{"title":"急性缺血性脑卒中患者全脑CT灌注最佳扫描方案。","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":"{\"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}","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
摘要
目的：全脑计算机断层扫描（CTP）成像是一种剂量密集型成像技术。本研究旨在探讨320排CT全脑CTP的最佳扫描方案，以降低急性缺血性卒中（AIS）患者的辐射剂量。方法：本研究纳入54例连续AIS患者，在320排CT扫描仪上进行全脑CTP。我们评估了CTPfull， CTP3/4和CTP1/2的半影和缺血核心体积，分别使用全扫描，3/4和1/2扫描数据创建。采用Wilcoxon符号秩检验、Spearman相关系数、Bland-Altman分析进行统计分析。此外，还评估了基于DEFUSE-3标准的假设治疗决策，以确定使用减少的抽样数据（CTP3/4和CTP1/2）与完整数据相比，治疗决策是否存在差异，以评估其临床疗效。结果：CTPfull、CTP3/4和CTP1/2的半暗区和缺血核心中位容积分别为111.5 mL[四分位数范围（IQR）： 52.0 ~ 173.0]和5.5 mL (IQR: 0 ~ 24.0), 106.5 mL （IQR: 47.0 ~ 170.0）和6.5 mL (IQR: 0 ~ 24.0), 106.5 mL （IQR: 48.0 ~ 178.0）和5.5 mL （IQR: 0 ~ 23.0）。CTPfull、CTP3/4和CTP1/2在半影区（P>0.05）和缺血核区（P>0.05）体积上无显著差异。Spearman相关分析显示，半影区CTPfull与CTP3/4、CTP1/2之间存在显著相关性（r=0.989 ~ 0.998）。结论：320排CT全脑CTP图像采用半扫描数据可降低AIS患者的辐射暴露，且灌注信息不丢失。
Optimal Scanning Protocol of Whole-Brain CT Perfusion in Patients With Acute Ischemic Stroke.
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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