The introduction of arterial spin labelling (ASL) techniques in magnetic resonance imaging (MRI) has made feasible a non-invasive measurement of the cerebral blood flow (CBF). However, to date, the low signal-to-noise ratio of ASL gives us no option but to repeat the acquisition to accumulate enough data in order to get a reliable signal. The perfusion signal is then usually extracted by averaging across the repetitions. But the sample mean is very sensitive to outliers. A single incorrect observation can therefore be the source of strong detrimental effects on the perfusion-weighted image estimated with the sample mean. We propose to estimate robust ASL CBF maps with M-estimators to overcome the deleterious effects of outliers. The behavior of this method is compared to z-score thresholding as recommended in Tan et al. (Journal of Magnetic Resonance Imaging 2009;29(5):1134-9.). Validation on simulated and real data is provided. Quantitative validation is undertaken by measuring the correlation with the most widespread technique to measure perfusion with MRI: dynamic susceptibility weighted contrast imaging.
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