Abstract
Arterial spin labeling (ASL) techniques are gaining popularity for visualizing and quantifying cerebral blood flow (CBF) in a range of patient groups. However, most ASL methods lack vessel-selective information, which is important for the assessment of collateral flow and the arterial supply to lesions. In this study, we explored the use of vessel-encoded pseudocontinuous ASL (VEPCASL) with multiple postlabeling delays to obtain individual quantitative CBF and bolus arrival time maps for each of the four main brain-feeding arteries and compared the results against those obtained with conventional pseudocontinuous ASL (PCASL) using matched scan time. Simulations showed that PCASL systematically underestimated CBF by up to 37% in voxels supplied by two arteries, whereas VEPCASL maintained CBF accuracy since each vascular component is treated separately. Experimental results in healthy volunteers showed that there is no systematic bias in the CBF estimates produced by VEPCASL and that the signal-to-noise ratio of the two techniques is comparable. Although more complex acquisition and image processing is required and the potential for motion sensitivity is increased, VEPCASL provides comparable data to PCASL but with the added benefit of vessel-selective information. This could lead to more accurate CBF estimates in patients with a significant collateral flow.
Highlights
Since its introduction,[1,2] arterial spin labeling (ASL) has gained popularity for cerebral perfusion imaging over contrast-enhanced methods due to its noninvasive nature, suitability for use in longitudinal studies, and concerns about links between Gadoliniumbased contrast agents and nephrogenic systemic fibrosis in patients with kidney dysfunction.[3]
We have shown that vessel-encoded pseudocontinuous ASL (VEPCASL) is a viable alternative to pseudocontinuous ASL (PCASL) for cerebral blood flow (CBF) quantification, but with the added benefit of vessel-selective information: simulations showed that VEPCASL can produce more accurate CBF estimates in regions with mixed supply and experimentally the two methods gave identical CBF estimates with comparable signal-to-noise ratio (SNR) in the same scan time
Vessel-encoded pseudocontinuous ASL does not have this systematic underestimation since both boluses are accurately modeled
Summary
Since its introduction,[1,2] arterial spin labeling (ASL) has gained popularity for cerebral perfusion imaging over contrast-enhanced methods due to its noninvasive nature, suitability for use in longitudinal studies, and concerns about links between Gadoliniumbased contrast agents and nephrogenic systemic fibrosis in patients with kidney dysfunction.[3] There is a wide range of potential applications for ASL, including acute stroke, chronic vascular disease, dementia, and assessment of tumor blood flow. The cause of any observed perfusion deficit cannot be accurately assigned to a particular feeding artery due to common variations in the morphology of the cerebral vasculature.[6] Vessel-selective information may be of use in assessing the arterial supply to lesions such as tumors
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