Non-Invasive Perfusion MR Imaging of the Human Brain via Breath-Holding

Abstract

AbstractDynamic susceptibility contrast (DSC) MRI plays a pivotal role in the accurate diagnosis and prognosis of several neurovascular diseases, but the technique’s reliance on gadolinium, an intravascularly injected metal, presents a major limitation. Here, we determined the feasibility of using breath-holds to noninvasively induce DSC perfusion contrast. To achieve this, we acquired T2*-weighted MRI data at both 3T and 7T from ten healthy participants who engaged in eight consecutive breath-holds (16 s each separated by 44 s of rest). By pairing a novel arterial input function with a standard DSC MRI analysis, we successfully quantified essential perfusion parameters, including the cerebral blood volume, flow, and transit delay, and found these perfusion values to be congruent with those documented in the literature using gadolinium. Breath-holding resulted in significantly higher contrast-to-noise (6.2 at 3T vs 8.5 at 7T) and gray matter-to-white matter contrast at higher field strength. For the first time, we have demonstrated the feasibility of DSC using breath-holds—we are confident that this technique holds major promise, both clinically and in research, by being a safe alternative to invasive methods, particularly at ultra-high field strength.