Recommendations for quantitative cerebral perfusion MRI using multi‐timepoint arterial spin labeling: Acquisition, quantification, and clinical applications
Magnetic Resonance in Medicine, vol. 92, pp. 469–495
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.
Authors 33
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Joseph G. Woods corresponding
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 Biomedical Engineering Rochester Institute of Technology Rochester New York USA
Department of Neuroscience University of Sussex Brighton UK
Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, New York, USA
Department of Neuroscience, University of Sussex, Brighton, UK
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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 New York USA
Department of Computer Science, State University of New York at Binghamton, Binghamton, New York, USA
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Affiliation as printed
Department of Neurology University of Pennsylvania Philadelphia Pennsylvania USA
Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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University of California, Davis
Affiliation as printed
Department of Biomedical Engineering University of California Davis Davis California USA
Department of Neurology University of California Davis Davis California USA
Department of Biomedical Engineering, University of California Davis, Davis, California, USA
Department of Neurology, University of California Davis, Davis, California, USA
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Navarre Institute of Health Research · Clinica Universidad de Navarra
Affiliation as printed
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
Gold Standard Phantoms Sheffield UK
UCL Queen Square Institute of Neurology University College London London UK
Gold Standard Phantoms, Sheffield, UK
UCL Queen Square Institute of Neurology, University College London, London, UK
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University of Bremen · Fraunhofer Institute for Digital Medicine
Affiliation as printed
Department of Physics and Electrical Engineering University of Bremen Bremen Germany
Imaging Physics Fraunhofer Institute for Digital Medicine MEVIS Bremen Germany
Department 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 California USA
Department of Bioengineering, University of California Riverside, Riverside, California, USA
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University of Michigan · Michigan Medicine
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 Missouri USA
Department of Radiology, University of Missouri, Columbia, Missouri, 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 Ontario Canada
Hurvitz Brain Sciences Program, Centre for Brain Resilience & Recovery Sunnybrook Research Institute Toronto Ontario Canada
Computational Radiology & Artificial Intelligence unit Oslo University Hospital Oslo Norway
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
Hurvitz Brain Sciences Program, Centre for Brain Resilience & Recovery, Sunnybrook Research Institute, Toronto, Ontario, 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 Texas USA
Department of Radiology and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, USA
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Amsterdam Neuroscience · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Neuroscience, Brain Imaging Amsterdam The Netherlands
Department of Radiology and Nuclear Medicine Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands
Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
Department of Radiology and Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, 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 Manchester UK
School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Manchester, UK
School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, 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
University at Buffalo Neurosurgery 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 The Netherlands
Medical Delta Delft The Netherlands
Department of Radiology & Nuclear Medicine Erasmus MC Rotterdam The Netherlands
Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands
Medical Delta, Delft, 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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UCL Queen Square Institute of Neurology · University College London
Affiliation as printed
Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology University College London London UK
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 The Netherlands 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 California USA
Laboratory of FMRI Technology (LOFT), Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, 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 The Netherlands
Department of Radiology & Nuclear Medicine Erasmus MC Rotterdam The Netherlands
Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands
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Stanford Medicine · Stanford University
Affiliation as printed
Department of Radiology Stanford University Stanford California USA
Department of Radiology, Stanford University, Stanford, California, USA
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Affiliation as printed
Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience Kings College London London UK
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 California USA
Maternal & Child Health Research Institute Stanford University Stanford California USA
Department of Radiology, Stanford University, Stanford, California, USA
Maternal & Child Health Research Institute, Stanford University, Stanford, California, 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
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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