title: Clinical evaluation of an arterial-spin-labeling product sequence in steno-occlusive disease of the brain.
abstract: BACKGROUND
  In brain perfusion imaging, arterial spin labeling (ASL) is a noninvasive alternative to dynamic susceptibility contrast-magnetic resonance imaging (DSC-MRI). For clinical imaging, only product sequences can be used. We therefore analyzed the performance of a product sequence (PICORE-PASL) included in an MRI software-package compared with DSC-MRI in patients with steno-occlusion of the MCA or ICA >70%.
  
  
  METHODS
  Images were acquired on a 3T MRI system and qualitatively analyzed by 3 raters. For a quantitative analysis, cortical ROIs were placed in co-registered ASL and DSC images. Pooled data for ASL-cerebral blood flow (CBF) and DSC-CBF were analyzed by Spearman's correlation and the Bland-Altman (BA)-plot.
  
  
  RESULTS
  In 28 patients, 11 ASL studies were uninterpretable due to patient motion. Of the remaining patients, 71% showed signs of delayed tracer arrival. A weak correlation for DSC-relCBF vs ASL-relCBF (r = 0.24) and a large spread of values in the BA-plot owing to unreliable CBF-measurement was found.
  
  
  CONCLUSIONS
  The PICORE ASL product sequence is sensitive for estimation of delayed tracer arrival, but cannot be recommended to measure CBF in steno-occlusive disease. ASL-sequences that are less sensitive to patient motion and correcting for delayed blood flow should be available in the clinical setting.
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany ; Department of Neurology, Charité Universitätsmedizin, Berlin, Germany.
authors: Matthias A
authors: MA
authors: Mutke
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany ; Department of Neurology, Charité Universitätsmedizin, Berlin, Germany.
authors: Vince I
authors: VI
authors: Madai
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany ; Fraunhofer/MEVIS, Bremen, Germany ; Department of Neurology, Charité Universitätsmedizin, Berlin, Germany.
authors: Federico C
authors: FC
authors: von Samson-Himmelstjerna
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany ; Max-Planck-Institute for Neurological Research, Cologne, Germany ; Department of Neurology, Charité Universitätsmedizin, Berlin, Germany.
authors: Olivier
authors: O
authors: Zaro Weber
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany.
authors: Gajanan S
authors: GS
authors: Revankar
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany ; Department of Neurology, Charité Universitätsmedizin, Berlin, Germany.
authors: Steve Z
authors: SZ
authors: Martin
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany ; Department of Neurology, Charité Universitätsmedizin, Berlin, Germany.
authors: Katharina L
authors: KL
authors: Stengl
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany ; Department of Neurology, Charité Universitätsmedizin, Berlin, Germany.
authors: Miriam
authors: M
authors: Bauer
authors: Berlin Center for Advanced Neuroimaging, Berlin, Germany.
authors: Stefan
authors: S
authors: Hetzer
authors: Fraunhofer/MEVIS, Bremen, Germany.
authors: Matthias
authors: M
authors: Günther
authors: Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany ; Department of Neurology, Charité Universitätsmedizin, Berlin, Germany.
authors: Jan
authors: J
authors: Sobesky
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000473:pathology*; D016477:Artifacts; D001921:Brain / Q000098:blood supply*; D002536:Cerebral Arteries / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013113:Spin Labels; D013997:Time Factors
chemical_list: D003287:Contrast Media; D013113:Spin Labels