164 Chapter 6 CONCLUSION In the current study, we investigated how ASL parameters measured during a physiological steady state relate to functional vascular parameters as measured using CVR in a patient population with brain metastases. When visually inspecting the MRI data, all vascularly compromised regions visible in the ASL data were also reflected in the CVR metrics. This was confirmed by both the regional and voxelwise relationship between on the one hand CBF and CVR measurements and the temporal metrics of ASL and CVR on the other hand. However, the relationship between ASL and CVR measures seems to be dependent on the vascular status of the underlying tissue. That is, relationships do not hold in tissues exhibiting vascular steal. Thus, CVR metrics may be able to flag at-risk areas before they become visible on ASL MRI. However, the downside of using BOLD-metrics is that they are influenced by multiple variables, making it difficult to pinpoint the exact mechanisms underlying this vascular risk. Consequently, to fully understand vascular changes within patients with pathology, combining ASL and CVR will provide a more complete picture. SUPPLEMENTARY MATERIALS
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