Hemodynamic imaging parameters in brain metastases patients - Agreement between multi-delay ASL and hypercapnic BOLD

Eva E van Grinsven*, Jamila Guichelaar, Marielle Ep Philippens, Jeroen CW Siero, Alex A Bhogal

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Arterial spin labeling (ASL) MRI is a routine clinical imaging technique that provides quantitative cerebral blood flow (CBF) information. A related technique is blood oxygenation level-dependent (BOLD) MRI during hypercapnia, which can assess cerebrovascular reactivity (CVR). ASL is weighted towards arteries, whereas BOLD is weighted towards veins. Their associated parameters in heterogeneous tissue types or under different hemodynamic conditions remains unclear. Baseline multi-delay ASL MRI and BOLD MRI during hypercapnia were performed in fourteen patients with brain metastases. In the ROI analysis, the CBF and CVR values were positively correlated in regions showing sufficient reserve capacity (i.e. non-steal regions, r rm  = 0.792). Additionally, longer hemodynamic lag times were related to lower baseline CBF ( r rm  = -0.822) and longer arterial arrival time (AAT; r rm  = 0.712). In contrast, in regions exhibiting vascular steal an inverse relationship was found with higher baseline CBF related to more negative CVR ( r rm  = -0.273). These associations were confirmed in voxelwise analyses. The relationship between CBF, AAT and CVR measures seems to be dependent on the vascular status of the underlying tissue. Healthy tissue relationships do not hold in tissues experiencing impaired or exhausted autoregulation. CVR metrics can possibly identify at-risk areas before perfusion deficiencies become visible on ASL MRI, specifically within vascular steal regions.

Original languageEnglish
Pages (from-to)2072-2084
Number of pages13
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number12
Early online date26 Aug 2023
Publication statusPublished - Dec 2023


  • Brain metastases
  • cerebral blood flow
  • cerebrovascular reactivity
  • hemodynamic lag
  • hemodynamics


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