Dynamic Angiography and Perfusion Imaging Using Flat Detector CT in the Angiography Suite: A Pilot Study in Patients with Acute Middle Cerebral Artery Occlusions

Abstract

BACKGROUND AND PURPOSE: Perfusion and angiographic imaging using intravenous contrast application to evaluate stroke patients is now technically feasible by flat detector CT performed by the angiographic system. The aim of this pilot study was to show the feasibility and qualitative comparability of a novel flat detector CT dynamic perfusion and angiographic imaging protocol in comparison with a multimodal stroke MR imaging protocol.

Evaluation of Collaterals and Clot Burden Using Time-Resolved C-Arm Conebeam CT Angiography in the Angiography Suite: A Feasibility Study

“…Recently, with a C-arm conebeam CT (CBCT) acquisition platform in the angiographic suite, the feasibility of acquiring dynamic CBCT perfusion (CBCTP) maps in the angiography suite has been demonstrated both in animals and in human subjects. 7,8 From the acquired CBCT perfusion dataset, time-resolved conebeam CT angiography (CBCTA) can also be generated to provide accurate diagnosis of large-vessel occlusions (LVOs). 9,10 In this study, we hypothesized that the use of timeresolved CBCTA would facilitate the evaluation of collateral status and clot burden in patients with AIS.…”

Usefulness of Flat Detector CT Perfusion Images in the Diagnosis and Determination of the Therapeutic Strategy for Intracranial Vascular Occlusion as a Complication of Cerebral Angiography: Technical Note

“…1,4) FD-CTP imaging is not inferior in detection sensitivity for hypoperfused areas in actual patients with cerebral ischemia compared with the CBV determined using conventional multi-slice CT, 1) and the sizes of the hypoperfused areas judged by the two methods have been reported to be closely correlated. 4,6) Struffert et al reported that areas in which the CBV did not recover after acute phase revascularization eventually lapsed into cerebral infarction by a study of 16 patients with acute cerebral infarction using FD-CTP imaging. 3) In the patient presented here, cerebral infarction is considered to have been prevented as the markedly reduced CBV of the left occipital lobe recovered after thrombectomy.…”

“…[1][2][3][4] We could accurately evaluate the condition of a patient who developed embolism during cerebral angiography before surgery for brain tumor by performing flat detector CT perfusion (FD-CTP) study and prevent cerebral angiography by thrombectomy. This case is presented as it first demonstrated the usefulness of FD-CTP for troubleshooting during cerebral angiography.…”

Optimized Flat-Detector CT in Stroke Imaging: Ready for First-Line Use?

“…Because of the small size of early signs of stroke in our study population, these results can be considered only preliminary. A step to improve the detection of ischemic stroke could be the use of multimodal functional FD-CT imaging [23,24]. We assume that by additive FD-CT angiography and FD-CT perfusion imaging, the sensitivity and specificity in the absence of early ischemic changes may be dramatically improved, comparably as described for conventional CT in the detection of acute ischemic stroke [4].…”