Yuhan Ma1, Hongfu Sun2, Junghun Cho3,4, Erin L. Mazerolle2, Yi Wang3,4, and G. Bruce Pike1,2
1McConnell Brain Imaging Centre and Department of Biomedical Engineering, McGill University, Montreal, QC, Canada, 2Hotchkiss Brain Institute and Department of Radiology, University of Calgary, Calgary, AB, Canada, 3Department of Biomedical Engineering, Cornell University, Ithaca, NY, United States, 4Department of Radiology, Weill Cornell Medical College, New York, NY, United States
Synopsis
The microvascular QSM approach for quantifying baseline brain oxygen
metabolism has great potential due to its simple set-up and high spatial
resolution. In this study,
we aim to investigate the feasibility of the high SNR microvascular QSM-OEF
technique with a hypercapnia gas challenge and compare OEF and CMRO2 measured by QSM-OEF with those measured using
the dual-gas calibrated BOLD technique (DGC-BOLD-OEF), a reference standard.
Baseline OEF and CMRO2 measured by hypercapnia QSM-OEF were
found within the expected normal range for healthy subjects. Statistically
significant but relatively small differences (5% difference) of OEF and CMRO2
were found between QSM-OEF and DGC-BOLD-OEF techniques.
Purpose
The microvascular QSM
approach for quantifying brain oxygen metabolism has great potential due to its
simple set-up and high spatial resolution. Previous studies using caffeine and
hyperventilation as stimuli were successful in quantifying OEF using QSM.1,2 QSM-OEF is yet to be compared with the calibrated
BOLD based reference standard. Therefore, this study aims to compare QSM-OEF with the dual-gas calibrated (DGC) BOLD-OEF.
We further investigate the feasibility of the microvascular QSM-OEF
technique of high SNR using a quantitative hypercapnia gas challenge that
overcomes the lack of quantitative control in the reported caffeine and hyperventilation induced
vasoconstrictions.Methods
All experiments were performed on a Siemens Tim
Trio 3 T scanner with a 32-channel RF receiver head coil. Ten healthy subjects
(five female, average age 29±5 yo) were scanned. A 3D T1-weighted 1
mm3 anatomical volume was acquired using MPRAGE. A 3D multi-echo flow-compensated
gradient echo (GRE) sequence was used (TR= 32 ms; 7 TEs, TE1= 4.6 ms, Echo spacing=4.06 ms; voxel size =
1 x 1 x 1 mm3; FA = 20 degrees; GRAPPA=2, Bandwidth= 977 Hz/pixel, monopolar readout, TA=5
mins 40 seconds)
to generate QSM at baseline and hypercapnia. Hypercapnia was achieved using a
RespirAct (Thornhill Research Inc., Toronto, ON, Canada) to target partial
pressure of end-tidal CO2 (Pet CO2) to 7 mmHg above the
participant’s baseline for 6 mins. Calibrated BOLD data were collected using an
EPI dual-echo pseudo-continuous arterial spin labeling (pCASL) sequence (TR/TE1/TE2
= 4000/10/30 ms, label duration/post-label delay = 1665/900 ms, 3.9 mm3
isotropic voxels, GRAPPA = 2, and descending acquisition order) under a
baseline condition, a hypercapnic challenge condition (Pet CO2 = +7 mmHg), and a hyperoxic condition (PetO2 = +300 mmHg) for
quantifying resting CBF and OEF.
QSM was reconstructed
using a novel least-norm direct dipole inversion method without the background
field removal step.3 Microvascular OEF values at both baseline and
hypercapnic states were calculated according to Zhang et al. 2 except that a hypercapnic
challenge was used and CMRO2 was assumed to remain unchanged.4 DGC-BOLD data were analyzed using the stepwise
approach for baseline OEF calculation 5: the calibration
parameter M was calculated based on the deoxyhemoglobin dilution model with a
hypercapnia challenge, 6,7 following which OEF can be calculated from the dHb
concentration changes with a hyperoxic challenge.
Comparisons of
OEF maps from the microvascular QSM and DGC-BOLD methods were performed in
vascular territory grey matter (GM) ROIs. Eight vascular territories including
anterior (A), middle (M1-M6), and posterior (P) vascular territories were
automatically segmented using an atlas, 8 which were
subsequently divided into left and right hemispheres, yielding a total of
sixteen ROIs.
Results
The voxel-wise maps and ROI averages of OEF and
CMRO2 as quantified from the microvascular QSM technique for each
subject are shown in Figure 1. The ROI average OEF and CMRO2
of all 10 subjects measured by QSM-OEF were 0.40 ± 0.04 and 176 ± 35 μmol O2/min/100g,
respectively. DGC-BOLD results are shown in Figure
2. The ROI average OEF and CMRO2 of all 10
subjects measured by DGC-BOLD were 0.38 ± 0.09 and 167 ± 53 μmol O2/min/100g. The voxel-wise average DGC-OEF map from all
subjects, registered to standard space shows slightly lower values than the
average QSM-OEF map (Figure
3). OEF values from the sixteen vascular
territories quantified in all subjects using both techniques were quantitatively
assessed by Bland-Altman analysis (Figure
4). Statistically significant differences of OEF
and CMRO2 values were found between QSM-OEF and DGC-BOLD-OEF mappings
(P < 0.05). However, the differences between the two methods were relatively
small (mean OEF difference = 0.02, mean CMRO2 difference = 9 μmol O2/min/100g).
Discussions and Conclusions
The employment of a hypercapnic challenge in
combination with QSM is able to quantify baseline OEF and CMRO2
with high SNR in different brain regions within the expected normal range for healthy
subjects. QSM-OEF and DGC-BOLD-OEF in cerebral vascular regions were statistically
different, as revealed by the Bland-Altman analysis. However, the differences
were small when all 10 subjects were considered (relative difference = 5%). In
addition, compared with DGC-BOLD-OEF experiments, QSM-OEF measurements resulted in smaller variance in regional OEF values and could be more favorable in
applications that are sensitive to small OEF changes. Furthermore,
compared to the dual challenges required by the DGC-BOLD technique, QSM-OEF involves
only one challenge, or no challenge when combined with qBOLD, 9 resulting in a shorter scan time.Acknowledgements
The authors gratefully acknowledge the assistance of Raphael Paquin (Siemens) in setting up the flow-compensated gradient-echo sequence. Thanks are extended to Isabelle Lajoie, Jingwei Zhang, Avery Berman, Rebecca Williams, Matthew Ethan MacDonald, and Ilana Leppert for their insightful discussions.References
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