Assessing and Improving the Reproducibility of Cerebrovascular Reactivity Evaluations in Healthy Subjects Using Short-Breath-Hold fMRI

• Published in: Diagnostics (Basel) Vol. 15; no. 15; p. 1946
• Main Authors: Renger, Emely, Hauser, Till-Karsten, Klose, Uwe, Ernemann, Ulrike, Zerweck, Leonie
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 03.08.2025; MDPI
• Subjects: breath-hold fMRI; cerebrovascular reactivity; Magnetic resonance imaging; Metabolism; Patient compliance; Patients; Physiology; Reproducibility; Scanners; short breath-hold periods; Veins & arteries; United States > US; breath-hold fMRI; cerebrovascular reactivity; short breath-hold periods; reproducibility
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics15151946

Background/Objectives: Cerebrovascular reactivity (CVR) is a key marker of cerebrovascular function, facilitating the early detection of neurovascular dysfunction. Breath-hold functional MRI (bh-fMRI) is a non-invasive method for assessing CVR. This study evaluates the reproducibility of bh-fMRI using short breath-hold periods, which are practical for clinical use. Methods: In a prospective study, 50 healthy subjects underwent three self-paced, end-expiration bh-fMRI sessions with 9 s breath-hold periods at 3T. A 30 min break between the second and third sessions was included. The reproducibility of the percentage signal change (PSC) in predefined volumes of interest for a ±0 s, ±3 s and ±6 s interval around the cerebellar peak (IAP)) was evaluated. The intraclass correlation coefficient (ICC) and the intra-personal coefficient of variation (CVintra) were calculated between the individual sessions. Results: This study demonstrated excellent reproducibility, with an ICC (2, k) for a ±0 s IAP across all sessions at 0.887 (95% CI: 0.882–0.892). The ICC values remained within an excellent range even when the participants left the scanner between sessions. The CVintra for the ±0 s IAP (14.54% ± 8.54%) remained below the 33% fiducial limit. A larger IAP revealed higher ICC values but higher CVintra values and lower PSC values. Conclusions: Bh-fMRI with 9 s breath-hold periods yields highly reproducible CVR assessments, supporting its feasibility for clinical implementation.