title: Cerebrovascular occlusive disease: quantitative cerebral blood flow using dynamic susceptibility contrast mr imaging correlates with quantitative H2[15O] PET.
abstract: OBJECTIVE
  To compare quantitative values of cerebral blood flow (CBF) derived from dynamic susceptibility contrast (DSC) magnetic resonance (MR) imaging with reference standard positron emission tomography (PET) in patients with confirmed cerebrovascular occlusive disease.
  
  
  METHODS
  Local institutional review board approval and informed consent were obtained for a prospective study of 18 patients (six men, 12 women; age range, 28-71 years; mean age, 45 years ± 10.4 [standard deviation]) with angiographically confirmed Moyamoya (n = 8) or internal carotid artery occlusions (n = 10). DSC MR images and oxygen 15-labeled water (H(2)[(15)O]) PET images were acquired on the same day. DSC images were postprocessed to yield parametric images of CBF (in mL/100 g/min), coregistered, and analyzed using grid-based regions of interest. Mean values of CBF in each region of interest from MR imaging and PET data sets were compared. Correlations for each patient were determined and overall agreement between pooled MR imaging and PET CBF was reported using linear regression analysis and Bland-Altman plots.
  
  
  RESULTS
  Strong correlations (r(2) ≥ 0.55) were found between MR imaging and PET CBF values in all patients. Use of the bookend approach was found to underestimate CBF predictably across the patient cohort (mean slope, 0.82; standard deviation, 0.18; slope of aggregated data, 0.75). This allowed for a simple rescaling of MR imaging values producing strong agreement with PET values in the aggregated data (r(2) = 0.66; slope = 1.00; intercept = 0.00).
  
  
  CONCLUSIONS
  The data show that the bookend MR imaging technique produces similar results for quantitative CBF between DSC MR imaging and H(2)[(15)O] PET. Although MR-derived CBF underestimated PET-derived CBF, the patient-to-patient variability in the slopes of the linear MR and PET relationships was significantly smaller than a competing quantitation technique. As a result, the bookend technique appears to more predictably measure quantitative CBF in a clinical setting.
authors.affiliation: Department of Biomedical Engineering and Feinberg School of Medicine, Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611, USA.
authors.forename: Parmede
authors.initials: P
authors.lastname: Vakil
authors.forename: John J
authors.initials: JJ
authors.lastname: Lee
authors.forename: Jessy J
authors.initials: JJ
authors.lastname: Mouannes-Srour
authors.forename: Colin P
authors.initials: CP
authors.lastname: Derdeyn
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Carroll
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010104:Oxygen Radioisotopes; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014867:Water; D055815:Young Adult
chemical_list: D003287:Contrast Media; D010104:Oxygen Radioisotopes; D019275:Radiopharmaceuticals; D014867:Water; D019786:Gadolinium DTPA