title: Quantitative cerebral perfusion imaging in children and young adults with Moyamoya disease: comparison of arterial spin-labeling-MRI and H(2)[(15)O]-PET.
abstract: OBJECTIVE
  Cerebral perfusion assessment is important in the preoperative evaluation and postoperative follow-up of patients with Moyamoya disease. The objective of this study was to evaluate the correlation of quantitative CBF measurements performed with arterial spin-labeling-MR imaging and H2[(15)O]-PET in children and young adults with Moyamoya disease.
  
  
  METHODS
  Thirteen children and young adults (8 female patients; age, 9.7 ± 7.1 years; range, 1-23 years) with Moyamoya disease underwent cerebral perfusion imaging with H2[(15)O]-PET (Discovery STE PET/CT, 3D Fourier rebinning filtered back-projection, 128 × 128 × 47 matrix, 2.34 × 2.34 × 3.27 mm(3) voxel spacing) and arterial spin-labeling (3T scanner, 3D pulsed continuous arterial spin-labeling sequence, 32 axial sections, TR = 5.5 seconds, TE = 25 ms, FOV = 24 cm, 128 × 128 matrix, 1.875 × 1.875 × 5 mm(3) voxel spacing) within less than 2 weeks of each other. Perfusion of left and right anterior cerebral artery, MCA, and posterior cerebral artery territories was qualitatively assessed for arterial spin-labeling-MR imaging and H2[(15)O]-PET by 2 independent readers by use of a 3-point-Likert scale. Quantitative correlation of relative CBF with cerebellar normalization between arterial spin-labeling-MR imaging and H2[(15)O]-PET was evaluated in a volume-based approach for each vascular territory after 3D image coregistration.
  
  
  RESULTS
  Interreader agreement was good (κ = 0.67-0.69), and strong and significant correlations were found between arterial spin-labeling-MR imaging and H2[(15)O]-PET for both qualitative perfusion scoring (ρ = 0.77; P < .001) and quantitative perfusion assessment of relative CBF with cerebellar normalization (r = 0.67, P < .001).
  
  
  CONCLUSIONS
  In children and young adults with Moyamoya disease, quantitative evaluation of CBF is possible with the use of arterial spin-labeling-MR imaging without ionizing radiation or contrast injection with a good correlation to H2[(15)O]-PET after cerebellar normalization.
authors: From the Departments of Diagnostic Imaging (R. Goetti, R. Guggenberger, I.S.)Diagnostic and Interventional Radiology (R. Goetti, F.P.K., R. Guggenberger) robertpaul.goetti@usz.ch.
authors: R
authors: R
authors: Goetti
authors: Nuclear Medicine (G.W., F.P.K., A.B.).
authors: G
authors: G
authors: Warnock
authors: Diagnostic and Interventional Radiology (R. Goetti, F.P.K., R. Guggenberger)Nuclear Medicine (G.W., F.P.K., A.B.).
authors: F P
authors: FP
authors: Kuhn
authors: From the Departments of Diagnostic Imaging (R. Goetti, R. Guggenberger, I.S.)Diagnostic and Interventional Radiology (R. Goetti, F.P.K., R. Guggenberger).
authors: R
authors: R
authors: Guggenberger
authors: Center for MR Research (R.O.).
authors: R
authors: R
authors: O'Gorman
authors: Nuclear Medicine (G.W., F.P.K., A.B.).
authors: A
authors: A
authors: Buck
authors: the Moyamoya Center, Division of Neurosurgery, Department of Surgery (N.K.), University Children's Hospital Zurich, Zurich, Switzerland.
authors: N
authors: N
authors: Khan
authors: From the Departments of Diagnostic Imaging (R. Goetti, R. Guggenberger, I.S.).
authors: I
authors: I
authors: Scheer
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity; D002533:Cerebral Angiography / Q000379:methods; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D009072:Moyamoya Disease / Q000175:diagnosis* / Q000503:physiopathology*; D015588:Observer Variation; D010104:Oxygen Radioisotopes; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels; D014867:Water; D055815:Young Adult
chemical_list: D010104:Oxygen Radioisotopes; D019275:Radiopharmaceuticals; D013113:Spin Labels; D014867:Water