Volume 51, Issue 1 pp. 183-194

Original Research

Simultaneous phase-contrast MRI and PET for noninvasive quantification of cerebral blood flow and reactivity in healthy subjects and patients with cerebrovascular disease

Yosuke Ishii MD, PhD,

Corresponding Author

Yosuke Ishii MD, PhD

[email protected]

orcid.org/0000-0001-8944-6241

Department of Radiology, Stanford University, Stanford, California, USA

Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan

Address reprint requests to: Y.I., Department of Radiology, Stanford University, 1201 Welch Rd., Stanford, CA 94305-5488. E-mail: [email protected]Search for more papers by this author

Thoralf Thamm,

Thoralf Thamm

Department of Radiology, Stanford University, Stanford, California, USA

Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany

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Jia Guo PhD,

Jia Guo PhD

Department of Radiology, Stanford University, Stanford, California, USA

Department of Bioengineering, University of California Riverside, Riverside, California, USA

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Mohammad Mehdi Khalighi PhD,

Mohammad Mehdi Khalighi PhD

Global Applied Science Lab, GE Healthcare, Menlo Park, California, USA

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Mirwais Wardak PhD,

Mirwais Wardak PhD

Department of Radiology, Stanford University, Stanford, California, USA

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Dawn Holley BS, CNMT,

Dawn Holley BS, CNMT

Department of Radiology, Stanford University, Stanford, California, USA

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Harsh Gandhi MS,

Harsh Gandhi MS

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Jun Hyung Park PhD,

Jun Hyung Park PhD

Department of Radiology, Stanford University, Stanford, California, USA

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Bin Shen PhD,

Bin Shen PhD

Department of Radiology, Stanford University, Stanford, California, USA

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Gary K. Steinberg MD, PhD,

Gary K. Steinberg MD, PhD

Department of Neurosurgery, Stanford University, Stanford, California, USA

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Frederick T. Chin PhD,

Frederick T. Chin PhD

Department of Radiology, Stanford University, Stanford, California, USA

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Greg Zaharchuk MD, PhD,

Greg Zaharchuk MD, PhD

Department of Radiology, Stanford University, Stanford, California, USA

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Audrey Peiwen Fan PhD,

Audrey Peiwen Fan PhD

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Yosuke Ishii MD, PhD,

Corresponding Author

Yosuke Ishii MD, PhD

[email protected]

orcid.org/0000-0001-8944-6241

Department of Radiology, Stanford University, Stanford, California, USA

Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan

Address reprint requests to: Y.I., Department of Radiology, Stanford University, 1201 Welch Rd., Stanford, CA 94305-5488. E-mail: [email protected]Search for more papers by this author

Thoralf Thamm,

Thoralf Thamm

Department of Radiology, Stanford University, Stanford, California, USA

Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany

Search for more papers by this author

Jia Guo PhD,

Jia Guo PhD

Department of Radiology, Stanford University, Stanford, California, USA

Department of Bioengineering, University of California Riverside, Riverside, California, USA

Search for more papers by this author

Mohammad Mehdi Khalighi PhD,

Mohammad Mehdi Khalighi PhD

Global Applied Science Lab, GE Healthcare, Menlo Park, California, USA

Search for more papers by this author

Mirwais Wardak PhD,

Mirwais Wardak PhD

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Dawn Holley BS, CNMT,

Dawn Holley BS, CNMT

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Harsh Gandhi MS,

Harsh Gandhi MS

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Jun Hyung Park PhD,

Jun Hyung Park PhD

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Bin Shen PhD,

Bin Shen PhD

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Gary K. Steinberg MD, PhD,

Gary K. Steinberg MD, PhD

Department of Neurosurgery, Stanford University, Stanford, California, USA

Search for more papers by this author

Frederick T. Chin PhD,

Frederick T. Chin PhD

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Greg Zaharchuk MD, PhD,

Greg Zaharchuk MD, PhD

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

Audrey Peiwen Fan PhD,

Audrey Peiwen Fan PhD

Department of Radiology, Stanford University, Stanford, California, USA

Search for more papers by this author

First published: 01 May 2019

https://doi.org/10.1002/jmri.26773

Citations: 18

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Abstract

Background

H₂¹⁵O-positron emission tomography (PET) is considered the reference standard for absolute cerebral blood flow (CBF). However, this technique requires an arterial input function measured through continuous sampling of arterial blood, which is invasive and has limitations with tracer delay and dispersion.

Purpose

To demonstrate a new noninvasive method to quantify absolute CBF with a PET/MRI hybrid scanner. This blood-free approach, called PC-PET, takes the spatial CBF distribution from a static H₂¹⁵O-PET scan, and scales it to the whole-brain average CBF value measured by simultaneous phase-contrast MRI.

Study Type

Observational.

Subjects

Twelve healthy controls (HC) and 13 patients with Moyamoya disease (MM) as a model of chronic ischemic disease.

Field Strength/Sequences

3T/2D cardiac-gated phase-contrast MRI and H₂¹⁵O-PET.

Assessment

PC-PET CBF values from whole brain (WB), gray matter (GM), and white matter (WM) in HCs were compared with literature values since 2000. CBF and cerebrovascular reactivity (CVR), which is defined as the percent CBF change between baseline and post-acetazolamide (vasodilator) scans, were measured by PC-PET in MM patients and HCs within cortical regions corresponding to major vascular territories.

Statistical Tests: Linear, mixed effects models were created to compare CBF and CVR, respectively, between patients and controls, and between different degrees of stenosis.

Results

The mean CBF values in WB, GM, and WM in HC were 42 ± 7 ml/100 g/min, 50 ± 7 ml/100 g/min, and 23 ± 3 ml/100 g/min, respectively, which agree well with literature values. Compared with normal regions (57 ± 23%), patients showed significantly decreased CVR in areas with mild/moderate stenosis (47 ± 17%, P = 0.011) and in severe/occluded areas (40 ± 16%, P = 0.016).

Data Conclusion: PC-PET identifies differences in cerebrovascular reactivity between healthy controls and cerebrovascular patients. PC-PET is suitable for CBF measurement when arterial blood sampling is not accessible, and warrants comparison to fully quantitative H₂¹⁵O-PET in future studies.

Level of Evidence: 3

Technical Efficacy Stage: 2

J. Magn. Reson. Imaging 2019. J. Magn. Reson. Imaging 2020;51:183–194.

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Volume51, Issue1

January 2020

Pages 183-194

Simultaneous phase-contrast MRI and PET for noninvasive quantification of cerebral blood flow and reactivity in healthy subjects and patients with cerebrovascular disease

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequences

Assessment

Results

References

Citing Literature

References

Information

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Simultaneous phase-contrast MRI and PET for noninvasive quantification of cerebral blood flow and reactivity in healthy subjects and patients with cerebrovascular disease

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequences

Assessment

Results

References

Citing Literature

References

Related

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