Recent advances in arterial spin labeling perfusion MRI in patients with vascular cognitive impairment

Huang, Dan; Guo, Yunlu; Guan, Bin; Pan, Lijun; Zhu, Ziyu; Chen, Zeng'ai; Dijkhuizen, Rick M.; Duering, Marco; Yu, Fang; Boltze, Johannes; Li, Peiying

doi:10.1177/0271678x221135353

Cited by 10 publications

(13 citation statements)

References 120 publications

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“…Although participants with clearly prolonged transit time based on visual inspection were excluded, this might have led to an underestimation of the observed associations and a lower sensitivity to detect associations. Future studies could perform multiple post‐labeling delay ASL to overcome this issue 48 . Second, CBF was only quantified in GM, as the signal of ASL is particularly low and noisy in WM due to the longer transit time and lower perfusion compared to GM 53 .…”

Section: Discussionmentioning

confidence: 99%

Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment

Dinther

Hooghiemstra

Bron

et al. 2023

Alzheimer's & Dementia

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INTRODUCTIONChronic cerebral hypoperfusion is one of the assumed pathophysiological mechanisms underlying vascular cognitive impairment (VCI). We investigated the association between baseline cerebral blood flow (CBF) and cognitive decline after 2 years in patients with VCI and reference participants.METHODSOne hundred eighty‐one participants (mean age 66.3 ± 7.4 years, 43.6% women) underwent arterial spin labeling (ASL) magnetic resonance imaging (MRI) and neuropsychological assessment at baseline and at 2‐year follow‐up. We determined the association between baseline global and lobar CBF and cognitive decline with multivariable regression analysis.RESULTSLower global CBF at baseline was associated with more global cognitive decline in VCI and reference participants. This association was most profound in the domain of attention/psychomotor speed. Lower temporal and frontal CBF at baseline were associated with more cognitive decline in memory.DISCUSSIONOur study supports the role of hypoperfusion in the pathophysiological and clinical progression of VCI.Highlights Impaired cerebral blood flow (CBF) at baseline is associated with faster cognitive decline in VCI and normal aging. Our results suggest that low CBF precedes and contributes to the development of vascular cognitive impairment. CBF determined by ASL might be used as a biomarker to monitor disease progression or treatment responses in VCI.

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Section: Discussionmentioning

confidence: 99%

Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment

Dinther

Hooghiemstra

Bron

et al. 2023

Alzheimer's & Dementia

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“…Pulsed arterial spin labeling (PASL) MRI is a fast, inexpensive, and noninvasive method of investigating perfusion when compared to high-resolution dynamic contrast enhanced MRI. It employs a proton labeling pulse in the neck and measures its signal within the brain after a time delay (TI) with background signal suppression [16, 17]. The residual signal is from the remaining labeled intracapillary blood protons and those leaked into interstitial spaces.…”

Section: Introductionmentioning

confidence: 99%

Utilizing Reduced Labeled Proton Clearance to Identify Preclinical Alzheimer Disease with 3D ASL MRI

Joseph,

Kreilach,

Reyna

et al. 2023

Case Rep Neurol

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Addressing the seminal pathophysiology in Alzheimer disease (AD) is the next logical focus for effective intervention, given the initial disappointing and more recent possibly encouraging results of monoclonal antibody trials. Endothelial cell dysfunction-induced blood-brain barrier leak with associated prolonged capillary mean transit time (cMTT) and glymphatic outflow dysfunction is the most proximal events in the degeneration cascade. Sensitive and reproducible markers are required to both identify early disease and assess future treatment trial outcomes. Two participants, with mild cognitive impairment (MCI) and one with AD, were evaluated clinically prior to MRI in this small case series report. From seven 3D turbo gradient and spin echo (TGSE) pulsed arterial spin echo (PASL) MRI sequences six homologous region of interest in bitemporal, bifrontal, and biparietal lobes for each sequence were examined and plotted against time. By choosing late perfusion times during cMTT phase of perfusion linear analysis of signal decay could be utilized. A reference axial FLAIR sequence was also obtained. Slope of the linear analysis correlated to the rate of labeled proton clearance with reduced clearance occurring in AD participants compared to normal participants in our previous study. Whether similar differences in clearance rate extend to either MCI or early AD was investigated. Participants were categorized by clinical phenotype before MRI and compared to previously published phenotype cohorts: n = 18 normal/healthy, n = 6 AD, n = 3 MCI. Significant differences in labeled proton clearance rates between AD and MCI/control phenotypes within bilateral temporal lobes (left p = 0.004, right p = 0.002) and within bilateral frontal lobes AD versus controls (left p = 0.001, right p = 0.008) and AD versus MCI (left p = 0.001, right p = 0.001) were found. This noninvasive MRI technique has potential for identifying MCI transition to AD.

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“…Arterial spin labeling (ASL) is a noninvasive MRI method that allows the measurement of perfusion without the need for exogenous contrast agent. Over the past three decades, substantial technical developments have led to the increased use of ASL both in the research settings and in clinical evaluation 1,2 . Consensus efforts within the ASL community have established standardized methods for broader adoption of ASL for brain perfusion imaging 3 .…”

Section: Introductionmentioning

confidence: 99%

“…Over the past three decades, substantial technical developments have led to the increased use of ASL both in the research settings and in clinical evaluation. 1,2 Consensus efforts within the ASL community have established standardized methods for broader adoption of ASL for brain perfusion imaging. 3 Beyond the brain, development efforts have also provided recommendations for ASL perfusion imaging in other anatomies such as kidneys.…”

Section: Introductionmentioning

confidence: 99%

A 3D‐printed phantom for quality‐controlled reproducibility measurements of arterial spin labeled perfusion

Wang,

Greer,

Zhou

et al. 2023

Magnetic Resonance in Med

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PurposeTo develop a portable MR perfusion phantom for quality‐controlled assessment and reproducibility of arterial spin labeled (ASL) perfusion measurement.MethodsA 3D‐printed perfusion phantom was developed that mimics the branching of arterial vessels, capillaries, and a chamber containing cellulose sponge representing tissue characteristics. A peristaltic pump circulated distilled water through the phantom, and was first evaluated at 300, 400, and 500 mL/min. Longitudinal reproducibility of perfusion was performed using 2D pseudo‐continuous ASL at 20 post‐label delays (PLDs, ranging between 0.2 and 7.8 s at 0.4‐s intervals) over a period of 16 weeks, with three repetitions each week. Multi‐PLD data were fitted into a general kinetic model for perfusion quantification (f) and arterial transit time (ATT). Intraclass correlation coefficient was used to assess intersession reproducibility.ResultsMR perfusion signals acquired in the 3D‐printed perfusion phantom agreed well with the experimental conditions, with progressively increasing signal intensities and decreasing ATT for pump flow rates from 300 to 500 mL/min. The perfusion signal at 400 mL/min and the general kinetic model–derived f and ATT maps were similar across all PLDs for both intrasession and intersession reproducibility. Across all 48 experimental time points, the average f was 75.55 ± 3.83 × 10−3 mL/mL/s, the corresponding ATT was 2.10 ± 0.20 s, and the T1 was 1.84 ± 0.102 s. Intraclass correlation coefficient was 0.92 (95% confidence interval 0.83–0.97) for f, 0.96 (0.91–0.99) for ATT, and 0.94 (0.88–0.98) for T1, demonstrating excellent reproducibility.ConclusionA simple, portable 3D‐printed perfusion phantom with excellent reproducibility of 2D pseudo‐continuous ASL measurements was demonstrated that can serve for quality‐controlled and reliable measurements of ASL perfusion.

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Recent advances in arterial spin labeling perfusion MRI in patients with vascular cognitive impairment

Cited by 10 publications

References 120 publications

Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment

Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment

Utilizing Reduced Labeled Proton Clearance to Identify Preclinical Alzheimer Disease with 3D ASL MRI

A 3D‐printed phantom for quality‐controlled reproducibility measurements of arterial spin labeled perfusion

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