Gray matter contamination in arterial spin labeling white matter perfusion measurements in patients with dementia

• A single slice distance analysis was performed.
• Perfusion signal in the white matter was compared with signal outside the brain.
• The application of erosion was compared with removal of partial volume voxels.
• White matter perfusion signal can be distinguished from gray matter contamination.
• The erosion of three voxels is warranted to avoid gray matter contamination.

IntroductionWhite matter (WM) perfusion measurements with arterial spin labeling can be severely contaminated by gray matter (GM) perfusion signal, especially in the elderly. The current study investigates the spatial extent of GM contamination by comparing perfusion signal measured in the WM with signal measured outside the brain.Material and methodsFour minute 3T pseudo-continuous arterial spin labeling scans were performed in 41 elderly subjects with cognitive impairment. Outward and inward geodesic distance maps were created, based on dilations and erosions of GM and WM masks. For all outward and inward geodesic distances, the mean CBF was calculated and compared.ResultsGM contamination was mainly found in the first 3 subcortical WM voxels and had only minor influence on the deep WM signal (distances 4 to 7 voxels). Perfusion signal in the WM was significantly higher than perfusion signal outside the brain, indicating the presence of WM signal.ConclusionThese findings indicate that WM perfusion signal can be measured unaffected by GM contamination in elderly patients with cognitive impairment. GM contamination can be avoided by the erosion of WM masks, removing subcortical WM voxels from the analysis. These results should be taken into account when exploring the use of WM perfusion as micro-vascular biomarker.