Improving Multi-Delay-ASL through specialized reconstruction.

Purpose: Although image reconstruction has received relatively little attention in ASL research to date, it has the potential to address several challenges in ASL. As well as speeding up measurements by increasing undersampling and reducing measurement artifacts, it can improve the signal-to-noise ratio (SNR) of a given data set and the reproducibility of examinations. Methods: This work focuses on extending a dedicated ASL reconstruction approach (ASL-TGV) [1] to multi-delay data and applying it to a high-resolution pCASL test-retest dataset. To show not only improvement in the Perfusion Weighted Images (PWIs), Cerebral Blood Flow and Arterial Transit Time was estimated and the test-retest reliability was estimated using the within subject Coefficient of Variance (wsCV), the Intraclass Correlation Coefficient (ICC) and Root-Mean-Squared-Error (RMSE). Results: The Perfusion-Weighted-Images reconstructed from highly undersampled single-shot data using ASL-TGV are clearly improved compared to a fully-sampled reference from the same data even after denoising, especially for long PLDs and the outermost slices. SNR calculated in grey and white matter ROIs shows an improvement of 62% and 35% respectively. The CBF maps produced from the ASL-TGV images have an improved test-retest reliability. Conclusion: ASL-TGV, which is now implemented in the Berkeley Advanced Reconstruction Toolbox (BART), can be used with any type of ASL labeling or data acquisition and any existing image post-processing pipeline and can improve SNR for the PWIs and reproducibility of the CBF maps.