Feasibility of multi-echo QSM to quantify cortical iron depositions hindering cognitive improvement in patients after carotid endarterectomy

Motivation: To clarify whether cortical magnetic susceptibility indicating iron deposition can affect cognitive improvement after revascularization to chronic ischemic patients. Goal(s): To determine whether preoperative cortical magnetic susceptibility quantified by QSM and changes in postoperative CBF are statistically associated with cognitive improvement after CEA. Approach: Preoperative QSM, pre- and post-operative brain perfusion SPECT and neuropsychological assessments are performed in patients undergoing CEA. After image normalization, magnetic susceptibility values and CBF were measured using the ROI templates. Results: Preoperative cortical magnetic susceptibility as well as postoperative changes in CBF are associated with cognitive improvement after CEA. Impact: The present study demonstrated that preoperative high cortical magnetic susceptibility adversely affects cognitive improvement after CEA and that preoperative QSM predicts patients who will not experience cognitive improvement after CEA.