Advances in arterial spin labelling MRI methods for measuring perfusion and collateral flow

Topic: Brain proteins, microglia and lab models

With the publication in 2015 of the consensus statement by the perfusion study group of the International Society for Magnetic Resonance in Medicine (ISMRM) and the EU-COST action 'ASL in dementia' on the implementation of arterial spin labelling MRI (ASL) in a clinical setting, the development of ASL can be considered to have become mature and ready for clinical prime-time. In this review article new developments and remaining issues will be discussed, especially focusing on quantification of ASL as well as on new technological developments of ASL for perfusion imaging and flow territory mapping. Uncertainty of the achieved labelling efficiency in pseudo-continuous ASL (pCASL) as well as the presence of arterial transit time artefacts, can be considered the main remaining challenges for the use of quantitative cerebral blood flow (CBF) values. New developments in ASL centre around time-efficient acquisition of dynamic ASL-images by means of time-encoded pCASL and diversification of information content, for example by combined 4D-angiography with perfusion imaging. Current vessel-encoded and super-selective pCASL-methodology have developed into easily applied flow-territory mapping methods providing relevant clinical information with highly similar information content as digital subtraction angiography (DSA), the current clinical standard. Both approaches seem therefore to be ready for clinical use.

Key findings

• In this review article new developments and remaining issues will be discussed, especially focusing on quantification of ASL as well as on new technological developments of ASL for perfusion imaging and flow territory mapping.
• Uncertainty of the achieved labelling efficiency in pseudo-continuous ASL (pCASL) as well as the presence of arterial transit time artefacts, can be considered the main remaining challenges for the use of quantitative cerebral blood flow (CBF) values.
• New developments in ASL centre around time-efficient acquisition of dynamic ASL-images by means of time-encoded pCASL and diversification of information content, for example by combined 4D-angiography with perfusion imaging.
• Current vessel-encoded and super-selective pCASL-methodology have developed into easily applied flow-territory mapping methods providing relevant clinical information with highly similar information content as digital subtraction angiography (DSA), the current clinical standard.
• Both approaches seem therefore to be ready for clinical use.

Why it matters

This review discusses technical developments in arterial spin labelling MRI for measuring perfusion and mapping flow territories, noting remaining challenges such as uncertainty in labelling efficiency and arterial transit time artefacts. It concerns imaging methods, not treating, curing, or preventing Alzheimer's disease.

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Study details

• Evidence strengthLow

Read the original

• DOI: 10.1177/0271678x17713434
• PubMed: 28598243
• Original source →
• Free full text: Journal of Cerebral Blood Flow & Metabolism →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{vanosch2018-28598243,
  author  = {van Osch, M. J. and Teeuwisse, W. M. and Chen, Z. and Suzuki, Y. and Helle, M. and Schmid, S.},
  title   = {{Advances in arterial spin labelling MRI methods for measuring perfusion and collateral flow}},
  journal = {Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism},
  year    = {2018},
  doi     = {10.1177/0271678x17713434},
  pmid    = {28598243},
  url     = {https://doi.org/10.1177/0271678x17713434}
}

Studies this one cites

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• Reliability of two-dimensional and three-dimensional pseudo-continuous arterial spin labeling perfusion MRI in elderly populations: comparison with 15O-water positron emission tomography Journal of magnetic resonance imaging : JMRI · 2013-09-13 · usefulness score 54/100 · Mild cognitive impairment

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