Abstract #1348

Non-invasive segmentation of individual watershed areas allows detection of hemodynamic impairments in internal carotid artery stenosis

Gabriel Hoffmann^1,2, Christine Preibisch^1,2,3, Franziska Richter¹, Matthias JP van Osch^4,5, Lena Václavů⁴, Jan Kufer¹, Jannis Bodden¹, Michael Kallmayer⁶, Jens Göttler¹, Claus Zimmer^1,2, Stephan Kaczmarz^1,2,7, and Lena Schmitzer^1,2

¹School of Medicine and Health, Department of Neuroradiology, Technical University of Munich, Munich, Germany, ²School of Medicine and Health, TUM-Neuroimaging Center, Technical University of Munich, Munich, Germany, ³School of Medicine and Health, Clinic of Neurology, Technical University of Munich, Munich, Germany, ⁴C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, Netherlands, ⁵Leiden Institute of Brain and Cognition, Leiden University, Leiden, Netherlands, ⁶School of Medicine and Health, Department of Vascular and Endovascular Surgery, Technical University of Munich, Munich, Germany, ⁷Philips GmbH Market DACH, Hamburg, Germany

Synopsis

Keywords: Blood Vessels, Atherosclerosis, Vascular Territories

Motivation: Internal carotid artery stenosis (ICAS) accounts for ≈10% of strokes. Individual watershed areas (iWSA) are especially susceptible to hemodynamic impairments. Currently, iWSA are segmented from contrast agent-based time-to-peak (TTP), limiting applicability.

Goal(s): We aimed towards non-invasive iWSA segmentation based on arterial transit time (ATT) from Hadamard-encoded pseudo-continuous ASL.

Approach: Overlap of iWSA from ATT and TTP was investigated and agreement of extracted hemodynamic parameter values such as cerebrovascular reactivity (CVR) was evaluated and ICAS-induced parameter-lateralization was investigated.

Results: ATT-based and TTP-based iWSAs overlapped well, with excellent agreement in quantitative parameters and significant lateralization of hemodynamic parameters in ICAS within both iWSA delineation approaches.

Impact: We successfully segmented iWSA from non-invasive ATT and demonstrated sensitivity to ICAS-related impairments, in agreement with TTP-based iWSA segmentation. ATT-based iWSAs facilitate longitudinal investigation without contrast application in cerebrovascular diseases such as ICAS or Moyamoya.

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