Interleaving Cerebral CT Perfusion with Neck CT Angiography. Part I: Proof of Concept and Accuracy of Cerebral Perfusion Values

M.T.H. Oei, F.J. Meijer, W.-J. van der Woude, E.J. Smit, B. van Ginneken, M. Prokop and R. Manniesing

European Radiology

DOI PMID

Abstract

Objectives: We present a novel One-Step-Stroke protocol for wide-detector CT scanners that interleaves cerebral CTP with volumetric neck CTA (vCTA). We evaluate whether the resulting time gap in CTP affects the accuracy of CTP values.

Methods: Cerebral CTP maps were retrospectively obtained from 20 patients with suspicion of acute ischemic stroke and served as the reference standard. To simulate a 4s gap for interleaving CTP with vCTA, we eliminated one acquisition at various time points of CTP starting from the bolus-arrival-time (BAT). Optimal timing of the vCTA was evaluated. At the time point with least errors, we evaluated elimination of a second time point (6s gap).

Results: Mean absolute percentage errors of all perfusion values remained below 10% in all patients when eliminating any one time point in the CTP sequence starting from the BAT. Acquiring the vCTA 2s after reaching a threshold of 70HU resulted in the lowest errors (mean<3.0%). Eliminating a second time point still resulted in mean errors <3.5%. CBF/CBV showed no significant differences in perfusion values except MTT. However, the percentage errors were always below 10% compared to the original protocol.

Conclusion: Interleaving cerebral CTP with neck CTA is feasible with minor effects on the perfusion values.

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