Recommendations for Quantitative Cerebral Perfusion MRI using Multi-Timepoint Arterial Spin Labeling: Acquisition, Quantification, and Clinical Applications
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. Acquiring ASL data with multiple label durations and/or post-labeling delays (PLDs) enables efficient mapping of perfusion, offering comparable accuracy to a conventional single-PLD approach within the same scan time. Additionally, multi-timepoint ASL allows for the estimation of arterial transit time (ATT) and the generation of ATT maps, mitigating the impact of variable and prolonged ATTs on perfusion measurements and providing valuable clinical insights. However, the acquisition and postprocessing of multi-timepoint ASL data presents challenges beyond single-PLD ASL, impeding its 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.
Authors 33
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University of California San Diego · University of Oxford · Wellcome Centre for Integrative Neuroimaging
Affiliation as printed
. Center for Functional Magnetic Resonance Imaging , Department of Radiology , University of California San Diego , La Jolla , California , USA
. Wellcome Centre for Integrative Neuroimaging , FMRIB , Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , UK
. Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA
. Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Affiliation as printed
. Ghent Institute for Functional and Metabolic Imaging (GIfMI) , Ghent University , Ghent , Belgium
. Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
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Rochester Institute of Technology · University of Sussex
Affiliation as printed
. Department of Neuroscience , University of Sussex , UK and
. Department of Neuroscience, University of Sussex, UK and Department of Biomedical Engineering,
Rochester Institute of Technology, USA
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University of California San Diego
Affiliation as printed
. Center for Functional Magnetic Resonance Imaging , Department of Radiology , University of California San Diego , La Jolla , California , USA
. Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA
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Affiliation as printed
. Department of Computer Science , State University of New York at Binghamton , Binghamton , NY , USA, 13902
. Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA, 13902
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Affiliation as printed
. Department of Neurology , University of Pennsylvania , 3 Dulles Building , 3400 Spruce Street , Philadelphia , PA 19104 USA
. Department of Neurology, University of Pennsylvania, 3 Dulles Building, 3400 Spruce Street, Philadelphia, PA 19104 USA
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University of California, Davis
Affiliation as printed
. Department of Biomedical Engineering , Department of Neurology , University of California Davis , Davis , CA , USA
. Department of Biomedical Engineering, Department of Neurology, University of California Davis, Davis, CA, USA
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Navarre Institute of Health Research · Clinica Universidad de Navarra · Universidad de Navarra
Affiliation as printed
. Department of Radiology , Clínica Universidad de Navarra , Pamplona , Spain ;
. Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain; IdiSNA,
Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
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UCL Queen Square Institute of Neurology · University College London
Affiliation as printed
. UCL Queen Square Institute of Neurology , University College London , London , UK;
. UCL Queen Square Institute of Neurology, University College London, London, UK;
Gold Standard Phantoms, UK
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University of Bremen · Fraunhofer Institute for Digital Medicine
Affiliation as printed
. Departments of Physics and Electrical Engineering , University of Bremen , Bremen , Germany
. Imaging Physics , Fraunhofer Institute for Digital Medicine MEVIS , Bremen , Germany
. Departments of Physics and Electrical Engineering, University of Bremen, Bremen, Germany
. Imaging Physics, Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
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University of California, Riverside
Affiliation as printed
. Department of Bioengineering , University of California Riverside , Riverside , CA , USA
. Department of Bioengineering, University of California Riverside, Riverside, CA, USA
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Affiliation as printed
. Department of Radiology , University of Michigan , Ann Arbor , Michigan , USA
. Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Affiliation as printed
. Department of Radiology , University of Missouri , Columbia , MO , USA
. Department of Radiology, University of Missouri, Columbia, MO, USA
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Harvard University · Massachusetts General Hospital · Athinoula A. Martinos Center for Biomedical Imaging
Affiliation as printed
. Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital , Charlestown , Massachusetts , USA
. Department of Radiology , Harvard Medical School , Boston , Massachusetts , USA
. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
. Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
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Johns Hopkins University · Johns Hopkins Medicine
Affiliation as printed
. The Russell H. Morgan Department of Radiology and Radiological Science , Johns Hopkins University School of Medicine , Baltimore , Maryland , USA
. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Oslo University Hospital · University of Toronto · Sunnybrook Research Institute
Affiliation as printed
. Computational Radiology & Artificial Intelligence unit, Oslo University Hospital, Oslo, Norway
. Department of Medical Biophysics, University of Toronto, Toronto, Canada
. Hurvitz Brain Sciences Program, Centre for Brain Resilience & Recovery, Sunnybrook Research Institute, Toronto, Canada
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The University of Texas Southwestern Medical Center
Affiliation as printed
. Department of Radiology and Advanced Imaging Research Center , UT Southwestern Medical Center , Dallas , TX , USA
. Department of Radiology and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
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Amsterdam Neuroscience · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
. Amsterdam Neuroscience , Brain Imaging , Amsterdam , The Netherlands
. Amsterdam UMC location Vrije Universiteit Amsterdam , Department of Radiology and Nuclear Medicine , Amsterdam , The Netherlands
. Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
. Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
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University of Oxford · Wellcome Centre for Integrative Neuroimaging
Affiliation as printed
. Wellcome Centre for Integrative Neuroimaging , FMRIB , Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , UK
. Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Manchester Academic Health Science Centre · University of Manchester
Affiliation as printed
. Geoffrey Jefferson Brain Research Centre , Manchester Academic Health Science Centre , UK
. School of Health Sciences , Faculty of Biology, Medicine and Health , University of Manchester , UK
. Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, UK
. School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
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Dent Neurologic Institute · University at Buffalo, State University of New York
Affiliation as printed
. Dent Neurologic Institute , Buffalo , New York , USA ;
. Dent Neurologic Institute, Buffalo, New York, USA; University at Buffalo Neurosurgery, Buffalo, New York, USA
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Affiliation as printed
. Institute of Biomedical Engineering , Department of Engineering Science , University of Oxford , Oxford , UK
. Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
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Johns Hopkins University · Johns Hopkins Medicine
Affiliation as printed
. The Russell H. Morgan Department of Radiology and Radiological Science , Johns Hopkins University School of Medicine , Baltimore , Maryland , USA
. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Erasmus MC · Erasmus MC Cancer Institute · Medical Delta
Affiliation as printed
. Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
. Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, NL
. Medical Delta, Delft, The Netherlands
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University of Oxford · Wellcome Centre for Integrative Neuroimaging
Affiliation as printed
University of Oxford
. Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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UCL Queen Square Institute of Neurology · University College London
Affiliation as printed
. Department of Brain Repair and Rehabilitation , UCL Queen Square Institute of Neurology ,
. Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology,
University College London, London, UK
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Matthias J.P. van Osch Aachen C.J. Gorter MRI Center Department of Radiology, Leiden University Medical Center
Leiden University Medical Center
Affiliation as printed
. C.J. Gorter MRI Center , Department of Radiology , Leiden University Medical Center , Leiden , The Netherlands
. C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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University of Southern California
Affiliation as printed
. Laboratory of FMRI Technology (LOFT) , Stevens Neuroimaging and Informatics Institute , University of Southern California , Los Angeles , CA , USA
. Laboratory of FMRI Technology (LOFT), Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
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Erasmus MC · Erasmus MC Cancer Institute
Affiliation as printed
. Department of Radiology & Nuclear Medicine , Erasmus MC , Rotterdam , The Netherlands
. Erasmus MC Cancer Institute , Erasmus MC , Rotterdam , NL
. Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
. Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, NL
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Stanford Medicine · Stanford University
Affiliation as printed
. Department of Radiology, Stanford University, Stanford, CA, USA
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Affiliation as printed
. Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
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Stanford Medicine · Stanford Maternal and Child Health Research Institute · Stanford University
Affiliation as printed
. Department of Radiology , Stanford University , Stanford , CA , USA
. Maternal & Child Health Research Institute , Stanford University , Stanford , CA , USA
. Department of Radiology, Stanford University, Stanford, CA, USA
. Maternal & Child Health Research Institute, Stanford University, Stanford, CA, USA
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University of Nottingham · University of Oxford · Wellcome Centre for Integrative Neuroimaging
Affiliation as printed
. Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK
. Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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