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AJNR Am J Neuroradiol. 2016 Dec;37(12):2265-2272. Epub 2016 Sep 29.

Comparison of Quantitative Cerebral Blood Flow Measurements Performed by Bookend Dynamic Susceptibility Contrast and Arterial Spin-Labeling MRI in Relapsing-Remitting Multiple Sclerosis.

Author information

1
University of Toronto (R.M.D., P.O.C., L.L., A.F., R.I.A.), Toronto, Ontario, Canada.
2
Medical Imaging (S.P.H., R.V., R.I.A.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada r.dortenzio@mail.utoronto.ca.
3
Medical Imaging (S.P.H., R.V., R.I.A.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
4
Departments of Biomedical Engineering (C.G.C., T.J.C.).
5
Neurology (L.L.).
6
From the Departments of Psychiatry (A.F.).
7
Radiology (T.J.C.), Northwestern University, Chicago, Illinois.

Abstract

BACKGROUND AND PURPOSE:

Quantitative CBF usage as a biomarker for cognitive impairment and disease progression in MS is potentially a powerful tool for longitudinal patient monitoring. Dynamic susceptibility contrast perfusion with bookend T1-calibration (bookend technique) and pseudocontinuous arterial spin-labeling have recently been used for CBF quantification in relapsing-remitting MS. The noninvasive nature of pseudocontinuous arterial spin-labeling is advantageous over gadolinium-based techniques, but correlation between the techniques is not well-established in the context of MS.

MATERIALS AND METHODS:

We compared pseudocontinuous arterial spin-labeling CBF with the bookend technique in a prospective cohort of 19 healthy controls, 19 subjects with relapsing-remitting MS without cognitive impairment, and 20 subjects with relapsing-remitting MS with cognitive impairment on a voxelwise and Brodmann region basis. The linear Pearson correlation, SNR, and coefficient of variation were quantified.

RESULTS:

Voxelwise paired t tests revealed no significant CBF differences between techniques after normalization of global mean intensities. The highest Pearson correlations were observed in deep GM structures (average r = 0.71 for the basal ganglia and r = 0.65 for the thalamus) but remained robust for cortical GM, WM, and white matter lesions (average r = 0.51, 0.53, 0.54, respectively). Lower Pearson correlations were observed for cortical lesions (average r = 0.23). Brodmann region correlations were significant for all groups. All correlations were maintained in healthy controls and in patients with relapsing-remitting multiple sclerosis. The highest SNR was present in bookend perfusion, while the highest coefficient of variation was present in white matter lesions.

CONCLUSIONS:

Agreement between pseudocontinuous arterial spin-labeling and bookend technique CBF measurements is demonstrated in healthy controls and patients with relapsing-remitting MS.

PMID:
27686489
PMCID:
PMC5161663
DOI:
10.3174/ajnr.A4939
[Indexed for MEDLINE]
Free PMC Article

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