BrainStat

Patrice Hervo
Adv Dev. manager
Premium MR team
GE Healthcare
 Overview
• BrainStat is an automated post-processing software that is designed to
process a time-series of MR images acquired in the brain.
• BrainStat depicts parametric images that are calculated from the image
intensity variations over time.
• This parametric images include:

Blood Volume (relative) Blood Flow (relative) Mean Transit Time Time To Peak
Measurement of signal intensity change
rCBV: integrated area
• Relative Blood Volume describes the blood of the signal intensity
volume of the cerebral capillaries and venules (not change
arteries) per cerebral tissue volume.

BV =  C (t )dt
0

• Relative Blood Flow quantifies the volume of

rCBF: ratio of the
arterial blood delivered to a given mass of tissue per integrated area to the time
unit time, thus representing instantaneous capillary
flow in tissue.
BV
BF =
MTT MTT: time from the
• Mean Transit Time measures the length of time a beginning of the
change of intensity
certain volume of bloods spends in the cerebral to the end of the

t
capillary circulation. intensity change
tC (t ) dt
MTT = t
t 0

t C (t )dt
0
• Time To Peak is inversely related to CBF in which TTP: time from the
reduction of blood flow results in an increase in the origin of the curve
to the maximum
time needed for the contrast to reach its peak in the
amplitude of the
perfuse volume of brain tissue signal intensity
change
New Features
• Automatic Arrival Time detection using curve
gradient and zero-crossing information Signal intensity curve
 -variate curve
• Gamma variate fitting:

C( t ) = DC + C p  e   (t - AT ) e - t - AT / 
 ( )
 
where
DC: Baseline signal
Cp: Peak concentration
 and : shape parameters

Advantages: Does not require AIF, no

deconvolution, reproducible, fast, robust, eliminates
recirculation effects;

Disadvantages: Semi-quantitative; does not provide

measure of absolute perfusion
BrainStat workflow
• Automatically opened when time course images selected and
Functool opened.
• Blood Volume and Blood Flow maps are immediately displayed.
• User is guided to set parameters for an optimal computation of the
functional maps.

Step 1 Step 2 Step 3 Step 4

Image registration: minimize Thresholds: Select range of Skip images: ignore phases Final settings: interactive
patient motion during scan signal to be processed before steady state is reached panel to modify parameters
settings in a “click”
 Additional tools
•BrainStat initially applies best-estimate window width and level values for the Blood Flow and
Blood Volume maps.
•Pressing the ‘w’ key causes the viewport to be triggered, resulting in a fresh recomputation of
the best-estimate width and level for that viewport.
• Pressing the ‘g’ key saves graphs as text file
•Graph data (Graph, Histogram or ROI list ) can be saved as screensave, TIFF or text file on hard
disk
•Selecting the Density ROI button, a ”density mask” region of interest can be created on the
views that is defined by a range of pixel values.

Density mask done on rCBV Density mask done on MTT

Relative quantification
Step5

• Mirror ROI creates an axis on the views,

then create ROIs that are mirrored relative
to this axis.
• Use the small squares at the two ends to
adjust the position of the axis of symmetry
on the views (typically adjusted to the mid-
sagittal-plane (MSP) of the brain)
• ROI statistics are automatically
displayed within the image viewport as DICOM SR report
value relative to the first ROI (active =
green) and expressed in percent of the
value of this ROI
• ROI statistics can be exported in a
DICOM SR report
Clinical Value
Published literature indicates that an area showing a
30%–40% decrease in CBF compared to the
unaffected side is an ischemic lesion that can be
salvaged, and an area showing a CBF decrease of
70%–80% or more will eventually become infarcted.
Brain Perfusion Haemodynamic maps

rCBV rCBF

Perfusion abnormality in the left

brain hemisphere (MCA
territory).
•Reduced Blood Volume and
Blood Flow (rCBV, rCBF) (red
arrow)
•TTP delay
•MTT increase
TTP MTT
Conclusion
• Automated post-processing for time-series of brain MR
images
• Calculates and automatically displays rCBV, rCBF, MTT, TTP
– Motion correction
– Automatic detection of contrast arrival
– Use of the gamma variate function
• Provides relative quantification to compare two regions of
interest that can be placed using an axis of symmetry in an
affected and unaffected area.
– DICOM report