{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T01:50:59Z","timestamp":1787881859598,"version":"build-2784847793"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003088","name":"Evangelisches Studienwerk Villigst","doi-asserted-by":"publisher","award":["Personal grant to G.H."],"award-info":[{"award-number":["Personal grant to G.H."]}],"id":[{"id":"10.13039\/501100003088","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Individualized diagnostic approaches are crucial in cerebrovascular diseases, such as internal carotid artery stenosis (ICAS). To evaluate individual collateral blood supply, vessel\u2010selective imaging has gained high relevance. However, clinically established digital subtraction angiography (DSA) exposes patients to intervention risks and radiation. Two noninvasive MRI\u2010based alternatives are super\u2010selective pseudo\u2010continuous arterial spin labeling (ss\u2010pCASL, a technique for selective labeling of arterial blood\u2010water) for perfusion territory mapping and four\u2010dimensional vessel\u2010selective angiography (4D\u2010sPACK). We hypothesized that asymptomatic atherosclerosis\u2010induced ICAS and Moyamoya disease result in chronic malperfusion. Therefore, we aimed towards quantitative assessment of collateral blood flow by ss\u2010pCASL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective monocentric study, we acquired data in three subgroups (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a023): patients with asymptomatic unilateral atherosclerosis\u2010induced ICAS, Moyamoya disease, and age\u2010matched healthy controls (HCs). On the basis of vascular territories from ss\u2010pCASL, we introduced four parameters: volume, territorial shift, overlap with an atlas, and cerebral blood flow (CBF). For patients with atherosclerosis\u2010induced ICAS, ipsi\u2010 and contralateral hemispheres were compared (paired\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test), and hemispheric lateralization\n                      <jats:italic>\u0394<\/jats:italic>\n                      was calculated subjectwise and compared between patients and HCs (unpaired\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test) (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included data from 20 subjects (8 ICAS, 3 Moyamoya, 9 HC). Group\u2010level results showed ICAS\u2010induced shifts with significant lateralization compared to HCs (\n                      <jats:italic>\u0394<\/jats:italic>\n                      <jats:sub>Volume,ICAS<\/jats:sub>\n                      \u00a0=\u00a018%\u00a0\u00b1\u00a010%,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.001;\n                      <jats:italic>\u0394<\/jats:italic>\n                      <jats:sub>Shift,ICAS<\/jats:sub>\n                      \u00a0=\u00a04.9%\u00a0\u00b1\u00a05.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.027;\n                      <jats:italic>\u0394<\/jats:italic>\n                      <jats:sub>Overlap,ICAS<\/jats:sub>\n                      \u00a0=\u00a00.2\u00a0\u00b1\u00a00.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.033,\n                      <jats:italic>\u0394<\/jats:italic>\n                      <jats:sub>CBF,ICAS<\/jats:sub>\n                      \u00a0=\u00a03\u00a0\u00b1\u00a03\u00a0mL\/100\u00a0g\/min,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.045). Furthermore, collateral blood supply in Moyamoya disease was assessed by 4D\u2010sPACK and showed comparable diagnostic value as DSA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Perfusion territory mapping by ss\u2010pCASL revealed chronic malperfusion in asymptomatic ICAS that can be objectively quantified, and 4D\u2010sPACK added diagnostic value similar to DSA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70101","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T06:06:07Z","timestamp":1763013967000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Perfusion Territory Shifts in Cerebrovascular Diseases Measured by Super\u2010Selective Arterial Spin Labeling"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5233-7532","authenticated-orcid":false,"given":"Gabriel","family":"Hoffmann","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health Technical University of Munich (TUM)  Munich Germany"},{"name":"School of Medicine and Health TUM\u2010Neuroimaging Center, TUM  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Reichert","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health Technical University of Munich (TUM)  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"G\u00f6ttler","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health Technical University of Munich (TUM)  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Helle","sequence":"additional","affiliation":[{"name":"Philips Innovative Technologies  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Schmitzer","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health Technical University of Munich (TUM)  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz Hernandez","family":"Petzsche","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health Technical University of Munich (TUM)  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Zimmer","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health Technical University of Munich (TUM)  Munich Germany"},{"name":"School of Medicine and Health TUM\u2010Neuroimaging Center, TUM  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Preibisch","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health Technical University of Munich (TUM)  Munich Germany"},{"name":"School of Medicine and Health TUM\u2010Neuroimaging Center, TUM  Munich Germany"},{"name":"School of Medicine and Health Clinic of Neurology, TUM  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kallmayer","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, School of Medicine and Health TUM  Munich 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