Advancements in DSC and BOLD perfusion imaging: Acquisition, analysis and clinical application
Abstract
This thesis is focused on perfusion MRI techniques and topics related to image acquisition, analysis and clinical applications. The first half of the thesis is focused on dynamic susceptibility contrast (DSC) MRI, a technique which is based on the contrast enhancements caused by an intravenously administered paramagnetic contrast agent. The second half of this thesis is focused on blood oxygen level dependent (BOLD) MRI, which leverages a signal effect caused by paramagnetic properties of venous blood. For application in peripheral muscle, this signal effect can be enhanced by restricting the blood flow of a feeding artery to the studied tissue. In papers I and III, it is shown that the duration of the contrast agent injection and the duration of the flow restriction, indeed affects the measures of perfusion produced with these techniques.
The pathophysiology of normal pressure hydrocephalus (iNPH) is not completely understood, but symptoms point toward brain stem regions. In paper II, DSC-MRI and diffusion MRI was applied to patients with iNPH, pre and post shunt-surgery, showing the possible involvement of these regions in iNPH symptoms and disease reversibility.
In paper IV peripheral muscle BOLD was applied to patients with peripheral artery disease (PAD) and controls, in an exploratory study. Perfusion related measures derived from acquired BOLD curves were able to separate between PAD patients and controls, in accordance with previous studies. Further data exploration found a number of curve traits that could be indicative of potential disease phenotypes, and these have now been documented. As the technique continues to develop towards individual prognostication, these curve traits may be of value for establishing disease severity.
In conclusion, this work has made advancements of the common knowledge base within the field of perfusion imaging, spanning from the well-studied area of DSC-MRI to the comparatively new technique of peripheral muscle BOLD imaging and their application to clinically relevant patient cohorts.
Parts of work
I. Arvidsson, J., Starck, G., Lagerstrand, K., Ziegelitz, D., Jalnefjord, O. (2022). Effects of bolus injection duration on perfusion estimates in dynamic CT and dynamic susceptibility contrast MRI. Magnetic Resonance Materials in Physics, Biology and Medicine, 36, 95-106. https://doi.org/10.1007/s10334-022-01038-y II. Agerskov, S., Arvidsson, J., Ziegelitz, D., Lagerstrand, K., Starck, G., Björkman-Burtscher, I., Wikkelsö, C., Tullberg M. (2020). MRI diffusion and perfusion alterations in the mesencephalon and pons as markers of disease and symptom reversibility in idiopathic normal pressure hydrocephalus. PLOS ONE, 15 (10), 1-13. https://doi.org/10.1371/journal.pone.0240327 III. Arvidsson, J., Eriksson, S., Johansson, E., Lagerstrand K. (2023). Arterial occlusion duration affects the cuff-induced hyperemic response in skeletal muscle BOLD perfusion imaging as shown in young healthy subjects. Magnetic Resonance Materials in Physics, Biology and Medicine. https://doi.org/10.1007/s10334-023-01105-y IV. Arvidsson, J., Eriksson, S., Jalnefjord, O., Johansson, E., Nordanstig J., Lagerstrand K. Exploring the dynamics of ischemia and reactive hyperemia with skeletal muscle BOLD imaging in patients with peripheral artery disease, age matched controls and young healthy subjects. Manuscript
Degree
Doctor of Philosophy (Medicine)
University
University of Gothenburg. Sahlgrenska Academy
Institution
Institute of Clinical Sciences. Department of Radiation Physics
Disputation
Torsdagen den 23 november, kl. 13.00, Hörsal Arvid Carlsson, Academicum, Medicinaregatan 3, Göteborg
Date of defence
2023-11-23
jonathan.arvidsson@gu.se
Date
2023-10-31Author
Arvidsson, Jonathan
Keywords
Magnetic Resonance Imaging
Cerebral Blood Flow
Cerebral Blood Volume
Time To Peak
Biophysical modelling
Signal representation
MRI
Publication type
Doctoral thesis
ISBN
978-91-8069-403-2 (PRINT)
978-91-8069-404-9 (PDF)
Language
eng