Recommendations for quantitative cerebral perfusion MRI using multi-timepoint arterial spin labeling: Acquisition,...

Area of Science:

• Neuroimaging
• Medical Physics
• Radiology

Background:

• Accurate cerebral perfusion assessment is crucial for neurological disorder diagnosis and treatment.
• Arterial spin labeling (ASL) is a key quantitative perfusion imaging technique.
• Existing guidelines need updating to incorporate advanced ASL methods.

Purpose of the Study:

• Provide comprehensive guidelines for multi-timepoint ASL brain imaging.
• Recommend protocols for acquisition and quantification.
• Address challenges to promote wider clinical adoption.

Main Methods:

• Review and detail multi-timepoint ASL acquisition protocols, including multiple label durations and post-labeling delays (PLDs).
• Propose an extended quantification model building on the 2015 consensus.
• Discuss post-processing techniques for enhanced data analysis.

Main Results:

• Multi-timepoint ASL enables accurate assessment of cerebral blood flow (CBF) and visualization of arterial transit time (ATT).
• Comparable precision to single-PLD ASL is achievable within similar scan times.
• Identified challenges in acquisition and post-processing that hinder widespread use.

Conclusions:

• Multi-timepoint ASL provides valuable insights into hemodynamic processes by characterizing ATT.
• Updated guidelines and extended quantification models are proposed for robust implementation.
• Significant potential clinical applications are expected, advancing beyond the 2015 consensus.