Prognostic Utility of Arterial Spin Labeling in Traumatic Brain Injury: From Pathophysiology to Precision Imaging

Area of Science:

• Neuroimaging
• Biomarkers
• Neurology

Background:

• Traumatic brain injury (TBI) is a leading cause of death and disability.
• Accurate prognostic biomarkers are essential for personalized TBI management.
• Current prognostic tools require improvement for better patient outcomes.

Purpose of the Study:

• To review the prognostic value of arterial spin labeling (ASL) in TBI.
• To focus on quantitative cerebral blood flow (CBF) and arterial transit time (ATT) measures.
• To assess ASL's utility in adult and pediatric TBI populations.

Main Methods:

• Comprehensive literature search of PubMed, Embase, Scopus, and IEEE.
• Inclusion of observational studies and clinical trials using ASL in TBI patients.
• Outcome assessment at least 3 months post-injury, focusing on functional and cognitive outcomes.

Main Results:

• ASL-derived CBF and ATT parameters show prognostic potential in acute and chronic TBI.
• Hypoperfusion correlates with poorer neurocognitive outcomes; regional alterations link to affective symptoms.
• Advanced ASL techniques improve sensitivity for heterogeneous TBI perfusion; ASL offers contrast-free quantification for repeated monitoring.

Conclusions:

• Arterial spin labeling (ASL) is a promising prognostic biomarker for TBI.
• Integrating ASL into multiparametric models can enhance risk stratification.
• ASL can guide individualized therapeutic strategies for TBI patients.