Scientific publications
Recommendations for quantitative cerebral perfusion MRI using multi-timepoint arterial spin labeling: Acquisition, quantification, and clinical applications
Joseph G Woods 1 2 , Eric Achten 3 , Iris Asllani 4 5 , Divya S Bolar 2 , Weiying Dai 6 , John A Detre 7 , Audrey P Fan 8 9 , María A Fernández-Seara 10 11 , Xavier Golay 12 13 , Matthias Günther 14 15 , Jia Guo 16 , Luis Hernandez-Garcia 17 , Mai-Lan Ho 18 , Meher R Juttukonda 19 20 , Hanzhang Lu 21 , Bradley J MacIntosh 22 23 24 , Ananth J Madhuranthakam 25 , Henk-Jan Mutsaerts 26 27 , Thomas W Okell 1 , Laura M Parkes 28 29 , Nandor Pinter 30 31 , Joana Pinto 32 , Qin Qin 21 , Marion Smits 33 34 35 , Yuriko Suzuki 1 , David L Thomas 36 , Matthias J P Van Osch 37 , Danny J J Wang 38 , Esther A H Warnert 33 35 , Greg Zaharchuk 39 , Fernando Zelaya 40 , Moss Zhao 39 41 , Michael A Chappell 1 42 ; ISMRM Perfusion Study Group
Abstract
Accurate assessment of cerebral perfusion is vital for understanding the hemodynamic processes involved in various neurological disorders and guiding clinical decision-making. This guidelines article provides a comprehensive overview of quantitative perfusion imaging of the brain using multi-timepoint arterial spin labeling (ASL), along with recommendations for its acquisition and quantification.
A major benefit of acquiring ASL data with multiple label durations and/or post-labeling delays (PLDs) is being able to account for the effect of variable arterial transit time (ATT) on quantitative perfusion values and additionally visualize the spatial pattern of ATT itself, providing valuable clinical insights. Although multi-timepoint data can be acquired in the same scan time as single-PLD data with comparable perfusion measurement precision, its acquisition and postprocessing presents challenges beyond single-PLD ASL, impeding widespread adoption.
Building upon the 2015 ASL consensus article, this work highlights the protocol distinctions specific to multi-timepoint ASL and provides robust recommendations for acquiring high-quality data. Additionally, we propose an extended quantification model based on the 2015 consensus model and discuss relevant postprocessing options to enhance the analysis of multi-timepoint ASL data. Furthermore, we review the potential clinical applications where multi-timepoint ASL is expected to offer significant benefits.
This article is part of a series published by the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group, aiming to guide and inspire the advancement and utilization of ASL beyond the scope of the 2015 consensus article.
CITATION Magn Reson Med. 2024 Apr 9. doi: 10.1002/mrm.30091