A vascular-task response dependency and its application in functional imaging of brain tumors.
A vascular-task response dependency and its application in functional imaging of brain tumors.
复制标题
血管任务反应依赖性及其在脑肿瘤功能成像中的应用。
DOI：
10.1016/j.jneumeth.2019.04.004
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发表时间：
2019
影响因子：
3
通讯作者：
Holodny,AndreiI
中科院分区：
文献类型：
--
作者：
Voss,HenningU;Peck,KyungK;PetrovichBrennan,NicoleM;Pogosbekyan,EduardL;Zakharova,NataliaE;Batalov,ArtyomI;Pronin,IgorN;Potapov,AlexanderA;Holodny,AndreiI
目的术前功能性 MRI (fMRI) 受到血管反应性异常和由此导致的恶性脑肿瘤附近神经血管解偶联引起的 BOLD 反应减弱的限制。我们建议通过屏气独立评估血管反应性并将这些数据纳入功能磁共振成像分析来克服这一局限性，更准确地识别脑肿瘤附近的雄辩区域。方法在 16 名患者（9 名胶质母细胞瘤、1 名间变性星形细胞瘤、5 名低级别星形细胞瘤和 1 名转移瘤）和 6 名健康对照受试者中，确定了使用屏气范例的局部血管反应性，其时间与功能性运动和语言任务相同。我们基于观察到的血管任务反应依赖性得出了一个功能磁共振成像模型，该模型考虑了脑肿瘤附近血流动力学的改变。结果在健康对照和脑肿瘤受试者中，我们发现屏气和任务 BOLD 反应之间存在统计依赖性。在肿瘤受试者中，考虑到这种血管任务依赖性的激活图显示了具有临床意义的激活区域，而在大约一半的研究病例中，使用仅任务分析时未发现这些区域。这包括脑肿瘤附近语言区域的定位。结论目前的初步结果表明，已知影响脑肿瘤附近 BOLD fMRI 准确性的神经血管解偶联可以通过在 BOLD 信号分析中纳入观察到的血管任务依赖性至少部分地克服。
PurposePreoperative functional MRI (fMRI) is limited by a muted BOLD response caused by abnormal vasoreactivity and resultant neurovascular uncoupling adjacent to malignant brain tumors. We propose to overcome this limitation and more accurately identify eloquent areas adjacent to brain tumors by independently assessing vasoreactivity using breath-holding and incorporating these data into the fMRI analysis.MethodsLocal vasoreactivity using a breath-holding paradigm with the same timing as the functional motor and language tasks was determined in 16 patients (9 glioblastomas, 1 anaplastic astrocytoma, 5 low grade astrocytomas, and 1 metastasis) and 6 healthy control subjects. We derived an fMRI model based on an observed vaso-task response dependency that takes into account the altered hemodynamics adjacent to brain tumors.ResultsIn both healthy controls and brain tumor subjects, we found a statistical dependency between breath-hold and task BOLD response. In tumor subjects, activation maps that take into account this vaso-task dependency demonstrated clinically meaningful areas of activation that were not seen using the task-only analysis in about half of the cases studied. This included localization of language areas adjacent to brain tumors.ConclusionsThe present preliminary results demonstrate that neurovascular uncoupling known to affect the accuracy of BOLD fMRI adjacent to brain tumors may be, at least partially, overcome by incorporating an observed vaso-task dependency in the BOLD signal analysis.