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Cerebrovascular occlusive disease: quantitative cerebral blood flow using dynamic susceptibility contrast mr imaging correlates with quantitative H2[15O] PET
Journal article   Open access   Peer reviewed

Cerebrovascular occlusive disease: quantitative cerebral blood flow using dynamic susceptibility contrast mr imaging correlates with quantitative H2[15O] PET

Parmede Vakil, John J Lee, Jessy J Mouannes-Srour, Colin P Derdeyn and Timothy J Carroll
Radiology, Vol.266(3), pp.879-886
03/2013
DOI: 10.1148/radiol.12120756
PMCID: PMC3579175
PMID: 23297337
url
https://doi.org/10.1148/radiol.12120756View
Published (Version of record) Open Access

Abstract

To compare quantitative values of cerebral blood flow (CBF) derived from dynamic susceptibility contrast (DSC) magnetic resonance (MR) imaging with reference standard positron emission tomography (PET) in patients with confirmed cerebrovascular occlusive disease. Local institutional review board approval and informed consent were obtained for a prospective study of 18 patients (six men, 12 women; age range, 28-71 years; mean age, 45 years ± 10.4 [standard deviation]) with angiographically confirmed Moyamoya (n = 8) or internal carotid artery occlusions (n = 10). DSC MR images and oxygen 15-labeled water (H(2)[(15)O]) PET images were acquired on the same day. DSC images were postprocessed to yield parametric images of CBF (in mL/100 g/min), coregistered, and analyzed using grid-based regions of interest. Mean values of CBF in each region of interest from MR imaging and PET data sets were compared. Correlations for each patient were determined and overall agreement between pooled MR imaging and PET CBF was reported using linear regression analysis and Bland-Altman plots. Strong correlations (r(2) ≥ 0.55) were found between MR imaging and PET CBF values in all patients. Use of the bookend approach was found to underestimate CBF predictably across the patient cohort (mean slope, 0.82; standard deviation, 0.18; slope of aggregated data, 0.75). This allowed for a simple rescaling of MR imaging values producing strong agreement with PET values in the aggregated data (r(2) = 0.66; slope = 1.00; intercept = 0.00). The data show that the bookend MR imaging technique produces similar results for quantitative CBF between DSC MR imaging and H(2)[(15)O] PET. Although MR-derived CBF underestimated PET-derived CBF, the patient-to-patient variability in the slopes of the linear MR and PET relationships was significantly smaller than a competing quantitation technique. As a result, the bookend technique appears to more predictably measure quantitative CBF in a clinical setting.
Water Cerebrovascular Disorders - physiopathology Reproducibility of Results Oxygen Radioisotopes Humans Middle Aged Magnetic Resonance Imaging - methods Male Cerebrovascular Circulation Statistics as Topic Positron-Emission Tomography - methods Young Adult Cerebrovascular Disorders - diagnosis Contrast Media Sensitivity and Specificity Blood Flow Velocity Adult Female Aged Radiopharmaceuticals Gadolinium DTPA

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