SCALE-PWI: A pulse sequence for absolute quantitative cerebral perfusion imaging

Jessy Mouannes Srour, Wanyong Shin, Saurabh Shah, Anindya Sen, Timothy J. Carroll*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


The Bookend technique is a magnetic resonance imaging (MRI) dynamic susceptibility contrast method that provides reliable quantitative measurement of cerebral blood flow (CBF) and cerebral blood volume (CBV). The quantification is patient specific, is derived from a steady-state measurement of CBV, and is obtained from T 1 changes in the white matter and the blood pool after contrast agent injection. In the current implementation, the Bookend technique consists of three scanning steps requiring a cumulative scan time of 3 minutes 47 seconds, a well-trained technologist, and extra time for offline image reconstruction. We present an automation and acceleration of the multiscan Bookend protocol through a self-calibrating pulse sequence, namely Self-Calibrated Epi Perfusion-Weighted Imaging (SCALE-PWI). The SCALE-PWI is a single-shot echo-planar imaging pulse sequence with three modules and a total scan time of under 2 minutes. It provides the possibility of performing online, quantitative perfusion image reconstruction, which reduces the latency to obtain quantitative maps. A validation study in healthy volunteers (N19) showed excellent agreement between SCALE-PWI and the conventional Bookend protocol (P0.05 with Student's t-test, r0.95/slope0.98 for quantitative CBF, and r0.91/slope0.94 for quantitative CBV). A single MRI pulse sequence for absolute quantification of cerebral perfusion has been developed.

Original languageEnglish (US)
Pages (from-to)1272-1282
Number of pages11
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number5
StatePublished - May 2011


  • dynamic susceptibility contrast
  • magnetic resonance imaging
  • pulse sequence
  • quantitative cerebral perfusion imaging
  • stroke

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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