Relating Cerebral Blood Flow to Structural & Functional Metrics in Typically Developing Children

Sample slices from the multivariate atlas used as a basis for neuro-anatomical comparison.

Purpose: To evaluate the relationships between cerebral blood flow and other magnetic resonance (MR) imaging based measures such as fractional anisotropy, magnetic transfer ratio, cortical thickness and mean resting state BOLD signal in typically developing children.

Methods: Eighty-eight children aged 7-17 underwent pseudo-continuous arterial spin-labeled perfusion MRI (pCASL) [1] examinations along with anatomical (T1), diffusion tensor (DTI), magnetic transfer (MT) and BOLD resting state functional MRI (rs-fMRI) examinations. For each imaging modality, the ANTs [2] toolkit was used to create a modality-specific template from a subset (n=30) of the subjects. For non-scalar modalities, derived scalar images were used for template building. For pCASL the mean CBF image was used; for DTI the average diffusion weighted image was used; for rs-fMRI the mean BOLD image was used; and for MT the M0 image was used. Each modality-specific template was then registered to the T1 template to obtain a single multi-modality template (MMT). The T1 component of the MMT was then brain-masked, labeled, and three-tissue segmented using the Atropos segmentation tool [2]. For each subject, each modality was aligned to the corresponding component of the MMT for brain-masking and labeling. Intra-subject registrations were then performed to align all modalities to each subject’s T1 image. To provide a basis for comparison, a scalar metric was derived for each image modality. For pCASL the mean CBF was calculated; for T1 images, the cortical thickness was measured using the DiRECT method; fractional anisotropy was calculated from the DTI; the magnetization transfer ratio (MTR) was calculated from the MT images; and mean BOLD signal was calculated from the resting state fMRI data.

Results: Regularized canonical correlation analysis, as implemented in the sscan tool [2], was used to identify the relationship between CBF and each of the additional modalities. The analysis of each modality type is restricted to the most informative tissue type for that modality. For CBF, rs-fMRI and cortical thickness, only values in gray matter are examined, while only values in white matter are examined for FA and MTR.

Discussion: To the best of our knowledge, this is the first study to simultaneously compare CBF to cortical thickness, fractional anisotropy, magnetization transfer ratio and mean resting BOLD signal in a single population. In doing so, we hope to gain insight regarding the degree to which CBF provides statistically unique information in relation to these additional MR imaging modalities. Additionally, the development of the framework for analyzing these modalities provides a basis for future studies to explore the relationship between CBF and network based measures of both structural and functional connectivity.

Conclusion: The relationship between cortical thickness and Mean CBF (R2=0.4777) was the strongest of the metrics examined. In white matter, the MTR (R2=0.3126)  was stronger than FA (R2=0.1462). The mean BOLD (R2=0.1414) metric was the weakest.

Poster PDF

Self link –


Longitudinal Reproducibility and Accuracy of Pseudo-Continuous Arterial Spin–labeled Perfusion MR Imaging in Typically Developing Children

Perfusion (top) and structural (bottom) templates calculated by using data from 22 subjects.

Purpose: To evaluate the longitudinal repeatability and accuracy of cerebral blood flow (CBF) measurements by using pseudo-continuous arterial spin–labeled (pCASL) perfusion magnetic resonance (MR) imaging in typically developing children.

Materials and Methods: Institutional review board approval with HIPAA compliance and informed consent were obtained. Twenty-two children aged 7–17 years underwent repeated pCASL examinations 2–4 weeks apart with a 3-T MR imager, along with in vivo blood T1 and arterial transit time measurements. Phase-contrast (PC) MR imaging was performed as the reference standard for global blood flow volume. Intraclass correlation coefficient (ICC) and within-subject coefficient of variation (wsCV) were used to evaluate accuracy and repeatability.

Results: The accuracy of pCASL against the reference standard of PC MR imaging increased on incorporating subjectwise in vivo blood T1 measurement (ICC: 0.32 vs 0.58). The ICC further increased to 0.65 by using a population-based model of blood T1. Additionally, CBF measurements with use of pCASL demonstrated a moderate to good level of longitudinal repeatability in whole brain (ICC = 0.61, wsCV = 15%), in gray matter (ICC = 0.65, wsCV = 14%), and across 16 brain regions (mean ICC = 0.55, wsCV = 17%). The mean arterial transit time was 1538 msec ± 123 (standard deviation) in the pediatric cohort studied, which showed an increasing trend with age (P = .043).

Conclusion: Incorporating developmental changes in blood T1 is important for improving the accuracy of pCASL CBF measurements in children and adolescents; the noninvasive nature, accuracy, and longitudinal repeatability should facilitate the use of pCASL perfusion MR imaging in neurodevelopmental studies.

Varsha Jain, BS, Jeffrey Duda, PhD, Brian Avants, PhD, Mariel Giannetta, BS, Sharon X. Xie, PhD, Timothy Roberts, PhD, John A. Detre, MD, Hallam Hurt, MD, Felix W. Wehrli, PhD and Danny J. J. Wang, PhD, MSCE. “Longitudinal Reproducibility and Accuracy of Pseudo-Continuous Arterial Spin–labeled Perfusion MR Imaging in Typically Developing Children,” Radiology 2010; 263:527-536.