Evidence map›Paper›PMID 42651196›Full record

ArticleBrain sciences2026

Identifying Diagnostic Thresholds for the Assessment of Cerebrovascular Reserve Impairment in Moyamoya Disease: CO

Patrick Haas, Lucas Moritz Wiggenhauser, Johannes Spang, Leonie Zerweck, Christian Volz, Marcos Tatagiba, Nadia Khan, Philipp T Meyer, Till-Karsten Hauser, Constantin Roder

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Article in Brain sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Patrick HaasDepartment of Neurosurgery and Moyamoya Center, University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.ORCID 0000-0001-7728-2091
Lucas Moritz WiggenhauserDepartment of Neurosurgery and Moyamoya Center, University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
Johannes SpangDepartment of Neurosurgery and Moyamoya Center, University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
Leonie ZerweckDepartment of Neuroradiology, University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.ORCID 0000-0003-4105-5131
Christian VolzDepartment of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany.
Marcos TatagibaDepartment of Neurosurgery and Moyamoya Center, University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
Nadia KhanDepartment of Neurosurgery and Moyamoya Center, University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
Philipp T MeyerDepartment of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany.ORCID 0000-0001-8336-750X
Till-Karsten HauserDepartment of Neuroradiology, University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.ORCID 0000-0001-7604-3419
Constantin RoderDepartment of Neurosurgery and Moyamoya Center, University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.ORCID 0000-0003-4487-2807

Funding

University of Tübingen (TÜFF program, 3067-0-0)
6 · The paper itself

Abstract

backgroundAssessment of cerebrovascular reserve capacity (CVRC) is central to treatment planning in adult Moyamoya disease. [

methodsThis retrospective diagnostic accuracy study compared bh-fMRI and PET-ACZ in 67 adult MMD patients (1072 ROIs across 402 supratentorial vascular territories) to determine correlation and clinically useful MRI thresholds for impaired cerebrovascular reserve. Data were analyzed using Pearson's correlation and ROC curves (STARD-compliant). Cerebellum-normalized percent signal change (CN-PSC) was referenced against PET-ACZ < 66% for pathological CVRC.

resultsSupratentorial territories showed strong correlation (r = 0.71, 95%CI 0.62-0.80). Optimal diagnostic threshold was <28.2% CN-PSC on bh-fMRI (Youden index; sensitivity 83.8%, specificity 80.9%, AUROC = 0.87); screening threshold < 60% CN-PSC yielded sensitivity 94.6% and NPV 91.1%. No patient factors (age, Suzuki stage, etc.) influenced agreement (univariate/multivariate analyses).

conclusionsBh-fMRI supplements PET-ACZ as a screening and diagnostic tool for cerebrovascular reserve impairment in adult MMD. PET remains the reference standard for confirmation, especially in intermediate or discordant cases, and the proposed thresholds (<30% CN-PSC: impaired CVRC; 30-60%: confirm with PET-ACZ; >60%: monitor) require prospective validation before routine decision-making use.

Indexed as

cerebral revascularizationcerebrovascular reserveEC-IC BypassMoyamoya disease

Identifiers

PMID42651196
PMCPMC13510470

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