{"title":"Optimal Scanning Protocol of Whole-Brain CT Perfusion in Patients With Acute Ischemic Stroke.","authors":"Sentaro Takada, Hiroyuki Uetani, Zaw Aung Khant, Seitaro Oda, Yasunori Nagayama, Hidetaka Hayashi, Sachiko Uchiumi, Takeshi Sugahara, Masatomo Miura, Seigo Shindo, Hiroshi Murakami, Tadashi Terasaki, Toshinori Hirai","doi":"10.1097/RCT.0000000000001792","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Whole-brain computed tomography perfusion (CTP) imaging is a dose-intensive imaging technique. We aimed to investigate optimal scanning protocol of the whole-brain CTP using a 320-detector row CT in reducing radiation dose for acute ischemic stroke (AIS) patients.</p><p><strong>Methods: </strong>This study included 54 consecutive AIS patients who underwent whole-brain CTP on a 320-detector row CT scanner. We evaluated the penumbra and ischemic core volumes of CTPfull, CTP3/4, and CTP1/2, created using full, 3/4 and 1/2 scanning data, respectively. Wilcoxon signed-rank test, Spearman correlation coefficient, and Bland-Altman analysis were used for the statistical analysis. In addition, hypothetical treatment decisions based on the DEFUSE-3 criteria were also evaluated to determine whether there were any differences in the treatment decisions when using reduced sampling data (CTP3/4 and CTP1/2) compared with full data to assess its clinical efficacy.</p><p><strong>Results: </strong>The penumbra and ischemic core median volumes on CTPfull, CTP3/4, and CTP1/2 were 111.5 mL [interquartile range (IQR): 52.0-173.0] and 5.5 mL (IQR: 0 to 24.0), 106.5 mL (IQR: 47.0 to 170.0) and 6.5 mL (IQR: 0 to 24.0), 106.5 mL (IQR: 48.0 to 178.0), and 5.5 mL (IQR: 0 to 23.0), respectively. There were no significant differences in penumbra (P>0.05) and ischemic core (P>0.05) volumes between CTPfull, CTP3/4, and CTP1/2. Spearman correlation analysis showed significant correlations between CTPfull and CTP3/4 and CTP1/2 for both penumbra (r=0.989 to 0.998, P<0.001) and ischemic core (r=0.997 to 0.982, P<0.001) volumes. The hypothetical treatment strategies determined using reduced sampling data (CTP3/4, and CTP1/2) were largely consistent compared with those using CTPfull.</p><p><strong>Conclusions: </strong>The use of half-scanning data for the whole-brain CTP image with a 320-detector row CT may help to lower the radiation exposure to AIS patients without significant loss of perfusion information.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Computer Assisted Tomography","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/RCT.0000000000001792","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Whole-brain computed tomography perfusion (CTP) imaging is a dose-intensive imaging technique. We aimed to investigate optimal scanning protocol of the whole-brain CTP using a 320-detector row CT in reducing radiation dose for acute ischemic stroke (AIS) patients.
Methods: This study included 54 consecutive AIS patients who underwent whole-brain CTP on a 320-detector row CT scanner. We evaluated the penumbra and ischemic core volumes of CTPfull, CTP3/4, and CTP1/2, created using full, 3/4 and 1/2 scanning data, respectively. Wilcoxon signed-rank test, Spearman correlation coefficient, and Bland-Altman analysis were used for the statistical analysis. In addition, hypothetical treatment decisions based on the DEFUSE-3 criteria were also evaluated to determine whether there were any differences in the treatment decisions when using reduced sampling data (CTP3/4 and CTP1/2) compared with full data to assess its clinical efficacy.
Results: The penumbra and ischemic core median volumes on CTPfull, CTP3/4, and CTP1/2 were 111.5 mL [interquartile range (IQR): 52.0-173.0] and 5.5 mL (IQR: 0 to 24.0), 106.5 mL (IQR: 47.0 to 170.0) and 6.5 mL (IQR: 0 to 24.0), 106.5 mL (IQR: 48.0 to 178.0), and 5.5 mL (IQR: 0 to 23.0), respectively. There were no significant differences in penumbra (P>0.05) and ischemic core (P>0.05) volumes between CTPfull, CTP3/4, and CTP1/2. Spearman correlation analysis showed significant correlations between CTPfull and CTP3/4 and CTP1/2 for both penumbra (r=0.989 to 0.998, P<0.001) and ischemic core (r=0.997 to 0.982, P<0.001) volumes. The hypothetical treatment strategies determined using reduced sampling data (CTP3/4, and CTP1/2) were largely consistent compared with those using CTPfull.
Conclusions: The use of half-scanning data for the whole-brain CTP image with a 320-detector row CT may help to lower the radiation exposure to AIS patients without significant loss of perfusion information.
期刊介绍：
The mission of Journal of Computer Assisted Tomography is to showcase the latest clinical and research developments in CT, MR, and closely related diagnostic techniques. We encourage submission of both original research and review articles that have immediate or promissory clinical applications. Topics of special interest include: 1) functional MR and CT of the brain and body; 2) advanced/innovative MRI techniques (diffusion, perfusion, rapid scanning); and 3) advanced/innovative CT techniques (perfusion, multi-energy, dose-reduction, and processing).
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