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- Title
A PET-Guided Framework Supports a Multiple Arterial Input Functions Approach in DSC-MRI in Acute Stroke.
- Authors
Livne, Michelle; Madai, Vince I.; Brunecker, Peter; Zaro‐Weber, Olivier; Moeller‐Hartmann, Walter; Heiss, Wolf‐Dieter; Mouridsen, Kim; Sobesky, Jan; Zaro-Weber, Olivier; Moeller-Hartmann, Walter; Heiss, Wolf-Dieter
- Abstract
<bold>Background and Purpose: </bold>In acute stroke, arterial-input-function (AIF) determination is essential for obtaining perfusion estimates with dynamic susceptibility-weighted contrast-enhanced magnetic resonance imaging (DSC-MRI). Standard DSC-MRI postprocessing applies single AIF selection, ie, global AIF. Physiological considerations, however, suggest that a multiple AIFs selection method would improve perfusion estimates to detect penumbral flow. In this study, we developed a framework based on comparable DSC-MRI and positron emission tomography (PET) images to compare the two AIF selection approaches and assess their performance in penumbral flow detection in acute stroke.<bold>Methods: </bold>In a retrospective analysis of 17 sub(acute) stroke patients with consecutive MRI and PET scans, voxel-wise optimized AIFs were calculated based on the kinetic model as derived from both imaging modalities. Perfusion maps were calculated based on the optimized-AIF using two methodologies: (1) Global AIF and (2) multiple AIFs as identified by cluster analysis. Performance of penumbral-flow detection was tested by receiver-operating characteristics (ROC) curve analysis, ie, the area under the curve (AUC).<bold>Results: </bold>Large variation of optimized AIFs across brain voxels demonstrated that there is no optimal single AIF. Subsequently, the multiple-AIF method (AUC range over all maps: .82-.90) outperformed the global AIF methodology (AUC .72-.85) significantly.<bold>Conclusions: </bold>We provide PET imaging-based evidence that a multiple AIF methodology is beneficial for penumbral flow detection in comparison with the standard global AIF methodology in acute stroke.
- Subjects
CONTRAST-enhanced magnetic resonance imaging; POSITRON emission tomography; ARTERIAL physiology; PERFUSION; FLUID flow; STROKE patients
- Publication
Journal of Neuroimaging, 2017, Vol 27, Issue 5, p486
- ISSN
1051-2284
- Publication type
journal article
- DOI
10.1111/jon.12428