• Junghun Cho, Pascal Spincemaille, Thanh D Nguyen, Ajay Gupta, and Yi Wang.
• Department of Radiology, Weill Cornell Medical College, New York, New York, USA.
• Magn Reson Med. 2021 Nov 1; 86 (5): 2635-2646.

PurposeTo improve the accuracy of quantitative susceptibility mapping plus quantitative blood oxygen level-dependent magnitude (QSM+qBOLD or QQ) based mapping of oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2 ) using temporal clustering, tissue composition, and total variation (CCTV).MethodsThree-dimensional multi-echo gradient echo and arterial spin labeling images were acquired from 11 healthy subjects and 33 ischemic stroke patients. Diffusion-weighted imaging (DWI) was also obtained from patients. The CCTV mapping was developed for incorporating tissue-type information into clustering of the previous cluster analysis of time evolution (CAT) and applying total variation (TV). The QQ-based OEF and CMRO2 were reconstructed with CAT, CAT+TV (CATV), and the proposed CCTV, and results were compared using region-of-interest analysis, Kruskal-Wallis test, and post hoc Wilcoxson rank sum test.ResultsIn simulation, CCTV provided more accurate and precise OEF than CAT or CATV. In healthy subjects, QQ-based OEF was less noisy and more uniform with CCTV than CAT. In subacute stroke patients, OEF with CCTV had a greater contrast-to-noise ratio between DWI-defined lesions and the unaffected contralateral side than with CAT or CATV: 1.9 ± 1.3 versus 1.1 ± 0.7 (P = .01) versus 0.7 ± 0.5 (P < .001).ConclusionThe CCTV mapping significantly improves the robustness of QQ-based OEF against noise.© 2021 International Society for Magnetic Resonance in Medicine.

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