Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: A consensus of the ISMRM perfusion study group and the European consortium for ASL in dementia.
This review provides a summary statement of recommended implementations of arterial spin labeling (ASL) for clinical applications. It is a consensus of the ISMRM Perfusion Study Group and the European ASL in Dementia consortium, both of whom met to reach this consensus in October 2012 in Amsterdam. Although ASL continues to undergo rapid technical development, we believe that current ASL methods are robust and ready to provide useful clinical information, and that a consensus statement on recommended implementations will help the clinical community to adopt a standardized approach. In this review, we describe the major considerations and trade-offs in implementing an ASL protocol and provide specific recommendations for a standard approach. Our conclusion is that as an optimal default implementation, we recommend pseudo-continuous labeling, background suppression, a segmented three-dimensional readout without vascular crushing gradients, and calculation and presentation of both label/control difference images and cerebral blood flow in absolute units using a simplified model.
Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
David C
DC
Alsop
Departments of Neurology and Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
John A
JA
Detre
Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.
Xavier
X
Golay
Fraunhofer MEVIS, Bremen, Germany.|University Bremen, Bremen, Germany.|Mediri GmbH, Heidelberg, Germany.
Matthias
M
Günther
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Jeroen
J
Hendrikse
FMRI Laboratory, Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.
Luis
L
Hernandez-Garcia
Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, USA.
Hanzhang
H
Lu
Department of Medical Biophysics, University of Toronto, Toronto, Canada.|Department of Physical Sciences, Sunnybrook Research Institute, Toronto, Canada.
Bradley J
BJ
MacIntosh
Centre for Imaging Science, Institute of Population Health, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.
Laura M
LM
Parkes
Department of Radiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Marion
M
Smits
C. J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Matthias J P
MJ
van Osch
Department of Neurology, University of California Los Angeles, Los Angeles, California, USA.
Danny J J
DJ
Wang
Departments of Radiology and Psychiatry, University of California San Diego, La Jolla, California, USA.
Eric C
EC
Wong
Department of Radiology, Stanford University, Stanford, California, USA.
Greg
G
Zaharchuk
D001783:Blood Flow Velocity; D001921:Brain / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology*; D005062:European Union; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000592:standards*; D009462:Neurology / Q000592:standards*; D017410:Practice Guidelines as Topic; D013113:Spin Labels
D013113:Spin Labels
arterial spin labeling; cerebral blood flow; perfusion