A Test-Retest Study of Single- and Multi-Delay pCASL for Choroid Plexus Perfusion Imaging in Healthy Subjects Aged 19 to 87 Years

• Published in: NeuroImage (Orlando, Fla.) Vol. 308; p. 121048
• Main Authors: Liu, Zixuan, Shou, Qinyang, Jann, Kay, Zhao, Chenyang, Wang, Danny JJ, Shao, Xingfeng
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2025; Elsevier Limited; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Aging; Arterial spin labeling (ASL); Blood flow; Cerebral blood flow; Cerebrospinal fluid; Cerebrovascular Circulation - physiology; Cerebrovascular diseases; Choroid plexus; Choroid Plexus - blood supply; Choroid Plexus - physiology; Data analysis; Disease; Efficiency; Female; Homeostasis; Humans; Magnetic Resonance Imaging - methods; Male; Medical imaging; Middle Aged; Multiple-delay ASL; Neuroimaging; Perfusion; Perfusion Imaging - methods; Quantification accuracy; Reproducibility of Results; Single-delay ASL; Spatial discrimination; Spin labeling; Spin Labels; Test-retest reliability; Vascular diseases; Young Adult; Choroid plexus; Test-retest reliability; Arterial spin labeling (ASL); Aging; Multiple-delay ASL; Cerebrospinal fluid; Single-delay ASL; Quantification accuracy
• ISSN: 1053-8119; 1095-9572; 1095-9572
• DOI: 10.1016/j.neuroimage.2025.121048

•The study comprehensively covered a wide age range, including participants aged 19 to 87 years.•CBF measurements' test-retest reliability was excellent for gray matter (GM) and ChP.•As individuals age, ChP volume increases while ChP perfusion decreases, highlighting the significant impact of aging on ChP perfusion.•Single-delay ASL underestimated CBF in voxels with ATTs longer than 2 ss.•Multi-delay ASL with model fitting is preferred for accurate and reliable CBF and ATT measurements in the ChP. There is a growing interest in the choroid plexus (ChP) due to its critical role in cerebrospinal fluid (CSF) production and its involvement in neurodegenerative and cerebrovascular diseases. However, comprehensive studies comparing the accuracy and reliability of single- and multi-PLD (post-labeling delay) arterial spin labeling (ASL) techniques, specifically in relation to the ChP, remain limited. This study systematically evaluated the test-retest reliability and quantification accuracy of cerebral blood flow (CBF) measurements, focusing on the ChP, using single-delay and multi-delay 3D gradient-and-spin echo (GRASE) pseudo-continuous ASL (pCASL) on 28 subjects (aged 19 to 87 years, 14 males/14 females) at 3.0 tesla. Both single-delay (2 s) and 5-PLD (0.5 – 2.5 s) pCASL scans were repeated approximately one week apart with a spatial resolution of 2.5 × 2.5 × 3 mm³. Voxel-wise and regional CBF and arterial transit time (ATT) measurements were compared to assess test-retest reliability, with a particular focus on ChP perfusion changes with age. In this study, 12.15 % of ChP voxels exhibited ATTs longer than 2 s, potentially leading to a significant underestimation of CBF using single-delay ASL. Multi-delay ASL showed improved accuracy in estimating CBF values for the ChP compared to single-delay ASL when ATT > PLD. Additionally, ChP volume (mean ± std = 1.72± 0.85 ml) increased (p < 0.01) and ChP perfusion (43.07±14.18 mL/100 g/min) decreased (p = 0.04) with age. These findings underscore the robustness of multi-delay ASL with model-fitting quantification in assessing ChP perfusion, making it the preferred method for accurate CBF and ATT estimation, particularly in regions with prolonged transit time such as ChP.