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Research ArticleNeurovascular/Stroke Imaging
Open Access

Assessing Perfusion in Steno-Occlusive Cerebrovascular Disease Using Transient Hypoxia-Induced Deoxyhemoglobin as a Dynamic Susceptibility Contrast Agent

Ece Su Sayin, James Duffin, Vittorio Stumpo, Jacopo Bellomo, Marco Piccirelli, Julien Poublanc, Vepeson Wijeya, Andrea Para, Athina Pangalu, Andrea Bink, Bence Nemeth, Zsolt Kulcsar, David J. Mikulis, Joseph A. Fisher, Olivia Sobczyk and Jorn Fierstra
American Journal of Neuroradiology January 2024, 45 (1) 37-43; DOI: https://doi.org/10.3174/ajnr.A8068
Ece Su Sayin
aFrom the Department of Physiology (E.S.S., J.D., J.A.F.), University of Toronto, Toronto, Ontario, Canada
cJoint Department of Medical Imaging and the Functional Neuroimaging Lab (E.S.S., J.P., V.W., A. Para, D.J.M., O.S.), University Health Network, Toronto, Ontario, Canada
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  • ORCID record for Ece Su Sayin
James Duffin
aFrom the Department of Physiology (E.S.S., J.D., J.A.F.), University of Toronto, Toronto, Ontario, Canada
dDepartment of Anesthesia and Pain Management (J.D., J.A.F.), University Health Network, University of Toronto, Toronto, Ontario, Canada
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Vittorio Stumpo
eDepartment of Neurosurgery (V.S., J.B. J.F.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Jacopo Bellomo
eDepartment of Neurosurgery (V.S., J.B. J.F.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Marco Piccirelli
fDepartment of Neuroradiology and Clinical Neuroscience Center (M.P., A. Pangalu, A.B., B.N., Z.K.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Julien Poublanc
cJoint Department of Medical Imaging and the Functional Neuroimaging Lab (E.S.S., J.P., V.W., A. Para, D.J.M., O.S.), University Health Network, Toronto, Ontario, Canada
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Vepeson Wijeya
cJoint Department of Medical Imaging and the Functional Neuroimaging Lab (E.S.S., J.P., V.W., A. Para, D.J.M., O.S.), University Health Network, Toronto, Ontario, Canada
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  • ORCID record for Vepeson Wijeya
Andrea Para
cJoint Department of Medical Imaging and the Functional Neuroimaging Lab (E.S.S., J.P., V.W., A. Para, D.J.M., O.S.), University Health Network, Toronto, Ontario, Canada
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Athina Pangalu
fDepartment of Neuroradiology and Clinical Neuroscience Center (M.P., A. Pangalu, A.B., B.N., Z.K.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Andrea Bink
fDepartment of Neuroradiology and Clinical Neuroscience Center (M.P., A. Pangalu, A.B., B.N., Z.K.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Bence Nemeth
fDepartment of Neuroradiology and Clinical Neuroscience Center (M.P., A. Pangalu, A.B., B.N., Z.K.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Zsolt Kulcsar
fDepartment of Neuroradiology and Clinical Neuroscience Center (M.P., A. Pangalu, A.B., B.N., Z.K.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
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David J. Mikulis
bDepartment of Medical Biophysics (D.J.M.), University of Toronto, Toronto, Ontario, Canada.
cJoint Department of Medical Imaging and the Functional Neuroimaging Lab (E.S.S., J.P., V.W., A. Para, D.J.M., O.S.), University Health Network, Toronto, Ontario, Canada
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Joseph A. Fisher
aFrom the Department of Physiology (E.S.S., J.D., J.A.F.), University of Toronto, Toronto, Ontario, Canada
dDepartment of Anesthesia and Pain Management (J.D., J.A.F.), University Health Network, University of Toronto, Toronto, Ontario, Canada
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Olivia Sobczyk
cJoint Department of Medical Imaging and the Functional Neuroimaging Lab (E.S.S., J.P., V.W., A. Para, D.J.M., O.S.), University Health Network, Toronto, Ontario, Canada
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Jorn Fierstra
eDepartment of Neurosurgery (V.S., J.B. J.F.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
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  • FIG 1.
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    FIG 1.

    The 2 BOLD signal (a.u.) waveforms in a voxel over the MCA versus time in a representative participant for Thx-dOHb (A) and GBCA (B). A.u. indicates arbitrary units.

  • FIG 2.
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    FIG 2.

    Bland-Altman plots comparing GBCA and THx-dOHb differences for perfusion metrics MTT, rCBF, and rCBV in GM and WM. The solid blue line depicts the mean, the dotted blue lines represent the 95% limits of agreement, and the red line represents the regression line.

  • FIG 3.
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    FIG 3.

    The affected-versus-nonaffected hemispheric perfusion metrics for GBCA and THx-dOHb for 8 participants who have unilateral steno-occlusive disease (patients 6 and 7 have bilateral disease and were excluded) in the MCA in the GM (on the right) and WM (on the left). The trends of affected-versus-unaffected hemispheres across both techniques are comparable. a.u. indicates arbitrary units.

  • FIG 4.
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    FIG 4.

    Perfusion maps of MTT, rCBF, and rCBV of a 71-year-old male participant (ID 1) with a right ICA occlusion comparing GBCA (A) and THx-dOHb (B). a.u. indicates arbitrary units.

Tables

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  • Average measures of ΔS in percentages and the CNR calculated for GBCA and THx-dOHb for the 10 participants

    ΔS (%)CNR
    GMWMGMWM
    GBCA25.20 (SD, 8.08)14.78 (SD, 4.36)11.21 (SD, 3.76)8.17 (SD, 2.64)
    THx-dOHb5.71 (SD, 1.60)2.87 (SD, 0.92)6.33 (SD, 1.22)6.41 (SD, 1.64)
    P value.002.002.004.002
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American Journal of Neuroradiology: 45 (1)
American Journal of Neuroradiology
Vol. 45, Issue 1
1 Jan 2024
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Cite this article
Ece Su Sayin, James Duffin, Vittorio Stumpo, Jacopo Bellomo, Marco Piccirelli, Julien Poublanc, Vepeson Wijeya, Andrea Para, Athina Pangalu, Andrea Bink, Bence Nemeth, Zsolt Kulcsar, David J. Mikulis, Joseph A. Fisher, Olivia Sobczyk, Jorn Fierstra
Assessing Perfusion in Steno-Occlusive Cerebrovascular Disease Using Transient Hypoxia-Induced Deoxyhemoglobin as a Dynamic Susceptibility Contrast Agent
American Journal of Neuroradiology Jan 2024, 45 (1) 37-43; DOI: 10.3174/ajnr.A8068

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Assessing Perfusion in Cerebrovascular Disease
Ece Su Sayin, James Duffin, Vittorio Stumpo, Jacopo Bellomo, Marco Piccirelli, Julien Poublanc, Vepeson Wijeya, Andrea Para, Athina Pangalu, Andrea Bink, Bence Nemeth, Zsolt Kulcsar, David J. Mikulis, Joseph A. Fisher, Olivia Sobczyk, Jorn Fierstra
American Journal of Neuroradiology Jan 2024, 45 (1) 37-43; DOI: 10.3174/ajnr.A8068
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  • Transient deoxyhemoglobin formation as a contrast for perfusion MRI studies in patients with brain tumors: a feasibility study
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    Frontiers in Physiology 2024 15
  • Cerebral perfusion metrics calculated directly from a hypoxia-induced step change in deoxyhemoglobin
    James Duffin, Ece Su Sayin, Olivia Sobczyk, Julien Poublanc, David J. Mikulis, Joseph A. Fisher
    Scientific Reports 2024 14 1

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