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Evaluation of Arterial Spin Labeling MRI: Comparison with 15O-Water PET on an Integrated PET/MR Scanner
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.ORCID-id: 0000-0002-2502-6026
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Landtblom: Neurologi.ORCID-id: 0000-0002-1952-8791
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
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2021 (Engelska)Ingår i: Diagnostics (Basel), ISSN 2075-4418, Vol. 11, nr 5, artikel-id 821Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Cerebral blood flow (CBF) measurements are of high clinical value and can be acquired non-invasively with no radiation exposure using pseudo-continuous arterial spin labeling (ASL). The aim of this study was to evaluate accordance in resting state CBF between ASL (CBFASL) and 15O-water positron emission tomography (PET) (CBFPET) acquired simultaneously on an integrated 3T PET/MR system. The data comprised ASL and dynamic 15O-water PET data with arterial blood sampling of eighteen subjects (eight patients with focal epilepsy and ten healthy controls, age 21 to 61 years). 15O-water PET parametric CBF images were generated using a basis function implementation of the single tissue compartment model. Cortical and subcortical regions were automatically segmented using Freesurfer. Average CBFASL and CBFPET in grey matter were 60 ± 20 and 75 ± 22 mL/100 g/min respectively, with a relatively high correlation (r = 0.78, p < 0.001). Bland-Altman analysis revealed poor agreement (bias = −15 mL/100 g/min, lower and upper limits of agreements = −16 and 45 mL/100 g/min, respectively) with a negative relationship. Accounting for the negative relationship, the width of the limits of agreement could be narrowed from 61 mL/100 g/min to 35 mL/100 g/min using regression-based limits of agreements. Although a high correlation between CBFASL and CBFPET was found, the agreement in absolute CBF values was not sufficient for ASL to be used interchangeably with 15O-water PET.

Ort, förlag, år, upplaga, sidor
MDPI, 2021. Vol. 11, nr 5, artikel-id 821
Nyckelord [en]
ASL, CBF, PET/MR, validation, 15O-water
Nationell ämneskategori
Radiologi och bildbehandling
Identifikatorer
URN: urn:nbn:se:uu:diva-404602DOI: 10.3390/diagnostics11050821ISI: 000653845000001PubMedID: 34062847OAI: oai:DiVA.org:uu-404602DiVA, id: diva2:1399513
Forskningsfinansiär
Science for Life Laboratory - a national resource center for high-throughput molecular bioscienceRegion Uppsala
Anmärkning

Authors and title in thesis list of papers: Fahlström, M., Appel, L., Danfors, T., Engström, M., Antoni, G., Kumlien, E., Wikström, J., Larsson, E-M., Lubberink, M. Evaluation of pseudo-continuous arterial spin labeling MRI – agreement with 15O-water PET with arterial input function and use of integrated PET/MR

Tillgänglig från: 2020-02-27 Skapad: 2020-02-27 Senast uppdaterad: 2024-01-15Bibliografiskt granskad
Ingår i avhandling
1. On potentials and limitations of perfusion MRI in neurological disorders
Öppna denna publikation i ny flik eller fönster >>On potentials and limitations of perfusion MRI in neurological disorders
2020 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Cerebral perfusion outlines several parameters which describe the status of cerebral haemodynamics. Numerous neurological diseases affect cerebral perfusion, thus the importance of diagnostic measurements. Perfusion magnetic resonance imaging (MRI) is a collection of non-ionizing magnetic resonance-based perfusion measurement techniques that can be used for clinical assessment of cerebral perfusion. The aim of this thesis was to investigate potentials and limitations of perfusion MRI used for clinical assessment of patients with neurological disorders. Patients with glioblastoma were examined with dynamic susceptibility contrast MRI (DSC-MRI) and dynamic contrast enhanced MRI (DCE-MRI) before/after treatment with fractionated radiotherapy (FRT). Radiation-induced changes in normal-appearing brain tissue were found in the form of decreased cerebral blood volume (CBV) and cerebral blood flow (CBF) measured with DSC-MRI and increased vascular permeability and increased fraction of the extravascular extracellular space measured with DCE-MRI. Papers I–II provide valuable information regarding the possibility that radiation-induced changes could be a confounder in DSC-MRI and that DCE-MRI could potentially act as a biomarker for vascular damage secondary to radiation exposure. Additionally, CBF derived from arterial spin labelling (ASL) was compared to the reference standard 15O-water positron emission tomography (PET). Simultaneous measurements were acquired with an integrated PET/MR scanner using arterial blood sampling and zero-echo time-based attenuation correction in healthy subjects and patients with epilepsy. Correlation- and Bland–Altman analysis showed fair correlation and a negative relationship with wide limits of agreement in several cortical and subcortical regions. Thus, agreement with 15O-water is insufficient for absolute quantification with ASL, but ASL provides reliable relative measures that could potentially be rescaled to absolute values. Moyamoya disease (MMD) is characterized by progressive stenosis/occlusion in large brain arteries. A limitation of ASL is the sensitivity to prolonged arterial transit times, which is common in the collateral vessels of the brain in patients with MMD. Given the non-invasiveness and non-ionizing exposure, ASL has a pronounced potential for use in diagnostic imaging in patients with MMD. ASL was performed before and after administration of acetazolamide; CBF and cerebrovascular reserve capacity were derived for large vascular regions. Artefacts originating from prolonged arterial transit times were found to have negligible effects on CBF and cerebrovascular reserve capacity derived from ASL. This thesis adds to the understanding of potential and limitations of perfusion MRI in neurological diseases. 

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2020. s. 63
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1642
Nyckelord
Neurological disease, MRI, Perfusion, 15O-water PET
Nationell ämneskategori
Radiologi och bildbehandling
Forskningsämne
Medicinsk radiofysik
Identifikatorer
urn:nbn:se:uu:diva-404604 (URN)978-91-513-0883-8 (ISBN)
Disputation
2020-04-17, H:Son-Holmdahlsalen, Akademiska Sjukhuset, Ing 100 2 tr, Uppsala, 13:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2020-03-26 Skapad: 2020-03-01 Senast uppdaterad: 2020-05-19

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Fahlström, MarkusAppel, LieuweKumlien, EvaDanfors, TorstenWikström, JohanAntoni, GunnarLarsson, Elna-MarieLubberink, Mark
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