Estimation of Cerebral Blood Flow Using the Pulse Wave Amplitude in Brain MRI

Julian Glandorf; Filip Klimeš; Agilo Luitger Kern; Andreas Voskrebenzev; Marcel Gutberlet; Norman Kornemann; Frank Wacker; Mike P Wattjes; Jens Vogel-Claussen

doi:10.1016/j.acra.2024.03.015

Estimation of Cerebral Blood Flow Using the Pulse Wave Amplitude in Brain MRI

Acad Radiol. 2024 Apr 24:S1076-6332(24)00157-0. doi: 10.1016/j.acra.2024.03.015. Online ahead of print.

Authors

Julian Glandorf¹, Filip Klimeš², Agilo Luitger Kern², Andreas Voskrebenzev², Marcel Gutberlet², Norman Kornemann², Frank Wacker², Mike P Wattjes³, Jens Vogel-Claussen²

Affiliations

¹ Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany; Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany. Electronic address: glandorf.julian@mh-hannover.de.
² Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany; Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany.
³ Institute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.

PMID: 38664144
DOI: 10.1016/j.acra.2024.03.015

Abstract

Rationale and objectives: First, to test the feasibility of cerebral blood flow (CBF) estimation using the pulse wave amplitude in flow-related enhancement (FREE) brain MRI in comparison to pseudo-continuous arterial spin labeling (pCASL-MRI). Second, the potential for acceleration was evaluated retrospectively.

Materials and methods: 24 healthy study participants between 20 and 61 years had cerebral MRI. Perfusion imaging was performed with a balanced steady-state free precession sequence for FREE-MRI and with pCASL-MRI for comparison.

Results: The value distribution of the estimated CBF showed a high overlap in the histogram between 0 and 20 mL/100 g/min. However, disparity of the values occurred with more values between 20 and 60 mL/100 g/min using pCASL-MRI and more high values > 60 mL/100 g/min applying FREE-MRI. A Kolmogorov-Smirnov test confirmed a differing probability distribution (P = 0.62). The approximated CBF from FREE-MRI remained stable until only 50% of the acquired data was used. Values from using 40% of the data increased significantly compared to 90% or more (P ≤ 0.05). Values within the white matter presented no significant change after data reduction. The global and voxel-wise correlation coefficients towards pCASL-MRI presented stability during data reduction of FREE-MRI.

Conclusion: In conclusion, the proposed technique allows a rough approximation of the CBF compared to pCASL-MRI. Further sequence optimization must be achieved to improve the measurement of relatively lowly perfused tissues. Nevertheless, it offers large potential for imaging speed optimization and enables perfusion-weighted images similarly to the color Doppler mode in ultrasound.

Keywords: CBF; Flow-related enhancement; Imaging speed optimization; PCASL; Perfusion; Quantification.