Current state and guidance on arterial spin labeling perfusion MRI in clinical neuroimaging

Thomas Lindner, Divya S. Bolar, the ISMRM Perfusion Study Group, Eric Achten, Frederik Barkhof, António J. Bastos-Leite, John A. Detre, Xavier Golay, Matthias Günther, Danny J.J. Wang, Sven Haller, Silvia Ingala, Hans R. Jäger, Geon Ho Jahng, Meher R. Juttukonda, Vera C. Keil, Hirohiko Kimura, Mai Lan Ho, Maarten Lequin, Xin LouJan Petr, Nandor Pinter, Francesca B. Pizzini, Marion Smits, Magdalena Sokolska, Greg Zaharchuk, Henk J.M.M. Mutsaerts*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

This article focuses on clinical applications of arterial spin labeling (ASL) and is part of a wider effort from the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group to update and expand on the recommendations provided in the 2015 ASL consensus paper. Although the 2015 consensus paper provided general guidelines for clinical applications of ASL MRI, there was a lack of guidance on disease-specific parameters. Since that time, the clinical availability and clinical demand for ASL MRI has increased. This position paper provides guidance on using ASL in specific clinical scenarios, including acute ischemic stroke and steno-occlusive disease, arteriovenous malformations and fistulas, brain tumors, neurodegenerative disease, seizures/epilepsy, and pediatric neuroradiology applications, focusing on disease-specific considerations for sequence optimization and interpretation. We present several neuroradiological applications in which ASL provides unique information essential for making the diagnosis. This guidance is intended for anyone interested in using ASL in a routine clinical setting (i.e., on a single-subject basis rather than in cohort studies) building on the previous ASL consensus review.

Original languageEnglish
Pages (from-to)2024-2047
Number of pages24
JournalMagnetic Resonance in Medicine
Volume89
Issue number5
DOIs
Publication statusPublished - May 2023

Bibliographical note

Funding Information:
H.M., F.B., V.K., and M.G. are supported by the Eurostars‐2 joint program with co‐funding from the European Union Horizon 2020 research and innovation program (ASPIRE E!113701), provided by the Netherlands Enterprise Agency (RvO). H.M. and J.P. are supported by the Dutch Heart Foundation (2020 T049). H.M., J.P., M.G., and E.A. are supported by the EU Joint Program for Neurodegenerative Disease Research, provided by the Netherlands Organization for Health Research and Development and Alzheimer Nederland (DEBBIE JPND2020‐568‐106). T.L. is supported by the German Research Foundation (LI‐3030/2‐1). F.B. and X.G. are supported by the National Institute of Health Research Biomedical Research Centre at University College London Hospitals. H.K. is supported by a scientific research grant from Japan Society for the Promotion of Science (21K07616). M.R.J. is supported by the American Heart Association (19CDA34790002) and by the National Institutes of Health/National Institute on Aging (1K01AG070318). X.L. is supported by grants from the National Natural Science Foundation of China (81825012, 81730048, and 82151309). N.P. is funded by the Dent Family Foundation.

Funding Information:
D.J.W. is a shareholder of Translational MRI, LLC. X.G. is founder, shareholder and CEO of Gold Standard Phantoms. M.G. is founder of mediri Gmbh and deputy director of Fraunhofer MEVIS. F.B. serves on trial steering/safety committees for Biogen, Merck, Roche, and EISAI. He is a consultant for Roche, Biogen, Merck, IXICO, Jansen, Combinostics, and has research agreements with Novartis, Merck, Biogen, GE, and Roche. He is co‐founder and shareholder of Queen Square Analytics. M.S. discloses receipt of speaker fees (paid to institution) from GE Healthcare. G.Z. is co‐founder of Subtle Medical, in the advisory board of Biogen and received research funding from GE Healthcare. D.B. received a GE Healthcare Industry‐supported research grant. M.H. received grants from RSNA/Siemens Healthineers Research Scholar Grant, Italfarmaco ImagingDMD Grant, Bayer Healthcare Radiology Medical Education Grant and Cardinal Health Foundation Research Grant.

Publisher Copyright:
© 2023 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.

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