TY - JOUR T1 - Comparison of Quantitative Cerebral Blood Flow Measurements Performed by Bookend Dynamic Susceptibility Contrast and Arterial Spin-Labeling MRI in Relapsing-Remitting Multiple Sclerosis JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 2265 LP - 2272 DO - 10.3174/ajnr.A4939 VL - 37 IS - 12 AU - R.M. D'Ortenzio AU - S.P. Hojjat AU - R. Vitorino AU - C.G. Cantrell AU - L. Lee AU - A. Feinstein AU - P. O'Connor AU - T.J. Carroll AU - R.I. Aviv Y1 - 2016/12/01 UR - http://www.ajnr.org/content/37/12/2265.abstract N2 - BACKGROUND AND PURPOSE: Quantitative CBF usage as a biomarker for cognitive impairment and disease progression in MS is potentially a powerful tool for longitudinal patient monitoring. Dynamic susceptibility contrast perfusion with bookend T1-calibration (bookend technique) and pseudocontinuous arterial spin-labeling have recently been used for CBF quantification in relapsing-remitting MS. The noninvasive nature of pseudocontinuous arterial spin-labeling is advantageous over gadolinium-based techniques, but correlation between the techniques is not well-established in the context of MS.MATERIALS AND METHODS: We compared pseudocontinuous arterial spin-labeling CBF with the bookend technique in a prospective cohort of 19 healthy controls, 19 subjects with relapsing-remitting MS without cognitive impairment, and 20 subjects with relapsing-remitting MS with cognitive impairment on a voxelwise and Brodmann region basis. The linear Pearson correlation, SNR, and coefficient of variation were quantified.RESULTS: Voxelwise paired t tests revealed no significant CBF differences between techniques after normalization of global mean intensities. The highest Pearson correlations were observed in deep GM structures (average r = 0.71 for the basal ganglia and r = 0.65 for the thalamus) but remained robust for cortical GM, WM, and white matter lesions (average r = 0.51, 0.53, 0.54, respectively). Lower Pearson correlations were observed for cortical lesions (average r = 0.23). Brodmann region correlations were significant for all groups. All correlations were maintained in healthy controls and in patients with relapsing-remitting multiple sclerosis. The highest SNR was present in bookend perfusion, while the highest coefficient of variation was present in white matter lesions.CONCLUSIONS: Agreement between pseudocontinuous arterial spin-labeling and bookend technique CBF measurements is demonstrated in healthy controls and patients with relapsing-remitting MS.BGbasal gangliaCLcortical lesionCVcoefficient of variationHChealthy controlspCASLpseudocontinuous arterial spin-labelingRRMSrelapsing-remitting MSRRMS-IRRMS with cognitive impairment cohortRRMS-NIRRMS not cognitively impaired cohortTHthalamusWMLwhite matter lesion ER -