Optimal location for arterial input function measurements near the middle cerebral artery in first-pass perfusion MRI

One of the main difficulties in obtaining quantitative perfusion values from dynamic susceptibility contrast-magnetic resonance imaging is a correct arterial input function (AIF) measurement, as partial volume effects can lead to an erroneous shape and amplitude of the AIF. Cerebral blood flow and volume scale linearly with the area under the AIF, but shape changes of the AIF can lead to large, nonlinear errors. Current manual and automated AIF selection procedures do not guarantee the exclusion of partial volume effects from AIF measurements. This study uses a numerical model, validated by phantom experiments, for predicting the optimal location for AIF measurements in the vicinity of the middle cerebral artery (MCA). Three different sequences were investigated and evaluated on a voxel-by-voxel basis by comparison with the ground truth. Subsequently, the predictions were evaluated in an in vivo example. The findings are fourfold: AIF measurements should be performed in voxels completely outside the artery, here a linear relation should be assumed between Delta R-2* and the concentration contrast agent, the exact optimal location differs per acquisition type, and voxels including a small MCA yield also correct AIF measurements for segmented echo planar imaging when a short echo time was used.