Impact of temporal resolution on perfusion metrics, therapy decision, and radiation dose reduction in brain CT perfusion in patients with suspected stroke.

Purpose CT perfusion of the brain is a powerful tool in stroke imaging, though the radiation dose is rather high. Several strategies for dose reduction have been proposed, including increasing the intervals between the dynamic scans. We determined the impact of temporal resolution on perfusion metri...

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Publicado en:Neuroradiology Vol. 66; no. 5; pp. 749 - 760
Autores principales: Rau, Alexander, Reisert, Marco, Stein, Thomas, Mueller‑Peltzer, Katharina, Rau, Stephan, Bamberg, Fabian, Taschner, Christian A., Urbach, Horst, Kellner, Elias
Formato: Journal Article
Publicado: Springer Nature May2024
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Impact of temporal resolution on perfusion metrics, therapy decision, and radiation dose reduction in brain CT perfusion in patients with suspected stroke.
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          Rau, Alexander
          Reisert, Marco
          Stein, Thomas
          Mueller‑Peltzer, Katharina
          Rau, Stephan
          Bamberg, Fabian
          Taschner, Christian A.
          Urbach, Horst
          Kellner, Elias
        affil: Department of Neurology and Clinical Neuroscience, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
      sug:
      ab: Purpose CT perfusion of the brain is a powerful tool in stroke imaging, though the radiation dose is rather high. Several strategies for dose reduction have been proposed, including increasing the intervals between the dynamic scans. We determined the impact of temporal resolution on perfusion metrics, therapy decision, and radiation dose reduction in brain CT perfusion from a large dataset of patients with suspected stroke. Methods We retrospectively included 3555 perfusion scans from our clinical routine dataset. All cases were processed using the perfusion software VEOcore with a standard sampling of 1.5 s, as well as simulated reduced temporal resolution of 3.0, 4.5, and 6.0 s by leaving out respective time points. The resulting perfusion maps and calculated volumes of infarct core and mismatch were compared quantitatively. Finally, hypothetical decisions for mechanical thrombectomy following the DEFUSE-3 criteria were compared. Results The agreement between calculated volumes for core (ICC=0.99, 0.99, and 0.98) and hypoperfusion (ICC=0.99, 0.99, and 0.97) was excellent for all temporal sampling schemes. Of the 1226 cases with vascular occlusion, 14 (1%) for 3.0 s sampling, 23 (2%) for 4.5 s sampling, and 63 (5%) for 6.0 s sampling would have been treated diferently if the DEFUSE-3 criteria had been applied. Reduction of temporal resolution to 3.0 s, 4.5 s, and 6.0 s reduced the radiation dose by a factor of 2, 3, or 4. Conclusion Reducing the temporal sampling of brain perfusion CT has only a minor impact on image quality and treatment decision, but signifcantly reduces the radiation dose to that of standard non-contrast CT.
      pubtype: Academic Journal
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    language: English
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