MRI scan, in the 1- to <3-day-old groups, HIE neonate CBF values were higher than those of controls in all brain regions (excluding the frontal lobe); in the 0- to <24-hour-old and 3- to <7-day-old groups, HIE neonate CBF values were lower than those of corresponding controls in all brain regions; in the 7- to <15-day-old and 15- to 28-day-old groups, there were no significant differences in the CBF values between groups in any brain regions. CONCLUSIONS The 3D-pcASL perfusion MRI scan combined with a PLD can assist in the early diagnosis of neonatal HIE, as this method more comprehensively reflects the HIE pathological process.
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22
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Abstract
Arterial Spin Labeling (ASL) is a perfusion-based functional magnetic resonance imaging technique that uses water in arterial blood as a freely diffusible tracer to measure regional cerebral blood flow (rCBF) noninvasively. To date its application to the study of pain has been relatively limited. Yet, ASL possesses key features that make it uniquely positioned to study pain in certain paradigms. For instance, ASL is sensitive to very slowly fluctuating brain signals (in the order of minutes or longer). This characteristic makes ASL particularly suitable to the evaluation of brain mechanisms of tonic experimental, post-surgical and ongoing/or continuously varying pain in chronic or acute pain conditions (whereas BOLD fMRI is better suited to detect brain responses to short-lasting or phasic/evoked pain). Unlike positron emission tomography or other perfusion techniques, ASL allows the estimation of rCBF without requiring the administration of radioligands or contrast agents. Thus, ASL is well suited for within-subject longitudinal designs (e.g., to study evolution of pain states over time, or of treatment effects in clinical trials). ASL is also highly versatile, allowing for novel paradigms exploring a flexible array of pain states, plus it can be used to simultaneously estimate not only pain-related alterations in perfusion but also functional connectivity. In conclusion, ASL can be successfully applied in pain paradigms that would be either challenging or impossible to implement using other techniques. Particularly when used in concert with other neuroimaging techniques, ASL can be a powerful tool in the pain imager's toolbox.
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23
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Elbejjani M, Auer R, Dolui S, Jacobs DR, Haight T, Goff DC, Detre JA, Davatzikos C, Bryan RN, Launer LJ. Cigarette smoking and cerebral blood flow in a cohort of middle-aged adults. J Cereb Blood Flow Metab 2019; 39:1247-1257. [PMID: 29355449 PMCID: PMC6668508 DOI: 10.1177/0271678x18754973] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 12/06/2017] [Indexed: 11/15/2022]
Abstract
Cigarette smoking is often associated with dementia. This association is thought to be mediated by hypoperfusion; however, how smoking behavior relates to cerebral blood flow (CBF) remains unclear. Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (mean age = 50; n = 522), we examined the association between smoking behavior (status, cumulative pack-years, age at smoking initiation, and years since cessation) and CBF (arterial spin labeling) in brain lobes and regions linked to dementia. We used adjusted linear regression models and tested whether associations differed between current and former-smokers. Compared to never-smokers, former-smokers had lower CBF in the parietal and occipital lobes, cuneus, precuneus, putamen, and insula; in contrast, current-smokers did not have lower CBF. The relationship between pack-years and CBF was different between current and former-smokers (p for interaction < 0.05): Among current-smokers, higher pack-years were associated with higher occipital, temporal, cuneus, putamen, insula, hippocampus, and caudate CBF; former-smokers had lower caudate CBF with increasing pack-years. Results show links between smoking and CBF at middle-age in regions implicated in cognitive and compulsive/addictive processes. Differences between current and former smoking suggest that distinct pathological and/or compensatory mechanisms may be involved depending on the timing and history of smoking exposure.
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Affiliation(s)
- Martine Elbejjani
- Laboratory of Epidemiology and
Population Sciences,
National
Institute on Aging, Bethesda, MD, USA
| | - Reto Auer
- Institute of Primary Health Care
(BIHAM), University of Bern, Bern, Switzerland
| | - Sudipto Dolui
- Department of Radiology, University of
Pennsylvania Health System, Philadelphia, PA, USA
| | - David R Jacobs
- Division of Epidemiology and Community
Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Thaddeus Haight
- Laboratory of Epidemiology and
Population Sciences,
National
Institute on Aging, Bethesda, MD, USA
| | - David C Goff
- National Heart, Lung, and Blood
Institute, Bethesda, MD, USA
| | - John A Detre
- Department of Neurology; University of
Pennsylvania Health System, Philadelphia, PA, USA
| | - Christos Davatzikos
- Department of Radiology, University of
Pennsylvania Health System, Philadelphia, PA, USA
| | - R Nick Bryan
- Department of Radiology, University of
Pennsylvania Health System, Philadelphia, PA, USA
| | - Lenore J Launer
- Laboratory of Epidemiology and
Population Sciences,
National
Institute on Aging, Bethesda, MD, USA
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Woods JG, Chappell MA, Okell TW. A general framework for optimizing arterial spin labeling MRI experiments. Magn Reson Med 2019; 81:2474-2488. [PMID: 30588656 PMCID: PMC6492260 DOI: 10.1002/mrm.27580] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/21/2018] [Accepted: 10/02/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE Arterial spin labeling (ASL) MRI is a non-invasive perfusion imaging technique that is inherently SNR limited, so scan protocols ideally need to be rigorously optimized to provide the most accurate measurements. A general framework is presented for optimizing ASL experiments to achieve optimal accuracy for perfusion estimates and, if required, other hemodynamic parameters, within a fixed scan time. The effectiveness of this framework is then demonstrated by optimizing the post-labeling delays (PLDs) of a multi-PLD pseudo-continuous ASL experiment and validating the improvement using simulations and in vivo data. THEORY AND METHODS A simple framework is proposed based on the use of the Cramér-Rao lower bound to find the protocol design which minimizes the predicted parameter estimation errors. Protocols were optimized for cerebral blood flow (CBF) accuracy or both CBF and arterial transit time (ATT) accuracy and compared to a conventional multi-PLD protocol, with evenly spaced PLDs, and a single-PLD protocol, using simulations and in vivo experiments in healthy volunteers. RESULTS Simulations and in vivo data agreed extremely well with the predicted performance of all protocols. For the in vivo experiments, optimizing for just CBF resulted in a 48% and 15% decrease in CBF errors, relative to the reference multi-PLD and single-PLD protocols, respectively. Optimizing for both CBF and ATT reduced CBF errors by 37%, without a reduction in ATT accuracy, relative to the reference multi-PLD protocol. CONCLUSION The presented framework can effectively design ASL experiments to minimize measurement errors based on the requirements of the scan.
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Affiliation(s)
- Joseph G. Woods
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Michael A. Chappell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Institute of Biomedical Engineering, Department of EngineeringUniversity of OxfordOxfordUnited Kingdom
| | - Thomas W. Okell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
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25
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Application of Postlabeling Delay Time in 3-Dimensional Pseudocontinuous Arterial Spin-Labeled Perfusion Imaging in Normal Children. J Comput Assist Tomogr 2019; 43:697-707. [DOI: 10.1097/rct.0000000000000911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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