title: 3D Pseudocontinuous arterial spin labeling in routine clinical practice: A review of clinically significant artifacts.
abstract: Arterial spin labeling (ASL) is a completely noninvasive magnetic resonance imaging (MRI) perfusion method for quantitatively measuring cerebral blood flow utilizing magnetically labeled arterial water. Advances in the technique have enabled the major MRI vendors to make the sequence available to the clinical neuroimaging community. Consequently, ASL is being increasingly incorporated into the routine neuroimaging protocol. Although a variety of ASL techniques are available, the ISMRM Perfusion Study Group and the European ASL in Dementia Consortium have released consensus guidelines recommending standardized implementation of 3D pseudocontinuous ASL with background suppression. The purpose of this review, aimed at the large number of neuroimaging clinicians who have either no or limited experience with this 3D pseudocontinuous ASL, is to discuss the common and clinically significant artifacts that may be encountered with this technique. While some of these artifacts hinder accurate interpretation of studies, either by degrading the images or mimicking pathology, there are other artifacts that are of clinical utility, because they increase the conspicuity of pathology. Cognizance of these artifacts will help the physician interpreting ASL to avoid potential diagnostic pitfalls, and increase their level of comfort with the technique.
authors: Department of Radiology, Stanford University and Stanford University Medical Center, Stanford, California, USA.
authors: Shalini A
authors: SA
authors: Amukotuwa
authors: Department of Radiology, Stanford University and Stanford University Medical Center, Stanford, California, USA.
authors: Caroline
authors: C
authors: Yu
authors: Department of Radiology, Stanford University and Stanford University Medical Center, Stanford, California, USA.
authors: Gregory
authors: G
authors: Zaharchuk
mesh_terms: D016477:Artifacts; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D003951:Diagnostic Errors / Q000517:prevention & control; D003955:Diagnostic Tests, Routine / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D056888:Patient Positioning / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels
chemical_list: D013113:Spin Labels
keywords: 3D stack-of-spirals segmented fast spin-echo; arterial spin labeling (ASL); artifacts; pseudocontinuous ASL (pcASL)