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The long and winding road to translation for imaging biomarker development: the case for arterial spin labelling (ASL)

The long and winding road to translation for imaging biomarker development: the case for arterial... Radiology is facing many challenges nowadays, and certainly needs to keep up with the fast pace of developments taking place in this field. This editorial aims at drawing the attention of the reader to the current establishment of quantitative imaging biomarkers, in particular through the efforts of the Quantitative Imaging Biomarker Alliance (QIBA) from the Radiological Society of North America (RSNA), as well as the European Imaging Biomarker Alliance (EIBALL) from the European Society of Radiology (ESR). The case of arterial spin labelling (ASL) is used as an example of the long and winding road to translate a good imaging technique into a clinically relevant imaging biomarker. Keywords: Quantitative evaluations, Biomarkers, Perfusion imaging, Calibration, Imaging, Phantoms Key points around the world. In particular, they may be particu- larly good in helping them peruse the hundreds of Radiology is moving from pattern recognition by sections typically provided by modern MRI or CT scan- experts to a specialty based on the measurements of ners for their reporting. Some fear, however, that they physical quantities might be powerful enough to replace the radiologist In order to move from pattern recognition to the altogether. scientific assessment of measurement techniques, In parallel, another revolution is taking place, at a less new paradigms need to be followed mediatised rate but no less certainly than the AI one, The two largest radiological associations in the and it has to do with quantification. Quantification in world are leading the way through the establishment radiology starts with simple anatomical precision, and of dedicated committees working on this the well-known Response Evaluation Criteria In Solid transformation Tumours criteria [2] used for assessment of treatment Arterial spin labelling (ASL), an MRI technique used response in cancer are based on the premise that meas- for the measurement of perfusion, is proposed as a urement of size can be made reproducibly over time, demonstration of what is needed to transform an even if the patient is not scanned by the same machine imaging technique into a quantitative imaging functioning on the same software level. While these biomarker criteria are rather rough and simple, the issue of repro- ducibility and anatomical precision becomes already more challenging when MRI (or less frequently CT) is Introduction used to assess the slow reduction in grey matter taking Radiology is currently at a crossroads. Having been the place in dementia over time [3]. Precision becomes first medical specialty to endorse the digital revolution, particularly crucial now that the new diagnostic criteria it is also the first to face the amazing opportunities, but for dementia are based on an increase in the yearly rate also the profound threats, from artificial intelligence of atrophy, at typically 2% for Alzheimer’s patients, with [1]. Such algorithms might one day be good enough to respect to the general population (0.5% per annum from provide substantial help to radiologists everywhere the age of 40 years) [4, 5]. The issue only becomes more Correspondence: x.golay@ucl.ac.uk difficult to handle when such criteria are used as UCL Institute of Neurology, Queen Square 8-11, London WC1N 3BG, UK © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Golay European Radiology Experimental (2017) 1:3 Page 2 of 4 outcome measures in clinical trials, in which hundreds quantification becomes an ever more important part of its of patients need to be individually followed up, and for practice, it becomes necessary for it to become more pre- which precision needs to be maintained throughout the cise, and with precision comes the need to become more whole duration of the trial. scientific. In particular, the implementation of quantitative In this context, the pioneering natural history study anatomical and physiological imaging requires the use of called Alzheimer’s Disease Neuroimaging Initiative has very strict rules based on metrology, the science dealing established some of the necessary requirements needed with measurement. This is particularly difficult for radi- in terms of quality assurance and reproducibility, as well ology, owing to the differences between the acquisition as presence of artefacts [6]. Through its first results, and analysis tools available on the market, as well as the published several years ago, extensive collaboration be- independent activities of the clinicians. It is, therefore, ab- tween basic scientists, statisticians and clinicians has solutely necessary for the field to move forward to increase allowed the development of the necessary standards for the collaboration between basic scientists and clinicians in the use of imaging as an outcome measure in large trials. order to overcome the hurdles linked with the develop- It thereby showed the necessity to use objects treated as ment of quantitative imaging biomarkers. Understanding reference standards across the various sites to ensure the seriousness of these issues, the Radiological Society of that no subtle drift was present, or that a scheduled soft- North America decided in 2007 to establish the Quantita- ware upgrade on a machine did not change the results tive Imaging Biomarker Alliance (QIBA) as a means to dramatically [6]. unite researchers, health care professionals, and industry Furthermore, the last 20–30 years have seen another stakeholders to advance the use of quantitative imaging in revolution, beyond simple anatomical imaging, through general [17]. which basic scientists and manufacturers have joined Through QIBA, scientists, clinicians and mathemati- forces with radiologists to increase both the quality and cians hope to validate quantitative imaging biomarkers, the information content of the medical imaging equip- based on metrological practices such as identification and ment available. Quantitative imaging has gained a new characterisation of the sources of error. In addition, a de- meaning through the development of most physio- tailed analysis of the entire imaging chain will need to be logical imaging techniques, be it, e.g. perfusion CT [7], undertaken, from acquisition to processing, to be able to Gd-based perfusion MRI [8], ASL [9] or diffusion- establish the presence or not of a bias along the entire weighted imaging [10] and its many applications, from measurement procedure. Here again, estimation of a bias the assessment of white matter fibre tracts in the brain size is generally made through the use of objects serving [11] to the detection and assessment of early changes as ‘gold standards’ or benchmarks for the measurements in water diffusion in cancer [12]. Yet, following from done. These objects are generally called phantoms and 30 years of development leading these techniques to be their role will, therefore, be more and more important widely used in most oncological examinations everywhere within the growing field of quantitative radiology. in the body, they are today still mostly interpreted in a In Europe as well, responding to the urgent need to semiqualitative way by radiologists around the world. This promote the development of imaging biomarkers, the is happening in the face of a large body of evidence indi- European Society of Radiology (ESR) has created a stand- cating that the quantitative measures themselves obtained ing subcommittee from its Research Committee, called by many of these techniques could serve as early indica- the European Imaging Biomarker Alliance (EIBALL). This tors of the presence of disease or indeed as biomarkers of committee aims at promoting the development of bio- response to treatment [13–16]. In addition, these tech- markers within the realm of the ESR, and has recently niques offer the added advantage of being usable as joined forces with the European Institute of Biomedical translational biomarkers between late preclinical stud- Imaging Research to start working on Europe based pro- ies involving animal models and first-in-man studies, jects in this matter. In particular, the EIBALL Committee thereby providing early indications of its potential has recently joined forces with QIBA to work on the first- therapeutic power. As such, it is hoped that the use of ever EIBALL-QIBA project on the development of a new quantitative physiological imaging as translational bio- quantitative imaging biomarker, based on the ASL perfu- markers by basic scientists and clinicians alike might one sion measurement technique. day allow a shortening of the time to market of new thera- peutics. More importantly for this community, it will nat- A typical case of biomarker development: ASL urally increase the participation by radiology departments The case of ASL is rather typical for a quantitative im- in clinical trials, and ensure its more frequent position as aging technique. Started in the early 1990s [9], the a leading partner. method underwent many technical improvements So, as radiology, like many other medical specialties, through a decade of developments by MRI physicists moves towards a more evidence-based approach, and as and engineers. This left the field in the early 2000s with Golay European Radiology Experimental (2017) 1:3 Page 3 of 4 many independent implementations, leading the major Within this context, it seems that many of the upcom- manufacturers to pick and choose one each differently ing activities linked in particular to quantitative imaging as a work-in-progress package [18]. In addition, at that biomarker development and validation, such as the case time, no clear consensus existed in terms of quantifica- in ASL, as well as its implementation within clinical tion, and every researcher and the few clinicians inter- practice, fall exactly within the target publication of this ested in the applications of this method were left with a very journal, European Radiology Experimental. rather daunting choice for quantification models, each Abbreviations providing a slightly different answer, depending on its ASL: Arterial spin labelling; EIBALL: European Imaging Biomarker Alliance; underlying hypotheses [19]. ESR: European Society of Radiology; ISMRM: International Society for Therefore, the community had to do something to try Magnetic Resonance in Medicine; QIBA: Quantitative Imaging Biomarker Alliance to sort out the two main issues plaguing the field: (1) the plethora of acquisition techniques and (2) the lack of con- Competing interests sensus on the quantification method. In addition, nobody The author is also chief executive officer of Gold Standard Phantoms Limited, a even knew whether this technique was reproducible, apart small spin-out company from University College London aiming at developing reference standards in quantitative MRI. from a handful of volunteers being scanned repeatedly at single institutions. Indeed, it took nearly 20 years between the first publication on rats to the first large test-retest Publisher’sNote Springer Nature remains neutral with regard to jurisdictional claims in study of one of the numerous techniques [20]. published maps and institutional affiliations. Thus, in 2009, a core group of researchers and clinicians gathered together at a first meeting in London, and decided Received: 22 December 2016 Accepted: 16 March 2017 to establish the ASL Network (http://www.asl-network.org). This group has since met on regular occasions primarily at References meetings of the International Society for Magnetic Reson- 1. Jha S, Topol EJ (2016) Adapting to artificial intelligence: radiologists and ance in Medicine (ISMRM) and, from 2011 to 2015, it was pathologists as information specialists. JAMA 316:2353–2354 2. Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to supported by a European Commission-funded COST evaluate the response to treatment in solid tumors. European Organization Action to try and establish the use of ASL in dementia [18]. for Research and Treatment of Cancer, National Cancer Institute of the One of the main achievements of this action has been United States, National Cancer Institute of Canada. J Natl Cancer Inst 92: 205–216 the publication, together with the Perfusion Study Group 3. O’Brien JT, Paling S, Barber R et al (2001) Progressive brain atrophy on serial of the ISMRM, of a position paper on the current state MRI in dementia with Lewy bodies, AD, and vascular dementia. Neurology of ASL, the so-called ‘ASL White Paper’, indicating 56:1386–1388 4. Dubois B, Feldman HH, Jacova C et al (2010) Revising the definition of clearly what sequence was thought to be providing the Alzheimer’s disease: a new lexicon. Lancet Neurol 9:1118–1127 best signal-to-noise ratio and what quantification 5. Scahill RI, Frost C, Jenkins R et al (2003) A longitudinal study of brain method needed to be employed [21]. Remarkably, this volume changes in normal aging using serial registered magnetic resonance imaging. Arch Neurol 60:989–994 paper, in addition to its 14 coauthors, was also officially 6. Jack CR Jr, Bernstein MA, Fox NC et al (2008) The Alzheimer’s Disease endorsed by over 230 people, representing a large pro- Neuroimaging Initiative (ADNI): MRI methods. J Magn Reson Imaging 27: portion of basic scientists and clinicians active at that 685–691 7. Nabavi DG, Cenic A, Craen RA et al (1999) CT assessment of cerebral time. In addition to this landmark paper, numerous perfusion: experimental validation and initial clinical experience. Radiology other studies tackled the problem of reproducibility and 213:141–149 difference in perfusion maps obtained by the different 8. Rosen BR, Belliveau JW, Vevea JM, Brady TJ (1990) Perfusion imaging with NMR contrast agents. Magn Reson Med 14:249–265 manufacturers (e.g. [22]). This led all major manufac- 9. Williams DS, Detre JA, Leigh JS, Koretsky AP (1992) Magnetic resonance turers to slowly change their implementation to the pre- imaging of perfusion using spin inversion of arterial water. Proc Natl Acad ferred version from the ASL White Paper. Sci U S A 89:212–216 10. Wesbey GE, Moseley ME, Ehman RL (1984) Translational molecular self-diffusion It is, therefore, the right time now to engage with the in magnetic resonance imaging. II. Measurement of the self-diffusion coefficient. process of establishing a QIBA profile, and it is great Investig Radiol 19:491–498 news that members of the EIBALL Committee have 11. Mori S, Crain BJ, Chacko VP, van Zijl PC (1999) Three-dimensional tracking of axonal projections in the brain by magnetic resonance imaging. Ann Neurol agreed to bring it forward. Within its tasks, the commit- 45:265–269 tee will need to implement further longitudinal studies 12. Takahara T, Imai Y, Yamashita T, et al (2004) Diffusion weighted whole body and to refine claims to establish exactly how quantitative imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. assessment of cerebral perfusion can shape the future of Radiat Med 22:275–782 neurological and neuroradiological research and applica- 13. Galban CJ, Chenevert TL, Meyer CR et al (2009) The parametric response tions. The future now seems bright, with the potential map is an imaging biomarker for early cancer treatment outcome. Nat Med 15:572–576 use of quantitative perfusion in stroke, dementia, and 14. Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic brain tumours, as well as in neuroinflammation and resonance imaging as a cancer biomarker: consensus and other neurological conditions! recommendations. Neoplasia 11:102–125 Golay European Radiology Experimental (2017) 1:3 Page 4 of 4 15. Willett CG, Duda DG, di Tomaso E et al (2009) Efficacy, safety, and biomarkers of neoadjuvant bevacizumab, radiation therapy, and fluorouracil in rectal cancer: a multidisciplinary phase II study. J Clin Oncol 27:3020–3026 16. Wolk DA, Detre JA (2012) Arterial spin labeling MRI: an emerging biomarker for Alzheimer’s disease and other neurodegenerative conditions. Curr Opin Neurol 25:421–428 17. Sullivan DC, Obuchowski NA, Kessler LG et al (2015) Metrology standards for quantitative imaging biomarkers. Radiology 277:813–825 18. Golay X, Guenther M (2012) Arterial spin labelling: final steps to make it a clinical reality. MAGMA 25:79–82 19. Petersen ET, Zimine I, Ho YC, Golay X (2006) Non-invasive measurement of perfusion: a critical review of arterial spin labelling techniques. Br J Radiol 79:688–701 20. Petersen ET, Mouridsen K, Golay X, all named co-authors of the QUASAR test-retest study (2010) The QUASAR reproducibility study, Part II: results from a multicentre Arterial Spin Labeling test-retest study. NeuroImage 49: 104–113 21. Alsop DC, Detre JA, Golay X et al (2015) Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: a consensus of the ISMRM Perfusion Study Group and the European Consortium for ASL in Dementia. Magn Reson Med 73:102–116 22. Mutsaerts HJ, van Osch MJ, Zelaya FO et al (2015) Multi-vendor reliability of arterial spin labeling perfusion MRI using a near-identical sequence: implications for multi-center studies. NeuroImage 113:143–152 Submit your manuscript to a journal and benefi t from: 7 Convenient online submission 7 Rigorous peer review 7 Immediate publication on acceptance 7 Open access: articles freely available online 7 High visibility within the fi eld 7 Retaining the copyright to your article Submit your next manuscript at 7 springeropen.com http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Radiology Experimental Springer Journals

The long and winding road to translation for imaging biomarker development: the case for arterial spin labelling (ASL)

Golay, Xavier
European Radiology Experimental , Volume 1 (1) – Jun 29, 2017
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Springer Journals
Copyright
Copyright © 2017 by The Author(s)
Subject
Medicine & Public Health; Imaging / Radiology; Diagnostic Radiology; Interventional Radiology; Neuroradiology; Ultrasound; Internal Medicine
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2509-9280
DOI
10.1186/s41747-017-0004-7
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Abstract

Radiology is facing many challenges nowadays, and certainly needs to keep up with the fast pace of developments taking place in this field. This editorial aims at drawing the attention of the reader to the current establishment of quantitative imaging biomarkers, in particular through the efforts of the Quantitative Imaging Biomarker Alliance (QIBA) from the Radiological Society of North America (RSNA), as well as the European Imaging Biomarker Alliance (EIBALL) from the European Society of Radiology (ESR). The case of arterial spin labelling (ASL) is used as an example of the long and winding road to translate a good imaging technique into a clinically relevant imaging biomarker. Keywords: Quantitative evaluations, Biomarkers, Perfusion imaging, Calibration, Imaging, Phantoms Key points around the world. In particular, they may be particu- larly good in helping them peruse the hundreds of Radiology is moving from pattern recognition by sections typically provided by modern MRI or CT scan- experts to a specialty based on the measurements of ners for their reporting. Some fear, however, that they physical quantities might be powerful enough to replace the radiologist In order to move from pattern recognition to the altogether. scientific assessment of measurement techniques, In parallel, another revolution is taking place, at a less new paradigms need to be followed mediatised rate but no less certainly than the AI one, The two largest radiological associations in the and it has to do with quantification. Quantification in world are leading the way through the establishment radiology starts with simple anatomical precision, and of dedicated committees working on this the well-known Response Evaluation Criteria In Solid transformation Tumours criteria [2] used for assessment of treatment Arterial spin labelling (ASL), an MRI technique used response in cancer are based on the premise that meas- for the measurement of perfusion, is proposed as a urement of size can be made reproducibly over time, demonstration of what is needed to transform an even if the patient is not scanned by the same machine imaging technique into a quantitative imaging functioning on the same software level. While these biomarker criteria are rather rough and simple, the issue of repro- ducibility and anatomical precision becomes already more challenging when MRI (or less frequently CT) is Introduction used to assess the slow reduction in grey matter taking Radiology is currently at a crossroads. Having been the place in dementia over time [3]. Precision becomes first medical specialty to endorse the digital revolution, particularly crucial now that the new diagnostic criteria it is also the first to face the amazing opportunities, but for dementia are based on an increase in the yearly rate also the profound threats, from artificial intelligence of atrophy, at typically 2% for Alzheimer’s patients, with [1]. Such algorithms might one day be good enough to respect to the general population (0.5% per annum from provide substantial help to radiologists everywhere the age of 40 years) [4, 5]. The issue only becomes more Correspondence: x.golay@ucl.ac.uk difficult to handle when such criteria are used as UCL Institute of Neurology, Queen Square 8-11, London WC1N 3BG, UK © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Golay European Radiology Experimental (2017) 1:3 Page 2 of 4 outcome measures in clinical trials, in which hundreds quantification becomes an ever more important part of its of patients need to be individually followed up, and for practice, it becomes necessary for it to become more pre- which precision needs to be maintained throughout the cise, and with precision comes the need to become more whole duration of the trial. scientific. In particular, the implementation of quantitative In this context, the pioneering natural history study anatomical and physiological imaging requires the use of called Alzheimer’s Disease Neuroimaging Initiative has very strict rules based on metrology, the science dealing established some of the necessary requirements needed with measurement. This is particularly difficult for radi- in terms of quality assurance and reproducibility, as well ology, owing to the differences between the acquisition as presence of artefacts [6]. Through its first results, and analysis tools available on the market, as well as the published several years ago, extensive collaboration be- independent activities of the clinicians. It is, therefore, ab- tween basic scientists, statisticians and clinicians has solutely necessary for the field to move forward to increase allowed the development of the necessary standards for the collaboration between basic scientists and clinicians in the use of imaging as an outcome measure in large trials. order to overcome the hurdles linked with the develop- It thereby showed the necessity to use objects treated as ment of quantitative imaging biomarkers. Understanding reference standards across the various sites to ensure the seriousness of these issues, the Radiological Society of that no subtle drift was present, or that a scheduled soft- North America decided in 2007 to establish the Quantita- ware upgrade on a machine did not change the results tive Imaging Biomarker Alliance (QIBA) as a means to dramatically [6]. unite researchers, health care professionals, and industry Furthermore, the last 20–30 years have seen another stakeholders to advance the use of quantitative imaging in revolution, beyond simple anatomical imaging, through general [17]. which basic scientists and manufacturers have joined Through QIBA, scientists, clinicians and mathemati- forces with radiologists to increase both the quality and cians hope to validate quantitative imaging biomarkers, the information content of the medical imaging equip- based on metrological practices such as identification and ment available. Quantitative imaging has gained a new characterisation of the sources of error. In addition, a de- meaning through the development of most physio- tailed analysis of the entire imaging chain will need to be logical imaging techniques, be it, e.g. perfusion CT [7], undertaken, from acquisition to processing, to be able to Gd-based perfusion MRI [8], ASL [9] or diffusion- establish the presence or not of a bias along the entire weighted imaging [10] and its many applications, from measurement procedure. Here again, estimation of a bias the assessment of white matter fibre tracts in the brain size is generally made through the use of objects serving [11] to the detection and assessment of early changes as ‘gold standards’ or benchmarks for the measurements in water diffusion in cancer [12]. Yet, following from done. These objects are generally called phantoms and 30 years of development leading these techniques to be their role will, therefore, be more and more important widely used in most oncological examinations everywhere within the growing field of quantitative radiology. in the body, they are today still mostly interpreted in a In Europe as well, responding to the urgent need to semiqualitative way by radiologists around the world. This promote the development of imaging biomarkers, the is happening in the face of a large body of evidence indi- European Society of Radiology (ESR) has created a stand- cating that the quantitative measures themselves obtained ing subcommittee from its Research Committee, called by many of these techniques could serve as early indica- the European Imaging Biomarker Alliance (EIBALL). This tors of the presence of disease or indeed as biomarkers of committee aims at promoting the development of bio- response to treatment [13–16]. In addition, these tech- markers within the realm of the ESR, and has recently niques offer the added advantage of being usable as joined forces with the European Institute of Biomedical translational biomarkers between late preclinical stud- Imaging Research to start working on Europe based pro- ies involving animal models and first-in-man studies, jects in this matter. In particular, the EIBALL Committee thereby providing early indications of its potential has recently joined forces with QIBA to work on the first- therapeutic power. As such, it is hoped that the use of ever EIBALL-QIBA project on the development of a new quantitative physiological imaging as translational bio- quantitative imaging biomarker, based on the ASL perfu- markers by basic scientists and clinicians alike might one sion measurement technique. day allow a shortening of the time to market of new thera- peutics. More importantly for this community, it will nat- A typical case of biomarker development: ASL urally increase the participation by radiology departments The case of ASL is rather typical for a quantitative im- in clinical trials, and ensure its more frequent position as aging technique. Started in the early 1990s [9], the a leading partner. method underwent many technical improvements So, as radiology, like many other medical specialties, through a decade of developments by MRI physicists moves towards a more evidence-based approach, and as and engineers. This left the field in the early 2000s with Golay European Radiology Experimental (2017) 1:3 Page 3 of 4 many independent implementations, leading the major Within this context, it seems that many of the upcom- manufacturers to pick and choose one each differently ing activities linked in particular to quantitative imaging as a work-in-progress package [18]. In addition, at that biomarker development and validation, such as the case time, no clear consensus existed in terms of quantifica- in ASL, as well as its implementation within clinical tion, and every researcher and the few clinicians inter- practice, fall exactly within the target publication of this ested in the applications of this method were left with a very journal, European Radiology Experimental. rather daunting choice for quantification models, each Abbreviations providing a slightly different answer, depending on its ASL: Arterial spin labelling; EIBALL: European Imaging Biomarker Alliance; underlying hypotheses [19]. ESR: European Society of Radiology; ISMRM: International Society for Therefore, the community had to do something to try Magnetic Resonance in Medicine; QIBA: Quantitative Imaging Biomarker Alliance to sort out the two main issues plaguing the field: (1) the plethora of acquisition techniques and (2) the lack of con- Competing interests sensus on the quantification method. In addition, nobody The author is also chief executive officer of Gold Standard Phantoms Limited, a even knew whether this technique was reproducible, apart small spin-out company from University College London aiming at developing reference standards in quantitative MRI. from a handful of volunteers being scanned repeatedly at single institutions. Indeed, it took nearly 20 years between the first publication on rats to the first large test-retest Publisher’sNote Springer Nature remains neutral with regard to jurisdictional claims in study of one of the numerous techniques [20]. published maps and institutional affiliations. Thus, in 2009, a core group of researchers and clinicians gathered together at a first meeting in London, and decided Received: 22 December 2016 Accepted: 16 March 2017 to establish the ASL Network (http://www.asl-network.org). This group has since met on regular occasions primarily at References meetings of the International Society for Magnetic Reson- 1. Jha S, Topol EJ (2016) Adapting to artificial intelligence: radiologists and ance in Medicine (ISMRM) and, from 2011 to 2015, it was pathologists as information specialists. JAMA 316:2353–2354 2. Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to supported by a European Commission-funded COST evaluate the response to treatment in solid tumors. European Organization Action to try and establish the use of ASL in dementia [18]. for Research and Treatment of Cancer, National Cancer Institute of the One of the main achievements of this action has been United States, National Cancer Institute of Canada. J Natl Cancer Inst 92: 205–216 the publication, together with the Perfusion Study Group 3. O’Brien JT, Paling S, Barber R et al (2001) Progressive brain atrophy on serial of the ISMRM, of a position paper on the current state MRI in dementia with Lewy bodies, AD, and vascular dementia. Neurology of ASL, the so-called ‘ASL White Paper’, indicating 56:1386–1388 4. Dubois B, Feldman HH, Jacova C et al (2010) Revising the definition of clearly what sequence was thought to be providing the Alzheimer’s disease: a new lexicon. Lancet Neurol 9:1118–1127 best signal-to-noise ratio and what quantification 5. Scahill RI, Frost C, Jenkins R et al (2003) A longitudinal study of brain method needed to be employed [21]. Remarkably, this volume changes in normal aging using serial registered magnetic resonance imaging. Arch Neurol 60:989–994 paper, in addition to its 14 coauthors, was also officially 6. Jack CR Jr, Bernstein MA, Fox NC et al (2008) The Alzheimer’s Disease endorsed by over 230 people, representing a large pro- Neuroimaging Initiative (ADNI): MRI methods. J Magn Reson Imaging 27: portion of basic scientists and clinicians active at that 685–691 7. Nabavi DG, Cenic A, Craen RA et al (1999) CT assessment of cerebral time. In addition to this landmark paper, numerous perfusion: experimental validation and initial clinical experience. Radiology other studies tackled the problem of reproducibility and 213:141–149 difference in perfusion maps obtained by the different 8. Rosen BR, Belliveau JW, Vevea JM, Brady TJ (1990) Perfusion imaging with NMR contrast agents. Magn Reson Med 14:249–265 manufacturers (e.g. [22]). This led all major manufac- 9. Williams DS, Detre JA, Leigh JS, Koretsky AP (1992) Magnetic resonance turers to slowly change their implementation to the pre- imaging of perfusion using spin inversion of arterial water. Proc Natl Acad ferred version from the ASL White Paper. Sci U S A 89:212–216 10. Wesbey GE, Moseley ME, Ehman RL (1984) Translational molecular self-diffusion It is, therefore, the right time now to engage with the in magnetic resonance imaging. II. Measurement of the self-diffusion coefficient. process of establishing a QIBA profile, and it is great Investig Radiol 19:491–498 news that members of the EIBALL Committee have 11. Mori S, Crain BJ, Chacko VP, van Zijl PC (1999) Three-dimensional tracking of axonal projections in the brain by magnetic resonance imaging. Ann Neurol agreed to bring it forward. Within its tasks, the commit- 45:265–269 tee will need to implement further longitudinal studies 12. Takahara T, Imai Y, Yamashita T, et al (2004) Diffusion weighted whole body and to refine claims to establish exactly how quantitative imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. assessment of cerebral perfusion can shape the future of Radiat Med 22:275–782 neurological and neuroradiological research and applica- 13. Galban CJ, Chenevert TL, Meyer CR et al (2009) The parametric response tions. The future now seems bright, with the potential map is an imaging biomarker for early cancer treatment outcome. Nat Med 15:572–576 use of quantitative perfusion in stroke, dementia, and 14. Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic brain tumours, as well as in neuroinflammation and resonance imaging as a cancer biomarker: consensus and other neurological conditions! recommendations. Neoplasia 11:102–125 Golay European Radiology Experimental (2017) 1:3 Page 4 of 4 15. Willett CG, Duda DG, di Tomaso E et al (2009) Efficacy, safety, and biomarkers of neoadjuvant bevacizumab, radiation therapy, and fluorouracil in rectal cancer: a multidisciplinary phase II study. J Clin Oncol 27:3020–3026 16. Wolk DA, Detre JA (2012) Arterial spin labeling MRI: an emerging biomarker for Alzheimer’s disease and other neurodegenerative conditions. Curr Opin Neurol 25:421–428 17. Sullivan DC, Obuchowski NA, Kessler LG et al (2015) Metrology standards for quantitative imaging biomarkers. Radiology 277:813–825 18. Golay X, Guenther M (2012) Arterial spin labelling: final steps to make it a clinical reality. MAGMA 25:79–82 19. Petersen ET, Zimine I, Ho YC, Golay X (2006) Non-invasive measurement of perfusion: a critical review of arterial spin labelling techniques. Br J Radiol 79:688–701 20. Petersen ET, Mouridsen K, Golay X, all named co-authors of the QUASAR test-retest study (2010) The QUASAR reproducibility study, Part II: results from a multicentre Arterial Spin Labeling test-retest study. NeuroImage 49: 104–113 21. Alsop DC, Detre JA, Golay X et al (2015) Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: a consensus of the ISMRM Perfusion Study Group and the European Consortium for ASL in Dementia. Magn Reson Med 73:102–116 22. Mutsaerts HJ, van Osch MJ, Zelaya FO et al (2015) Multi-vendor reliability of arterial spin labeling perfusion MRI using a near-identical sequence: implications for multi-center studies. NeuroImage 113:143–152 Submit your manuscript to a journal and benefi t from: 7 Convenient online submission 7 Rigorous peer review 7 Immediate publication on acceptance 7 Open access: articles freely available online 7 High visibility within the fi eld 7 Retaining the copyright to your article Submit your next manuscript at 7 springeropen.com

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European Radiology Experimental – Springer Journals

Published: Jun 29, 2017

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