Cerebral perfusion metrics calculated directly, model-free, from a hypoxia-induced step change in deoxyhemoglobin

Dynamic susceptibility contrast (DSC) perfusion MRI measures blood flow metrics via application of a BOLD pulse sequence during transit of a gadolinium-based contrast agent (GBCA), We have previously shown that can also be performed using endogenous deoxyhemoglobin (dOHb) as a replacement for GBCA since dOHb also has the necessary paramagnetic properties similar to GBCA 1. Conventional analysis with these contrast agents includes deconvolution of an arterial input function (AIF) assuming a kinetic model. However, the immediate decrease in dOHb that occurs during reoxygenation from a transient hypoxia constitutes a step reduction in susceptibility that permits direct, model-free, calculation of relative resting perfusion metrics. The metrics from this step analysis for seven healthy volunteers were compared to those from a conventional analysis of GBCA and dOHb. Voxel- wise maps of mean transit time, and relative cerebral blood flow and cerebral blood volume, had a high spatial congruence for all three analyses and were similar in appearance to published maps. The time course of the T2*-weighted signal step response identifies both the arrival time, the distribution of the step increase in arterial oxygen saturation, SaO2, and the voxel filling phase. The analysis of a step change in dOHb during rapid reoxygenation is an alternative way of calculating perfusion metrics directly from measurements of the resulting T2*-weighted signal, avoiding the potential errors from the use of a kinetic model and requirement for selection of an AIF.