ARTERIAL SPIN LABELING(ASL)

JUSTIN MALIMBAN

 INTRODUCTION
BASIC PRINCIPLES
TYPES OF ASL
ADVANTAGES AND DISADVANTAGES

INTRODUCTION
PERFUSION
flow of blood through arteries and
capillaries
crucial in delivering nutrients and
oxygen to cells and removing cellular
waste products.
important
for
the
diagnosis,
characterization and monitoring of
inflammatory tissue changes
Presence of ischemia or hyperemia

Figure 2. (left) 60 y/o man 8.8 hrs after stroke onset, (right) 80
y/o man 8.2 hrs after stroke onset

INTRODUCTION
PERFUSION IMAGING
Traditionally
Positron
Emission
Tomography
(PET)
Fluorodeoxyglucose
Dynamic Susceptibility Contrast
(DSC) MRI
Gadolinium Contrast

Figure 3. patient with and occlusion of the left internal carotid

artery (left) DSC MRI and (right) PET scan

INTRODUCTION
ARTERIAL SPIN LABELING (ASL)
noninvasive MRI perfusion technique
that uses magnetically labeled arterial
blood as an endogenous tracer
initially
designed
for
cerebral
perfusion
has been used on studies of various
brain
disorders,
including
neurodegenerative diseases such as
Alzheimers disease

Figure 1. Dynamic Susceptibility Contrast (DSC) MRI and

ASL perfusion images

Basic Principles
I.

Labeled Image
Inversion of spins around
the neck (RF pulse)
Post labeling delay to allow
blood to flow in the region
of interest
Image acquisition (labeled
image)

Basic Principles
II. Control Image
without labeling

Labeled and Control images

are subtracted to produce the
perfusion image

Basic Principles

Magnetic
tracer
decays
at
longitudinal relaxation rate T1 (i.e.,
1~2 s)
Post labelling delay < T1 relaxation
time
Avoid T1 decay
Adequate amount of labeled blood
Depends on the patient

Basic Principles
Low signal-to-noise ratio (SNR)
Multiple images taken then averaged
Higher fields = higher SNR

Signal is about 0.5~1.5% of the

tissue signal
Echo planar imaging sequence is
used
High SNR
Fast acquisition time
Eliminate motion artifact

TYPES OF ASL
CONTINUOUS ARTERIAL
SPIN LABELING (CASL)
1st type of ASL
inversion by continuous RF
pulse in a thin plane
labeling for about 2~4s
High perfusion contrast
not available in most MRI
scanners

TYPES OF ASL
CONTINUOUS ARTERIAL
SPIN LABELING (CASL)
High deposition of RF on
the patient
continuous RF pulse is not
supported by RF hardware
commercially available
Induction of magnetization
transfer

TYPES OF ASL
PULSE ARTERIAL SPIN
LABELING (PASL)
single short inversion pulse
in a thick slab about 10~15
cm
duration of 10~20 ms
Shorter labeling duration =
lower SNR than CASL

ADVANTAGES AND DISADVANTAGES

Avoids the use of radioactive
tracers or paramagnetic contrast
agents
healthy individuals
pediatric populations
patients with renal impairment
eliminates potential risk of
nephrogenic systemic fibrosis
post-treatment monitoring

ADVANTAGES AND DISADVANTAGES

Very efficient method in
screening and monitoring
disease progression
Hypoperfusion -> stroke,
ischemia, stenosis,
neurodegenerative diseases
like Alzheimers disease
Hyperperfusion -> tumors

ADVANTAGES AND DISADVANTAGES

similar image patterns

comparable diagnostic
accuracy

ADVANTAGES AND DISADVANTAGES

several disadvantages of the current ASL techniques which have
delayed their widespread application
relatively low signal-to-noise ratio (SNR)
relatively short tracer lifetime
Difficulties in post-processing of images
No universal protocol
Lack of guidelines for interpretation

FIN.

REFERENCES
Ferr, J.C., Bannier, E., Raoult, H., Mineur, G., Carsin-Nicol, B.,
Gauvrit, J.Y. Arterial Spin Labelling (ASL) Perfusion): Techniques
and Clinical Use. Elsevier 2013; 94:1211-1223.
Grade, M., Hernandez Tamames, J.A., Pizzini, F.B., Achten,E.,
Golay, X., Smits, M. A Neurologists Guide to Arterial Spin Labelling
MRI in Clinical Practice. Neuroradioloogy 2015; 57:1181-1202.
Borogovac, A., Asllani, I. Arterial Spin Labelling (ASL) fMRI:
Advantages, Theoretical Constraints and Experimental Challenges
in Neurosciences. International Jornal of Biomedical Imaging 2012.
Saba, L. (2016). Image Principles, Neck and the Brain. Taylor and
Francis Group, LLC.