Abstract

To demonstrate the feasibility of noninvasively measuring pancreatic perfusion using pseudocontinuous arterial spin labeling (ASL) and to derive quantitative blood-flow and transit-time measurements in healthy volunteers. A pseudocontinuous ASL sequence with background suppression and a single-slice single-shot fast-spin-echo readout was acquired at 3T in 10 subjects with a single standard postlabeling delay (PLD) of 1.5s and in 4 additional subjects with 4 PLD from 0.7 to 2s. An imaging synchronized breathing approach was used to minimize motion artifacts during the 3min of acquisition. Scan-rescan reproducibility was assessed in 3 volunteers with single-delay ASL. Quantitative blood flow and arterial transit time (ATT) were derived and the impact of ATT correction was studied using either subject-specific ATT in the second group or an average ATT derived from the group with multidelay ASL for subjects with single-delay ASL. Successful ASL acquisitions were performed in all volunteers. An average pancreatic blood flow of 201±40mL/100g/min was measured in the single-delay group using an assumed ATT of 750ms Average ATT measured in the multidelay group was 1029±89ms Using the longer, measured ATT reduced the measured flow to 162±12 and 168±28mL/100g/min with subject-specific or average ATT correction, respectively. ASL signal heterogeneities were observed at shorter PLD, potentially linked to its complex vascular supply and islet distribution. ASL enables reliable measurement of pancreatic perfusion in healthy volunteers. It presents a valuable alternative to contrast-enhanced methods and may be useful for diagnosis and characterization of several inflammatory, metabolic, and neoplastic diseases affecting the pancreas.

Highlights

  • Non-invasive functional pancreas imaging presents high clinical relevance to diagnose, grade and monitor multiple neoplastic, inflammatory or metabolic diseases

  • Two different sub-studies are presented in the current work: - #1: assessing whether measuring pancreatic perfusion is feasible when single-delay pseudocontinuous ASL (pCASL) is used at 3T - #2: quantifying arterial transit-time (ATT) and determining its influence on blood-flow quantification using multi-delay Arterial Spin Labeling (ASL)

  • Perfusion images were acquired with a single-slice axial pCASL-single-shot Fast-Spin-Echo (SSFSE) sequence with the following readout parameters: TR/TE=6000/45ms, receiver bandwidth =19.23kHz, echo spacing 5.9ms, 72 echoes echo train (1st 155° refocusing pulse followed by a train of 130° flip angles) no parallel imaging, FOV=30-32cm, slice thickness 10mm, 128x128 matrix

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Summary

Introduction

Non-invasive functional pancreas imaging presents high clinical relevance to diagnose, grade and monitor multiple neoplastic, inflammatory or metabolic diseases. Some challenges of abdominal ASL include intrinsic low sensitivity, respiratory and physiological (cardiac, peristalsis) motion leading to signal instability and errors when subtracting control and label experiments, as well as magnetic (B0) and radiofrequency field (B1) inhomogeneities affecting labeling efficiency [9]. These must all be addressed for robust and reproducible body imaging, especially at 3 Tesla (T). Straightforward, ASL-based blood-flow quantification relies on prior knowledge or measurement of T1 relaxation and arterial transit-time (ATT) between the labeling location and tissue of interest

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