Sensitivity assessment of QSM+qBOLD (or QQ) in detecting elevated oxygen extraction fraction (OEF) in physiological change

The study investigated the sensitivity of a novel MRI-based OEF mapping, quantitative susceptibility mapping plus quantitative blood oxygen level-dependent imaging (QSM+qBOLD or QQ), to physiological changes, particularly increased oxygen extraction fraction (OEF) by using hyperventilation as a vasoconstrictive stimulus. While QQ's sensitivity to decreased OEF during hypercapnia has been demonstrated, its sensitivity to increased OEF levels, crucial for cerebrovascular disorders like vascular dementia and Parkinson's disease, remains unexplored. In comparison with a previous QSM-based OEF, we evaluated QQ's sensitivity to high OEF values. MRI data were obtained from 11 healthy subjects during resting state (RS) and hyperventilation state (HV) using a 3 T MRI with a three-dimensional multi-echo gradient echo sequence (mGRE) and arterial spin labeling (ASL). Region of interest (ROI) analysis and paired t-tests were used to compare OEF, CMRO₂ and CBF between QQ and QSM. Similar to QSM, QQ showed higher OEF during HV compared to RS: in cortical gray matter, QQ-OEF and QSM-OEF was 36.4<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mo> </mml:mo><mml:mo>±</mml:mo><mml:mo> </mml:mo></mml:math>4.7% and 35.3<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mo> </mml:mo><mml:mo>±</mml:mo><mml:mo> </mml:mo></mml:math>12.5% at RS and 45.0<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mo> </mml:mo><mml:mo>±</mml:mo><mml:mo> </mml:mo></mml:math>11.6% and 45.0<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mo> </mml:mo><mml:mo>±</mml:mo><mml:mo> </mml:mo></mml:math>14.8% in HV, respectively. These findings demonstrate QQ's ability to detect physiological changes and suggest its potential in studying brain metabolism in neurological disorders.