Evaluating quantitative approaches to dynamic susceptibility contrast MRI among carotid endarterectomy patients

Authors

  • David E. Crane MS,

    1. Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
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  • Manus J. Donahue PhD,

    1. Departments of Radiology and Radiological Sciences, Psychiatry, and Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
    2. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
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  • Michael A. Chappell DPhil,

    1. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
    2. Institute of Biomedical Engineering, John Radcliffe Hospital, University of Oxford, Oxford, UK
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  • Ediri Sideso MD,

    1. Acute Stroke Programme, John Radcliffe Hospital, University of Oxford, Oxford, UK
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  • Ashok Handa MD,

    1. Nuffield Department of Surgery, John Radcliffe Hospital, University of Oxford, Oxford, UK
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  • James Kennedy MD,

    1. Acute Stroke Programme, John Radcliffe Hospital, University of Oxford, Oxford, UK
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  • Peter Jezzard PhD,

    1. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
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  • Bradley J. MacIntosh PhD

    Corresponding author
    1. Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
    2. Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
    • Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Research Institute, 2075 Bayview Ave., Rm. M6-180, Toronto, ON, M4N 3M5, Canada
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Abstract

Purpose:

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.

Materials and 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).

Conclusion:

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. J. Magn. Reson. Imaging 2013;37:936–943. © 2012 Wiley Periodicals, Inc.

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