title: Evaluating quantitative approaches to dynamic susceptibility contrast MRI among carotid endarterectomy patients.
abstract: OBJECTIVE
  To evaluate two dynamic susceptibility contrast (DSC) quantification methods in symptomatic carotid artery disease patients undergoing carotid endarterectomy (CEA) surgery by comparing methods directly and assessing the reliability of each method in the hemisphere contralateral to surgery.
  
  
  METHODS
  Absolute cerebral blood flow (CBF) and volume (CBV) was calculated in putamen and sensorimotor gray matter of 17 patients using two methods: 1) The Bookend method that scales relative DSC images to CBV values calculated from the ratio of pre- and postcontrast T1-weighted images, and 2) the Tail-scaling method that uses the ratio of area under the tails of the venous and arterial concentration time-courses to scale the DSC images.
  
  
  RESULTS
  There was a positive correlation between the methods with significant correlation post-CEA (P < 0.035). Intersession correlation was greater when using the Tail-scaling method contralateral to surgery (P < 0.004).
  
  
  CONCLUSIONS
  We have demonstrated correlation between methods that is significant after surgery and have found that the Tail-scaling method produces better test-retest reliability than our implementation of the Bookend method. Results from this study suggest that DSC has the potential to measure hemodynamic changes after endarterectomy and future work is required to establish clinical value.
authors.affiliation: Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.
authors.forename: David E
authors.initials: DE
authors.lastname: Crane
authors.forename: Manus J
authors.initials: MJ
authors.lastname: Donahue
authors.forename: Michael A
authors.initials: MA
authors.lastname: Chappell
authors.forename: Ediri
authors.initials: E
authors.lastname: Sideso
authors.forename: Ashok
authors.initials: A
authors.lastname: Handa
authors.forename: James
authors.initials: J
authors.lastname: Kennedy
authors.forename: Peter
authors.initials: P
authors.lastname: Jezzard
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: MacIntosh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001783:Blood Flow Velocity / Q000502:physiology; D001810:Blood Volume / Q000502:physiology*; D001921:Brain / Q000098:blood supply*; D016893:Carotid Stenosis / Q000503:physiopathology / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003287:Contrast Media / Q000008:administration & dosage*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods*; D016894:Endarterectomy, Carotid; D005260:Female; D005682:Gadolinium; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011699:Putamen / Q000098:blood supply; D013003:Somatosensory Cortex / Q000098:blood supply; D013223:Statistics as Topic
chemical_list: D003287:Contrast Media; D005682:Gadolinium