Vascular Territory Map
Dynamic angiography above the circle of Willis
Combined angiography and perfusion imaging: angiographic reconstruction
Combined angiography and perfusion imaging: perfusion reconstruction
Thomas Okell
Associate Professor
- Sir Henry Dale Fellow
- Head of Neurovascular Imaging
- WIN MRI Graduate Programme Director
My research focusses on the development of novel non-invasive MRI methods which visualise blood flowing through the arteries that feed the brain and the resulting perfusion of the brain tissue. Much of my initial research focussed on developing techniques which allow blood from individual feeding arteries to be followed through the vascular tree. In addition to providing information about the structural and functional status of each artery, these methods allow the assessment of "collateral blood flow". This is when the main feeding artery to a certain brain region becomes blocked or significantly narrowed, but the flow of blood from secondary arteries maintains perfusion in this brain region, preventing a significant stroke. The presence or absence of collateral flow can be important in deciding between potential treatment options in patients with arterial disease. These vessel-selective strategies also have applications in diseases where the arterial source of blood flow is important, such as tumours and arteriovenous malformations.
In my previous five year research fellowship from the Royal Academy of Engineering, I aimed to address one of the key downsides to these imaging techniques, which is that obtaining 3D time-resolved images of the arteries as well as maps of tissue perfusion is time-consuming, and therefore difficult to apply in a clinical setting. I designed a single scan which can track the flow of blood through the arteries, all the way into the tissue, thereby providing both sets of information at the same time. I used recently developed acquisition and image reconstruction methods to accelerate this process, allowing images to be acquired in a fraction of the time normally required.
I have recently been awarded a Sir Henry Dale Fellowship, jointly funded by the Wellcome Trust and the Royal Society, to develop new brain blood flow imaging methods using a powerful ultra-high field MRI scanner. There are a series of technical challenges to overcome to make these methods efficient and robust, but once these have been overcome, highly sensitive measurements of brain blood flow will be possible. I plan to use this improved sensitivity to obtain very high spatial and temporal resolution information, as well as examine blood flow to the white matter of the brain, which is extremely challenging using conventional scanners, but has relevance to a broad range of conditions, including dementia.
I will continue to trial existing techniques and new methods, as they emerge, in collaboration with clinical colleagues in a range of patient groups, including those with stroke, arteriovenous malformation and vascular cognitive impairment. I hope that this will show the potential utility of these techniques for understanding the progression of these diseases, and in the longer term help with diagnosis, prognosis and therapeutic planning in these patients.
Research groups
Recent publications
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Highly accelerated intracranial time-of-flight magnetic resonance angiography using wave-encoding.
Journal article
Ji Y. et al, (2023), Magn Reson Med
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Aerobic exercise increases brain vessel lumen size and blood flow in young adults with elevated blood pressure. Secondary analysis of the TEPHRA randomized clinical trial.
Journal article
Lapidaire W. et al, (2023), Neuroimage Clin, 37
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Optimization of 4D combined angiography and perfusion using radial imaging and arterial spin labeling.
Journal article
Okell TW. and Chiew M., (2022), Magn Reson Med
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Time-encoded pseudo-continuous arterial spin labeling: increasing SNR in ASL dynamic angiography
Journal article
Woods J. et al, (2022), Magnetic Resonance in Medicine
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Recent technical developments in ASL: A Review of the State of the Art
Journal article
Hernandez-Garcia L. et al, (2022), Magnetic Resonance in Medicine
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Quantitative chemical exchange saturation transfer imaging of nuclear overhauser effects in acute ischemic stroke.
Journal article
Msayib Y. et al, (2022), Magn Reson Med
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Reliability of multi-site UK Biobank MRI brain phenotypes for the assessment of neuropsychiatric complications of SARS-CoV-2 infection: The COVID-CNS travelling heads study.
Journal article
Duff E. et al, (2022), PLoS One, 17