Measurement of cerebral blood volume using angiographic C-arm systems

C-Arm CT Measurement of Cerebral Blood Volume and Cerebral Blood Flow Using a Novel High-Speed Acquisition and a Single Intravenous Contrast Injection

“…7,8 Previous work has demonstrated qualitative and quantitative accuracy of CBV measurements made with the use of C-arm CT in conjunction with a contrast injection protocol aimed at delivering a steady-state of contrast in the parenchyma. [2][3][4][5][9][10][11] Although this method provides information that is helpful in better understanding the viability of ischemic tissue (ie, identifying tissue when autoregulation appears to be intact), it does not provide the ability to distinguish ischemic core from penumbra. Ganguly et al 8 and others 12,13 have recently demonstrated, in a swine model, the feasibility of the use of C-arm CT for dynamic perfusion measurement.…”

Flat Detector CT in the Evaluation of Brain Parenchyma, Intracranial Vasculature, and Cerebral Blood Volume: A Pilot Study in Patients with Acute Symptoms of Cerebral Ischemia

“…[26][27][28] Postprocessing of this special data acquisition should also provide visualization of the brain and vasculature.…”

C-Arm Flat Detector CT Parenchymal Blood Volume Thresholds for Identification of Infarcted Parenchyma in the Neurointerventional Suite

“…For calculation of C-arm CT PBV, the intravenously administered iodinated contrast material is assumed to have reached a steady-state concentration in the cerebral vasculature (contrast concentration in arteries ϭ contrast concentration in tissues ϭ contrast concentration in veins), maintained for the duration of the scan. 1 If this assumption is fully met, the C-arm CT PBV would be equivalent to the CBV derived from dynamic perfusion imaging modalities. However, an ideal steady-state may not be achieved in practice for the clinical scans, and the contrast profile in the cerebral vasculature may show intersubject differences due to various factors such as recirculation of contrast, hemodynamic perturbation effect, and slow bolus …”

“…1 Initial reports document agreement between C-arm flat detector CT (FDCT) PBV and CT perfusion-derived cerebral blood volume in both canines and humans. 2,3 The availability of PBV maps in the interventional suite is an important development and has potential implications in the management of patients with ischemic cerebrovascular disease and their selection for revascularization procedures.…”

“…However, an equivalence between the 2 is usually inferred if a steady-state contrast concentration is achieved in the cerebral vasculature during the C-arm FDCT PBV scan; in the absence of an ideal steady-state, the PBV may have combined CBF and CBV weighting or even preferential CBF weighting. 1,5 For CTP, although debate exists as to which perfusion parameter best defines irreversible infarction, thresholds for various parameters corresponding to acute DWI abnormality and infarct core have been reported. [6][7][8] No such thresholds have so far been investigated for C-arm CT PBV.…”