Sex-Specific Vascular Score: A Novel Perfusion Biomarker from Supervoxel Analysis of 3D pCASL MRI

Abstract: We propose a novel framework that leverages 3D pseudo-continuous arterial spin labeling (3D pCASL) MRI to compute sex-specific vascular scores that quantify cerebrovascular health and potential disease susceptibility. The brain is parcellated into spatially contiguous regions of homogeneous perfusion using supervoxel clustering, capturing both microvascular and macrovascular contributions. Mean cerebral blood flow (CBF) values are extracted from 186 cognitively healthy participants and used to train a custom convolutional neural network, achieving 95 percent accuracy in sex classification. This highlights robust, sex-specific perfusion patterns across the brain. Additionally, regional CBF variations and age-related effects are systematically evaluated within male and female cohorts. The proposed vascular risk-scoring framework enhances understanding of normative brain perfusion and aging, and may facilitate early detection and personalized interventions for neurodegenerative diseases such as Alzheimer's.