ExploreASL: An image processing pipeline for multi-center ASL perfusion MRI studies

Arterial spin labeling (ASL) has undergone significant development since its inception, with a focus on improving standardization and reproducibility of its acquisition and quantification. In a community-wide effort towards robust and reproducible clinical ASL image processing, we developed the software package ExploreASL, allowing standardized analyses across centers and scanners. The procedures used in ExploreASL capitalize on published image processing advancements and address the challenges of multi-center datasets with scanner-specific processing and artifact reduction to limit patient exclusion. ExploreASL is self-contained, written in MATLAB and based on Statistical Parameter Mapping (SPM) and runs on multiple operating systems. To facilitate collaboration and data-exchange, the toolbox follows several standards and recommendations for data structure, provenance, and best analysis practice. ExploreASL was iteratively refined and tested in the analysis of >10,000 ASL scans using different pulse-sequences in a variety of clinical populations, resulting in four processing modules: Import, Structural, ASL, and Population that perform tasks, respectively, for data curation, structural and ASL image processing and quality control, and finally preparing the results for statistical analyses on both single-subject and group level. We illustrate ExploreASL processing results from three cohorts: perinatally HIV-infected children, healthy adults, and elderly at risk for neurodegenerative disease. We show the reproducibility for each cohort when processed at different centers with different operating systems and MATLAB versions, and its effects on the quantification of gray matter cerebral blood flow. ExploreASL facilitates the standardization of image processing and quality control, allowing the pooling of cohorts which may increase statistical power and discover between-group perfusion differences. Ultimately, this workflow may advance ASL for wider adoption in clinical studies, trials, and practice

ExploreASL: image processing toolbox for multi-center arterial spin labeling population analyses

Arterial spin labeling (ASL) perfusion MRI1 is rapidly maturing as a research tool, potential future biomarker2 and pharmacological monitoring agent3 for many diseases including neurodegeneration. There is thus a growing need for standardization of ASL image processing and quality control (QC) for voxel-based (VBA) and region-of-interest (ROI)-based analyses. Here, we present ExploreASL, a non-commercial software package that aims to harmonize image processing for ASL perfusion images for single- and multi-center studies4, 5. In addition, ExploreASL combines key structural image processing tools from recent literature to differentiate perfusion from structural effects. Initiated through the EU-funded COST-action "ASL In Dementia", ExploreASL is a collaborative framework of researchers and clinical investigators. It was already used to process ~4000 ASL images from all major MRI vendors and ASL sequences, and a large variety of patient populations. The ultimate goal is to combine data from a large number of studies and identify common and different perfusion patterns to enhance knowledge of ASL image analysis and of the role of perfusion and structural changes in neurodegenerative pathophysiology

ExploreASL: An image processing pipeline for multi-center ASL perfusion MRI studies

10.1016/j.neuroimage.2020.117031NeuroImage21911703