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Intravoxel incoherent motion perfusion in patients with Moyamoya disease: comparison with 15O-gas positron emission tomography.

ABSTRACT: Background:Intravoxel incoherent motion magnetic resonance imaging (IVIM) enables non-invasive measurement of brain perfusion. Purpose:To investigate whether IVIM could be used to evaluate the hemodynamic disturbance of Moyamoya disease (MMD) by comparison with the gold-standard 15O-gas positron emission tomography (PET) method. Material and Methods:Ten consecutive patients with MMD (six women; mean age?=?42.8 years) and 10 age-matched healthy controls were evaluated by diffusion-weighted images with 12 different b values in the range of 0-900 s/mm2 and 15O-gas PET. Tomographic maps of IVIM parameters, perfusion fraction (f?), pseudo-diffusion coefficient (D*), and f?D*, as well as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) maps obtained with PET, were normalized and hemispheric gray and white matter values were calculated. IVIM parametric values were compared with PET parameters and with clinically assessed disease severity. Results:There was significant correlation between D* and MTT (r?=?-0.74, P?

SUBMITTER: Hara S

PROVIDER: S-EPMC6535913 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Intravoxel incoherent motion perfusion in patients with Moyamoya disease: comparison with <sup>15</sup>O-gas positron emission tomography.

Hara Shoko S Hori Masaaki M Ueda Ryo R Hagiwara Akifumi A Hayashi Shihori S Inaji Motoki M Tanaka Yoji Y Maehara Taketoshi T Ishii Kenji K Aoki Shigeki S Nariai Tadashi T

Acta radiologica open 20190523 5

<h4>Background</h4>Intravoxel incoherent motion magnetic resonance imaging (IVIM) enables non-invasive measurement of brain perfusion.<h4>Purpose</h4>To investigate whether IVIM could be used to evaluate the hemodynamic disturbance of Moyamoya disease (MMD) by comparison with the gold-standard <sup>15</sup>O-gas positron emission tomography (PET) method.<h4>Material and methods</h4>Ten consecutive patients with MMD (six women; mean age = 42.8 years) and 10 age-matched healthy controls were evalu ...[more]

PMID: 31205752

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Project description:Background and Purpose- Noninvasive imaging of brain perfusion has the potential to elucidate pathophysiological mechanisms underlying Moyamoya disease and enable clinical imaging of cerebral blood flow (CBF) to select revascularization therapies for patients. We used hybrid positron emission tomography (PET)/magnetic resonance imaging (MRI) technology to characterize the distribution of hypoperfusion in Moyamoya disease and its relationship to vessel stenosis severity, through comparisons with a normative perfusion database of healthy controls. Methods- To image CBF, we acquired [15O]-water PET as a reference and simultaneously acquired arterial spin labeling (ASL) MRI scans in 20 Moyamoya patients and 15 age-matched, healthy controls on a PET/MRI scanner. The ASL MRI scans included a standard single-delay ASL scan with postlabel delay of 2.0 s and a multidelay scan with 5 postlabel delays (0.7-3.0s) to estimate and account for arterial transit time in CBF quantification. The percent volume of hypoperfusion in patients (determined as the fifth percentile of CBF values in the healthy control database) was the outcome measure in a logistic regression model that included stenosis grade and location. Results- Logistic regression showed that anterior ( P<0.0001) and middle cerebral artery territory regions ( P=0.003) in Moyamoya patients were susceptible to hypoperfusion, whereas posterior regions were not. Cortical regions supplied by arteries with stenosis on MR angiography showed more hypoperfusion than normal arteries ( P=0.001), but the extent of hypoperfusion was not different between mild-moderate versus severe stenosis. Multidelay ASL did not perform differently from [15O]-water PET in detecting perfusion abnormalities, but standard ASL overestimated the extent of hypoperfusion in patients ( P=0.003). Conclusions- This simultaneous PET/MRI study supports the use of multidelay ASL MRI in clinical evaluation of Moyamoya disease in settings where nuclear medicine imaging is not available and application of a normative perfusion database to automatically identify abnormal CBF in patients.

Dataset Information

Intravoxel incoherent motion perfusion in patients with Moyamoya disease: comparison with 15O-gas positron emission tomography.

Publications

Intravoxel incoherent motion perfusion in patients with Moyamoya disease: comparison with <sup>15</sup>O-gas positron emission tomography.

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