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Clinical Application of Arterial Spin-Labeling MR Imaging in Patients with Carotid Stenosis: Quantitative Comparative Study with Single-Photon Emission CT

Clinical Application of Arterial Spin-Labeling MR Imaging in Patients with Carotid Stenosis:... This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2525v1 32/8/1545 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Uchihashi, Y. Articles by Kohmura, E. PubMed PubMed Citation Articles by Uchihashi, Y. Articles by Kohmura, E. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1545-1551, September 2011 © 2011 American Society of Neuroradiology HEAD AND NECK Clinical Application of Arterial Spin-Labeling MR Imaging in Patients with Carotid Stenosis: Quantitative Comparative Study with Single-Photon Emission CT Y. Uchihashi a , K. Hosoda a , I. Zimine c , A. Fujita a , M. Fujii b , K. Sugimura b and E. Kohmura a a From the Departments of Neurosurgery (Y.U., K.H., A.F., E.K.) b Radiology (M.F., K.S.), Kobe University Graduate School of Medicine, Kobe, Japan c Philips Healthcare Japan (I.Z.), Tokyo, Japan. Please address correspondence to Kohkichi Hosoda, MD, Department of Neurosurgery, Kobe University Graduate School of Medicine, 650-0017, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe-city, Hyogo, Japan; e-mail: khosoda@med.kobe-u.ac.jp BACKGROUND AND PURPOSE: Arterial spin-labeling is an emerging technique for noninvasive measurement of cerebral perfusion, but concerns remain regarding the reliability of CBF quantification and clinical applications. Recently, an ASL implementation called QUASAR was proposed, and it was shown to have good reproducibility of CBF assessment in healthy volunteers. This study aimed to determine the utility of QUASAR for CBF assessment in patients with cerebrovascular diseases. MATERIALS AND METHODS: Twenty patients with carotid stenosis underwent CBF quantification by ASL (QUASAR) within 3 days of performance of 123 I-iodoamphetamine-SPECT. CVR to acetazolamide also was assessed by ASL and SPECT. In surgically treated patients, the respective scans before and after the procedures were compared. RESULTS: Regional CBF and CVR values measured by ASL were significantly correlated and agreed with those measured by SPECT ( r s = 0.92 and 0.88, respectively). A Bland-Altman plot demonstrated good agreement between 2 methods in terms of CBF quantification. Furthermore, ASL could detect pathologic states such as hypoperfusion, impaired vasoreactivity, and postoperative hyperperfusion, equivalent to SPECT. However, ASL tended to overestimate CBF values especially in high-perfusion regions. CONCLUSIONS: ASL perfusion MR imaging is clinically applicable and can be an alternative method for CBF assessment in patients with cerebrovascular diseases. Abbreviations: ACZ, acetazolamide • AIF, arterial input function • ASL, arterial spin labeling • CAS, carotid artery stenting • CBF, cerebral blood flow • CEA, carotid endarterectomy • CVR, cerebral vasoreactivity • IMP, iodine 123 N -isopropy-p-iodoamphetamine • NASCET, North American Symptomatic Carotid Endarterectomy Trial • PET, positron-emission tomography • QUASAR, quantitative STAR labeling of arterial regions • ROC, receiver operating characteristic • ROI, region of interest • SPECT, single-photon emission CTl • Venc, velocity encoding Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Clinical Application of Arterial Spin-Labeling MR Imaging in Patients with Carotid Stenosis: Quantitative Comparative Study with Single-Photon Emission CT

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2011 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2525
Publisher site
See Article on Publisher Site

Abstract

This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2525v1 32/8/1545 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Uchihashi, Y. Articles by Kohmura, E. PubMed PubMed Citation Articles by Uchihashi, Y. Articles by Kohmura, E. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1545-1551, September 2011 © 2011 American Society of Neuroradiology HEAD AND NECK Clinical Application of Arterial Spin-Labeling MR Imaging in Patients with Carotid Stenosis: Quantitative Comparative Study with Single-Photon Emission CT Y. Uchihashi a , K. Hosoda a , I. Zimine c , A. Fujita a , M. Fujii b , K. Sugimura b and E. Kohmura a a From the Departments of Neurosurgery (Y.U., K.H., A.F., E.K.) b Radiology (M.F., K.S.), Kobe University Graduate School of Medicine, Kobe, Japan c Philips Healthcare Japan (I.Z.), Tokyo, Japan. Please address correspondence to Kohkichi Hosoda, MD, Department of Neurosurgery, Kobe University Graduate School of Medicine, 650-0017, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe-city, Hyogo, Japan; e-mail: khosoda@med.kobe-u.ac.jp BACKGROUND AND PURPOSE: Arterial spin-labeling is an emerging technique for noninvasive measurement of cerebral perfusion, but concerns remain regarding the reliability of CBF quantification and clinical applications. Recently, an ASL implementation called QUASAR was proposed, and it was shown to have good reproducibility of CBF assessment in healthy volunteers. This study aimed to determine the utility of QUASAR for CBF assessment in patients with cerebrovascular diseases. MATERIALS AND METHODS: Twenty patients with carotid stenosis underwent CBF quantification by ASL (QUASAR) within 3 days of performance of 123 I-iodoamphetamine-SPECT. CVR to acetazolamide also was assessed by ASL and SPECT. In surgically treated patients, the respective scans before and after the procedures were compared. RESULTS: Regional CBF and CVR values measured by ASL were significantly correlated and agreed with those measured by SPECT ( r s = 0.92 and 0.88, respectively). A Bland-Altman plot demonstrated good agreement between 2 methods in terms of CBF quantification. Furthermore, ASL could detect pathologic states such as hypoperfusion, impaired vasoreactivity, and postoperative hyperperfusion, equivalent to SPECT. However, ASL tended to overestimate CBF values especially in high-perfusion regions. CONCLUSIONS: ASL perfusion MR imaging is clinically applicable and can be an alternative method for CBF assessment in patients with cerebrovascular diseases. Abbreviations: ACZ, acetazolamide • AIF, arterial input function • ASL, arterial spin labeling • CAS, carotid artery stenting • CBF, cerebral blood flow • CEA, carotid endarterectomy • CVR, cerebral vasoreactivity • IMP, iodine 123 N -isopropy-p-iodoamphetamine • NASCET, North American Symptomatic Carotid Endarterectomy Trial • PET, positron-emission tomography • QUASAR, quantitative STAR labeling of arterial regions • ROC, receiver operating characteristic • ROI, region of interest • SPECT, single-photon emission CTl • Venc, velocity encoding Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Sep 1, 2011

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