Effect of blood T1 estimation strategy on arterial spin labeled cerebral blood flow quantification in children and young adults with kidney disease

Hua-Shan Liu; Abbas F Jawad; Nina Laney; Erum A Hartung; Susan L Furth; John A Detre

doi:10.1016/j.neurad.2018.03.002

Effect of blood T1 estimation strategy on arterial spin labeled cerebral blood flow quantification in children and young adults with kidney disease

J Neuroradiol. 2019 Feb;46(1):29-35. doi: 10.1016/j.neurad.2018.03.002. Epub 2018 Mar 28.

Authors

Hua-Shan Liu¹, Abbas F Jawad², Nina Laney³, Erum A Hartung⁴, Susan L Furth⁵, John A Detre⁶

Affiliations

¹ School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; International Ph.D. Program in Biomedical Engineering & Graduate Institute of Biomedical Optomechatronics, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Radiogenomic Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: HeatherLiu2016@gmail.com.
² Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. Electronic address: jawad@email.chop.edu.
³ Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: laneyn@email.chop.edu.
⁴ Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. Electronic address: hartunge@email.chop.edu.
⁵ Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, USA; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: furths@email.chop.edu.
⁶ Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. Electronic address: detre@mail.med.upenn.edu.

Abstract

Purpose: To compare blood T1 estimation approaches used for quantifying cerebral blood flow (CBF) with arterial spin labeled (ASL) perfusion MRI in a developmental cohort of chronic kidney disease (CKD) patients with anemia and a control group.

Methods: 61 patients with CKD and 47 age-matched control subjects were studied. Blood T1 approaches included: (1) a fixed value, (2) estimation based on measured hematocrit (Hct), and (3) estimation based on Age+Sex using a published formula. Resulting T1 and CBF values were compared along with group, age and sex effects.

Results: Highly significant group differences in CBF using fixed blood T1 were reduced when Hct-corrected blood T1 was used, and were eliminated entirely when using the Age+Sex estimated approach. In the control cohort, fixed T1 method showed the strongest correlations of CBF with age and sex. Hct-corrected T1 preserved a significant correlation between CBF and age and sex, while Age+Sex estimated T1 produced a poor fit of CBF with age and sex.

Conclusions: Blood T1 estimation method can confound the interpretation of CBF changes measured using ASL MRI in patients with CKD. Blood T1 should ideally be corrected for hematocrit effects in clinical populations with anemia.

Keywords: Anemia; Arterial spin labeling; Cerebral blood flow; Chronic kidney disease; T1 correction.

MeSH terms

Adolescent
Adult
Anemia / complications*
Anemia / physiopathology*
Case-Control Studies
Cerebrovascular Circulation / physiology*
Child
Female
Hematocrit
Humans
Image Interpretation, Computer-Assisted
Kidney Failure, Chronic / complications*
Kidney Failure, Chronic / physiopathology*
Magnetic Resonance Imaging / methods*
Male
Spin Labels
Young Adult

Substances

Spin Labels

Abstract

MeSH terms

Substances

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