Abstract
The current generation of calibrated MRI methods goes beyond simple localization of task-related responses to allow the mapping of resting-state cerebral metabolic rate of oxygen (CMRO2) in micromolar units and estimation of oxygen extraction fraction (OEF). Prior to the adoption of such techniques in neuroscience research applications, knowledge about the precision and accuracy of absolute estimates of CMRO2 and OEF is crucial and remains unexplored to this day. In this study, we addressed the question of methodological precision by assessing the regional inter-subject variance and intra-subject reproducibility of the BOLD calibration parameter M, OEF, O2 delivery and absolute CMRO2 estimates derived from a state-of-the-art calibrated BOLD technique, the QUantitative O2 (QUO2) approach. We acquired simultaneous measurements of CBF and R2* at rest and during periods of hypercapnia (HC) and hyperoxia (HO) on two separate scan sessions within 24 hours using a clinical 3 T MRI scanner. Maps of M, OEF, oxygen delivery and CMRO2, were estimated from the measured end-tidal O2, CBF0, CBFHC/HO and R2*HC/HO. Variability was assessed by computing the between-subject coefficients of variation (bwCV) and within-subject CV (wsCV) in seven ROIs. All tests GM-averaged values of CBF0, M, OEF, O2 delivery and CMRO2 were: 49.5 ± 6.4 mL/100 g/min, 4.69 ± 0.91%, 0.37 ± 0.06, 377 ± 51 μmol/100 g/min and 143 ± 34 μmol/100 g/min respectively. The variability of parameter estimates was found to be the lowest when averaged throughout all GM, with general trends toward higher CVs when averaged over smaller regions. Among the MRI measurements, the most reproducible across scans was R2*0 (wsCVGM = 0.33%) along with CBF0 (wsCVGM = 3.88%) and R2*HC (wsCVGM = 6.7%). CBFHC and R2*HO were found to have a higher intra-subject variability (wsCVGM = 22.4% and wsCVGM = 16% respectively), which is likely due to propagation of random measurement errors, especially for CBFHC due to the low contrast-to-noise ratio intrinsic to ASL. Reproducibility of the QUO2 derived estimates were computed, yielding a GM intra-subject reproducibility of 3.87% for O2 delivery, 16.8% for the M value, 13.6% for OEF and 15.2% for CMRO2. Although these results focus on the precision of the QUO2 method, rather than the accuracy, the information will be useful for calculation of statistical power in future validation studies and ultimately for research applications of the method. The higher test-retest variability for the more extensively modeled parameters (M, OEF, and CMRO2) highlights the need for further improvement of acquisition methods to reduce noise levels.
Highlights
Mapping of resting metabolism in the brain is of considerable interest for diagnostic and research applications
The approach proposed by our team, Quantitative O2 (QUO2) magnetic resonance imaging (MRI) is based on respiratory calibration of the BOLD signal, in which the oxygen extraction fraction (OEF) at rest is determined using hypercapnia (HC) and hyperoxia (HO)
end-tidal O2 (ETO2), BOLD and cerebral blood flow (CBF) serve as inputs to the generalized calibration model (GCM) described in Gauthier and Hoge [5], which yields a system of two equations with solutions for the BOLD calibration parameter M, i.e. the maximum BOLD signal increase when venous O2 saturation approaches 100%, and resting OEF
Summary
Mapping of resting metabolism in the brain is of considerable interest for diagnostic and research applications. Positron emission tomography (PET) using a triple injection of radio-labeled O2 was the only imaging method for measuring cerebral metabolic rate of O2 consumption (CMRO2) [1]. The PET method requires exposure to ionizing radiation, arterial sampling, and access to an on-site cyclotron to produce the short-lived 15O-labeled tracers, limitations that have led to the development of magnetic resonance imaging (MRI) techniques to measure O2 consumption [2,3,4]. The approach proposed by our team, Quantitative O2 (QUO2) MRI is based on respiratory calibration of the BOLD signal, in which the oxygen extraction fraction (OEF) at rest is determined using hypercapnia (HC) and hyperoxia (HO). Multiplication of OEF by baseline CBF and arterial O2 content (estimated from ETO2 monitoring and, optionally, blood testing) gives resting CMRO2 in absolute units, e.g. μmol/100 g/min
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