Using negative signal in mono-TI pulsed arterial spin labeling to outline pathological increases in arterial transit times

The presence of unexpected negative perfusion estimates has been sparsely discussed in the ASL literature [2,3]. In the study of perfusion maps extracted from a single inversion time in ASL (mono-TI ASL), it is however common to deal with areas of significant negative signal. This is problematic since performing statistical analysis based on this data might therefore lead to inacurrate results. Though isolated negative values could be attributed to noise, clusters of significant negative signal should be explained by another phenomenon. Following previous authors, which outlined that negative values might arise due to increased transit times, we investigated this hypothesis based on real clinical datasets including healthy control and patient data.