Improved reproducibility for myocardial ASL: Impact of physiological and acquisition parameters

• Published in: Magnetic resonance in medicine Vol. 91; no. 1; pp. 118 - 132
• Main Authors: Božić‐Iven, Maša, Rapacchi, Stanislas, Tao, Qian, Pierce, Iain, Thornton, George, Nitsche, Christian, Treibel, Thomas A., Schad, Lothar R., Weingärtner, Sebastian
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.01.2024; Wiley; John Wiley and Sons Inc
• Subjects: Blood flow; cardiac arterial spin labeling; cardiac magnetic resonance imaging; Computer Science; Coronary Circulation - physiology; flow‐sensitive alternating inversion recovery; Heart Rate; Humans; Image acquisition; Imaging Methodology; Mathematical analysis; Medical Imaging; myocardial blood flow; Myocardial Perfusion Imaging - methods; Myocardium; Parameters; Phantoms, Imaging; Physiological effects; Physiology; Relaxation time; Reproducibility; Reproducibility of Results; Simulation; Spin labeling; Variability; flow-sensitive alternating inversion recovery; myocardial blood flow; cardiac magnetic resonance imaging; cardiac arterial spin labeling
• ISSN: 0740-3194; 1522-2594; 1522-2594
• DOI: 10.1002/mrm.29834

Purpose To investigate and mitigate the influence of physiological and acquisition‐related parameters on myocardial blood flow (MBF) measurements obtained with myocardial Arterial Spin Labeling (myoASL). Methods A Flow‐sensitive Alternating Inversion Recovery (FAIR) myoASL sequence with bSSFP and spoiled GRE (spGRE) readout is investigated for MBF quantification. Bloch‐equation simulations and phantom experiments were performed to evaluate how variations in acquisition flip angle (FA), acquisition matrix size (AMS), heart rate (HR) and blood T1$$ {\mathrm{T}}_1 $$ relaxation time (T1,B$$ {\mathrm{T}}_{1,B} $$) affect quantification of myoASL‐MBF. In vivo myoASL‐images were acquired in nine healthy subjects. A corrected MBF quantification approach was proposed based on subject‐specific T1,B$$ {\mathrm{T}}_{1,B} $$ values and, for spGRE imaging, subtracting an additional saturation‐prepared baseline from the original baseline signal. Results Simulated and phantom experiments showed a strong dependence on AMS and FA (R2$$ {R}^2 $$>0.73), which was eliminated in simulations and alleviated in phantom experiments using the proposed saturation‐baseline correction in spGRE. Only a very mild HR dependence (R2$$ {R}^2 $$>0.59) was observed which was reduced when calculating MBF with individual T1,B$$ {\mathrm{T}}_{1,B} $$. For corrected spGRE, in vivo mean global spGRE‐MBF ranged from 0.54 to 2.59 mL/g/min and was in agreement with previously reported values. Compared to uncorrected spGRE, the intra‐subject variability within a measurement (0.60 mL/g/min), between measurements (0.45 mL/g/min), as well as the inter‐subject variability (1.29 mL/g/min) were improved by up to 40% and were comparable with conventional bSSFP. Conclusion Our results show that physiological and acquisition‐related factors can lead to spurious changes in myoASL‐MBF if not accounted for. Using individual T1,B$$ {\mathrm{T}}_{1,B} $$ and a saturation‐baseline can reduce these variations in spGRE and improve reproducibility of FAIR‐myoASL against acquisition parameters.