Journal article
Hypercapnic BOLD MRI compared to H215O PET/CT for the hemodynamic evaluation of patients with Moyamoya Disease.
- Hauser TK Department of Neuroradiology, Eberhard Karls University Tübingen, Germany.
- Seeger A Department of Neuroradiology, Eberhard Karls University Tübingen, Germany.
- Bender B Department of Neuroradiology, Eberhard Karls University Tübingen, Germany.
- Klose U Department of Neuroradiology, Eberhard Karls University Tübingen, Germany.
- Thurow J Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Ernemann U Department of Neuroradiology, Eberhard Karls University Tübingen, Germany.
- Tatagiba M Department of Neurosurgery, Eberhard Karls University Tübingen, Germany.
- Meyer PT Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Khan N Department of Neurosurgery, Eberhard Karls University Tübingen, Germany; Moyamoya Center, Division of Pediatric Neurosurgery, University Children's Hospital Zürich, Switzerland. Electronic address: moyamoya@neurochirurgie-tuebingen.de.
- Roder C Department of Neurosurgery, Eberhard Karls University Tübingen, Germany.
- 2019-02-12
Published in:
- NeuroImage. Clinical. - 2019
BOLD MRI
Cerebrovascular reserve
Moyamoya
PET/CT
Adult
Female
Hemodynamics
Humans
Hypercapnia
Magnetic Resonance Imaging
Male
Moyamoya Disease
Neuroimaging
Oxygen Radioisotopes
Positron Emission Tomography Computed Tomography
Radiopharmaceuticals
Retrospective Studies
English
BACKGROUND AND PURPOSE
Patients with Moyamoya Disease (MMD) need hemodynamic evaluation of vascular territories at risk of stroke. Today's investigative standards include H215O PET/CT with pharmacological challenges with acetazolamide (ACZ). Recent developments suggest that CO2-triggered blood‑oxygen-level-dependent (BOLD) functional MRI might provide comparable results to current standard methods for evaluation of territorial hemodynamics, while being a more widely available and easily implementable method. This study examines results of a newly developed quantifiable analysis algorithm for CO2-triggered BOLD MRI in Moyamoya patients and correlates the results with H215O PET/CT with ACZ challenge to assess comparability between both modalities.
METHODS
CO2-triggered BOLD MRI was performed and compared to H215O PET/CT with ACZ challenge in patients with angiographically proven MMD. Images of both modalities were analyzed retrospectively in a blinded, standardized fashion by visual inspection, as well as with a semi-quantitative analysis using stimuli-induced approximated regional perfusion-weighted data and BOLD-signal changes with reference to cerebellum.
RESULTS
20 consecutive patients fulfilled the inclusion criteria, a total of 160 vascular territories were analyzed retrospectively. Visual analysis (4-step visual rating system) of standardized, color-coded cerebrovascular reserve/reactivity maps showed a very strong correlation (Spearman's rho = 0.9, P < 0.001) between both modalities. Likewise, comparison of approximated regional perfusion changes across vascular territories (normalized to cerebellar change) reveal a highly significant correlation between both methods (Pearson's r = 0.71, P < 0.001).
CONCLUSIONS
The present analysis indicates that CO2-triggered BOLD MRI is a very promising tool for the hemodynamic evaluation of MMD patients with results comparable to those seen in H215O PET/CT with ACZ challenge. It therefore holds future potential in becoming a routine examination in the pre- and postoperative evaluation of MMD patients after further prospective evaluation.
Patients with Moyamoya Disease (MMD) need hemodynamic evaluation of vascular territories at risk of stroke. Today's investigative standards include H215O PET/CT with pharmacological challenges with acetazolamide (ACZ). Recent developments suggest that CO2-triggered blood‑oxygen-level-dependent (BOLD) functional MRI might provide comparable results to current standard methods for evaluation of territorial hemodynamics, while being a more widely available and easily implementable method. This study examines results of a newly developed quantifiable analysis algorithm for CO2-triggered BOLD MRI in Moyamoya patients and correlates the results with H215O PET/CT with ACZ challenge to assess comparability between both modalities.
METHODS
CO2-triggered BOLD MRI was performed and compared to H215O PET/CT with ACZ challenge in patients with angiographically proven MMD. Images of both modalities were analyzed retrospectively in a blinded, standardized fashion by visual inspection, as well as with a semi-quantitative analysis using stimuli-induced approximated regional perfusion-weighted data and BOLD-signal changes with reference to cerebellum.
RESULTS
20 consecutive patients fulfilled the inclusion criteria, a total of 160 vascular territories were analyzed retrospectively. Visual analysis (4-step visual rating system) of standardized, color-coded cerebrovascular reserve/reactivity maps showed a very strong correlation (Spearman's rho = 0.9, P < 0.001) between both modalities. Likewise, comparison of approximated regional perfusion changes across vascular territories (normalized to cerebellar change) reveal a highly significant correlation between both methods (Pearson's r = 0.71, P < 0.001).
CONCLUSIONS
The present analysis indicates that CO2-triggered BOLD MRI is a very promising tool for the hemodynamic evaluation of MMD patients with results comparable to those seen in H215O PET/CT with ACZ challenge. It therefore holds future potential in becoming a routine examination in the pre- and postoperative evaluation of MMD patients after further prospective evaluation.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1016/j.nicl.2019.101713
- PMID 30743136
- Persistent URL
- https://sonar.ch/global/documents/298930
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