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The development of an accurate marker for Alzheimer's disease (AD) at the earliest stage is an important public health goal. Modern neuroimaging techniques offer one potential approach to identify a marker for AD. This review focuses on the detection of alterations in brain perfusion as a potentially sensitive index of AD pathology using arterial spin labeling (ASL) perfusion mapping - a relatively new variant of magnetic resonance imaging (MRI). Key findings of ASL perfusion studies in AD mild cognitive impairment (MCI), a transitional stage between normal aging and AD as well as in other forms of dementia are discussed. Furthermore, the value of ASL-MRI for improved diagnosis and prediction of AD is critically reviewed.