Pseudocontinuous Arterial Spin Labeling: Clinical Applications and Usefulness in Head and Neck Entities

Round 1

Reviewer 1 Report

Thank you for giving me to have the opportunity to review your article. 

Authors reviewed the ASL technique for head and neck patients. They reported the useful of the ASL for brain and head and neck.

The manuscript was well-written. I think conclusion part should be clear.

They said “machine learning approach should be applied….” I think the introduction of the machine learning approach should be added in the manuscript. Moreover, native English speaker check should be performed.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

1.     From the simple summary and abstract, it seems that this review only focused on the clinical applications of ASL in diagnosis, but in the content, its application in prediction of prognosis was also introduced. Suggest revising the simple summary and abstract to avoid confusion.

2.     In table 8,9, and 10, suggest adding ADCmean for these cases, as 10percentile somehow is not that repeatable and easily influenced by the contours.

3.     What’s new in this review compared to the review recently published? “Martín-Noguerol T, Kirsch CFE, Montesinos P, Luna A. Arterial spin labeling for head and neck lesion assessment: technical adjustments and clinical applications. Neuroradiology. 2021 Dec;63(12):1969-1983. doi: 10.1007/s00234-021-02772-1. Epub 2021 Aug 24. PMID: 34427708.”

4.     Although this is not a systematic review, to point out the new points out new things in this review, strongly suggest that authors should review all related papers, and try to cover any clinical applications of pCASL in head and neck entities. For example: pCASL to predict HPV + and HPV- SCC, tumour types differentiation, pre-tx to predict treatment response etc.

5.     Suggest writing the applications either according to the clinical applications, i.e. diagnosis, treatment response, outcome prediction; OR according to the locations of the entities.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 3 Report

The purpose of this study is to comprehensively review the latest progress in the pseudocontinuous arterial spin labeling in head and neck entities.  The paper has merit and summarizes important findings

However, due to some minor deficiencies, I recommended to revise the manuscript. My concerns are as follows:

1. Structured tables that summarize the findings of the previous important studies might be needed for better presentation.
2. For better understanding, the authors may consider adding a diagram that explains how pseudocontinuous arterial spin labeling works

Once the above concerns are fully addressed, the manuscript could be accepted for publication in this journal.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Authors have added contents that I suggested.