Mutke, M.A.M.A.MutkeMadai, V.I.V.I.MadaiSamson-Himmelstjerna, F.C. vonF.C. vonSamson-HimmelstjernaWeber, O.Z.O.Z.WeberRevankar, G.S.G.S.RevankarMartin, S.Z.S.Z.MartinStengl, K.L.K.L.StenglBauer, M.M.BauerHetzer, S.S.HetzerGünther, M.M.GüntherSobesky, J.J.Sobesky2022-03-042022-03-042014https://publica.fraunhofer.de/handle/publica/23673410.1371/journal.pone.00871432-s2.0-84895510834Introduction: 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. Conclusion: 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.en500journal article