ASL-based pipeline for cerebral perfusion imaging in essential tremor patients undergoing MRgFUS

Abstract

Magnetic Resonance-guided Focused Ultrasounds (MRgFUS) has emerged as an effective minimally invasive treatment for essential tremor (ET), but its cerebral physiological effects beyond the lesioned region remain poorly understood. This work presents and evaluates a pipeline for the analysis of cerebral blood perfusion changes in ET patients treated with MRgFUS. The pipeline processes pseudo-continuous Arterial Spin Labelling (pCASL) data from 19 patients using the ExploreASL framework, incorporating quality control procedures and a Minimum Detectable Change threshold of 24% to distinguish true biological effects from measurement noise. 13 out of the 19 patients exhibited at least one significant perfusion change, yielding 49 perfusion changes exceeding the detection threshold across several regions of interest. These preliminary results suggest that MRgFUS may induce hemodynamic effects beyond the lesion, potentially related to diaschisis