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Abstract #0354

Staging hemodynamic failure: BOLD fMRI cerebrovascular reactivity beats [15O]-H2O-PET.

Marco Piccirelli1, Christiaan van Niftrik2, Geoffrey Warnock3, Susanne Wegener4, Athina Pangalu1, Giuseppe Esposito2, Antonios Valavanis1, Alfred Buck5, Andreas Luft4, Oliver Bozinov2, Luca Regli2, and Jorn Fierstra2

1Neuroradiology, University Hospital Zurich, Zurich, Switzerland, 2Neurosurgery, University Hospital Zurich, Zurich, Switzerland, 3Pharmacology & Toxicology, University Hospital Zurich, Zurich, Switzerland, 4Neurology, University Hospital Zurich, Zurich, Switzerland, 5Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland

The actual gold standard stroke risk assessment is cerebral blood flow (CBF) measured with [15O]-H2O-PET, which is available only in few specialized centers and requires ~1mSv radioactive dose.

Otherwise, quantitative CVR measurements derived (with our temporal decomposition iterative algorithm) from Blood-Oxygen-Level-Dependent (BOLD) fMRI with CO2 challenge might apply as a surrogate imaging-marker for hemodynamic failure, as the <7 minutes acquisition can easily be clinically implemented, and has – as proved in this study – twice higher specificity*sensitivity for staging hemodynamic failure in chronic cerebrovascular steno-occlusive diseases than PET.

Therefore, BOLD CVR shall be widely implemented for assessing stroke risk.

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