Test–retest reliability of arterial spin labelling for cerebral blood flow in older adults with small vessel disease

Author:

Binnie Lauren R.,Pauls Mathilde M. H.,Benjamin Philip,Dhillon Mohani-Preet K.,Betteridge Shai,Clarke Brian,Ghatala Rita,Hainsworth Fearghal A. H.,Howe Franklyn A.,Khan Usman,Kruuse Christina,Madigan Jeremy B.,Moynihan Barry,Patel Bhavini,Pereira Anthony C.,Rostrup Egill,Shtaya Anan B. Y.,Spilling Catherine A.,Trippier Sarah,Williams Rebecca,Isaacs Jeremy D.,Barrick Thomas R.,Hainsworth Atticus H.ORCID

Abstract

AbstractCerebral small vessel disease (SVD) is common in older people and is associated with lacunar stroke, white matter hyperintensities (WMH) and vascular cognitive impairment. Cerebral blood flow (CBF) is reduced in SVD, particularly within white matter.Here we quantified test–retest reliability in CBF measurements using pseudo-continuous arterial spin labelling (pCASL) in older adults with clinical and radiological evidence of SVD (N=54, mean (SD): 66.9 (8.7) years, 15 females/39 males). We generated whole-brain CBF maps on two visits at least 7 days apart (mean (SD): 20 (19), range 7-117 days).Test–retest reliability for CBF was high in all tissue types, with intra-class correlation coefficient [95%CI]: 0.758 [0.616, 0.852] for whole brain, 0.842 [0.743, 0.905] for total grey matter, 0.771 [0.636, 0.861] for deep grey matter (caudate-putamen and thalamus), 0.872 [0.790, 0.923] for normal-appearing white matter (NAWM) and 0.780 [0.650, 0.866] for WMH (all p<0.001). ANCOVA models indicated significant decline in CBF in total grey matter, deep grey matter and NAWM with increasing age and diastolic blood pressure (all p<0.001). CBF was lower in males relative to females (p=0.013 for total grey matter, p=0.004 for NAWM).We conclude that pCASL has high test–retest reliability as a quantitative measure of CBF in older adults with SVD. These findings support the use of pCASL in routine clinical imaging and as a clinical trial endpoint.All data come from the PASTIS trial, prospectively registered at: https://eudract.ema.europa.eu (2015-001235-20, registered 13/05/2015), http://www.clinicaltrials.gov (NCT02450253, registered 21/05/2015).

Funder

alzheimer's drug discovery foundation

uk alzheimer society

national institute for health research

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine,Neurology (clinical),General Neuroscience

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