Ultra-high field MR angiography in human migraine models: a 3.0 T/7.0 T comparison study

Casper Emil Christensen, Samaira Younis, Ulrich Lindberg, Vincent Oltman Boer, Patrick de Koning, Esben Thade Petersen, Olaf Bjarne Paulson, Henrik Bo Wiberg Larsson, Faisal Mohammad Amin, Messoud Ashina, Casper Emil Christensen, Samaira Younis, Ulrich Lindberg, Vincent Oltman Boer, Patrick de Koning, Esben Thade Petersen, Olaf Bjarne Paulson, Henrik Bo Wiberg Larsson, Faisal Mohammad Amin, Messoud Ashina

Abstract

Background: Sildenafil and calcitonin gene-related peptide both dilate the intradural segments of the middle meningeal artery measured with 3.0 tesla (T) MR angiography. Here we hypothesized that an increase in field strength to 7.0 T and concomitant enhanced voxel resolution would lower variance in measurements of dilation in the intradural middle meningeal artery.

Methods: Five subjects completed two sessions at respectively 3.0 T and 7.0 T. Each session comprised MR angiography scans once before and twice after administration of sildenafil, calcitonin gene-related peptide or placebo in a three-way, crossover, double-blind, placebo-controlled design.

Results: Standard deviations of arterial circumference revealed no difference between 3.0 T and 7.0 T measurements (p = 0.379). We found a decrease in standard deviation from our original angiography analysis software (QMra) to a newer (LAVA) software package (p < 0.001). Furthermore, we found that the dilation after sildenafil and calcitonin gene-related peptide were comparable between 3.0 T and 7.0 T.

Conclusions: Our findings suggest no gain from the increase in voxel resolution but cemented dilatory findings from earlier. The implemented software update improved variance in circumference measurements in the intradural middle meningeal artery, which should be exploited in future studies.

Trial registration: The study is part of a parent study, which is registered at ClinicalTrials.gov ( NCT03143465 ).

Keywords: Calcitonin gene-related peptide; Dura mater; Middle meningeal artery; Neurovascular; Sildenafil.

Conflict of interest statement

CEC/SY/UL/VOB/PDK/ETP/OBP/HBWL report no conflicts of interest pertaining to this work. FMA has received personal fees and/or honoraria for lecturing from Teva, Eli Lilly and Novartis. FMA is principal investigator for a Novartis Phase IV trial and member of advisory boards for Eli Lilly and Novartis.

MA is a consultant or scientific advisor for Allergan, Amgen, Alder, Eli Lilly, Novartis and Teva, principal investigator for Amgen 20120178 (Phase II), 20120295 (Phase II), 20130255 (Open label extension), 20120297 (Phase III), 20150308 (Phase II), ElectroCore GM-11 gamma-Core-R, TEVA TV48125-CNS- 30068 (Phase III), Novartis CAMG334A2301 (Phase III) and Alder PROMISE-2 (Phase III). MA has no ownership interest and does not hold stock in any pharmaceutical company. MA serves as associated editor of Cephalalgia and co-editor of the Journal of Headache and Pain.

Figures

Fig. 1
Fig. 1
Standard deviations of the intradural MMA measurements in the four analysis iterations. 7.0 T High Res: 7.0 T scan at full resolution; 7.0 T Low Res: 7.0 T scan resampled to 3.0 T resolution
Fig. 2
Fig. 2
Change in intradural MMA circumference over time after each of the three interventions. 3.0 T and 7.0 T data is depicted as mean ± SE, all data analyzed with LAVA software
Fig. 3
Fig. 3
Bland-Altmann plot depicting agreement between circumference measurements of intradural MMA 3.0 T vs 7.0 T within subject, within drug, within time point analyzed with LAVA software. Each point represents difference in circumference between 3.0 T and 7.0 T as a function of mean of the two measurements. Dashed lines are overall mean of differences ±2SD
Fig. 4
Fig. 4
Examples of the middle meningeal artery (arrow) in three different data sets. a: 3.0 T scan; b: 7.0 T scan at low resolution; c: 7.0 T scan at high resolution
Fig. 5
Fig. 5
Mean arterial blood pressure by time in the individual participants after each of the three interventions

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