Skip to main content
Top
Published in: European Radiology 12/2008

01-12-2008 | Neuro

Dose reduction in dynamic perfusion CT of the brain: effects of the scan frequency on measurements of cerebral blood flow, cerebral blood volume, and mean transit time

Authors: Martin Wiesmann, Scott Berg, G. Bohner, R. Klingebiel, V. Schöpf, B. M. Stoeckelhuber, I. Yousry, J. Linn, U. Missler

Published in: European Radiology | Issue 12/2008

Login to get access

Abstract

The influence of the frequency of computed tomography (CT) image acquistion on the diagnostic quality of dynamic perfusion CT (PCT) studies of the brain was investigated. Eight patients with clinically suspected acute ischemia of one hemisphere underwent PCT, performed on average 3.4 h after the onset of symptoms. Sixty consecutive images per slice were obtained with individual CT images obtained at a temporal resolution of two images per second. Eight additional data sets were reconstructed with temporal resolutions ranging from one image per second to one image per 5 s. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) measurements were performed in identical regions of interest. Two neuroradiologists evaluated the PCT images visually to identify areas of abnormal perfusion. Perfusion images created up to a temporal resolution of one image per 3 s were rated to be diagnostically equal to the original data. Even at one image per 4 s, all areas of infarction were identified. Quantitative differences of CBF, CBV and MTT measurements were ≤10% up to one image per 3 s. For PCT of the brain, temporal resolution can be reduced to one image per 3 s without significant compromise in image quality. This significantly reduces the radiation dose of the patient.
Literature
1.
go back to reference Latchaw RE, Yonas H, Hunter GJ, Yuh WT, Ueda T, Sorensen AG, Sunshine JL, Biller J, Wechsler L, Higashida R, Hademenos G, Council on Cardiovascular Radiology of the American Heart Association (2003) Guidelines and recommendations for perfusion imaging in cerebral ischemia: a scientific statement for healthcare professionals by the writing group on perfusion imaging, from the council on cardiovascular radiology of the American Heart Association. Stroke 34:1084–1104PubMedCrossRef Latchaw RE, Yonas H, Hunter GJ, Yuh WT, Ueda T, Sorensen AG, Sunshine JL, Biller J, Wechsler L, Higashida R, Hademenos G, Council on Cardiovascular Radiology of the American Heart Association (2003) Guidelines and recommendations for perfusion imaging in cerebral ischemia: a scientific statement for healthcare professionals by the writing group on perfusion imaging, from the council on cardiovascular radiology of the American Heart Association. Stroke 34:1084–1104PubMedCrossRef
2.
go back to reference Mayer TE, Hamann GF, Baranczyk J, Rosengarten B, Klotz E, Wiesmann M, Missler U, Schulte-Altedorneburg G, Brueckmann HJ (2000) Dynamic CT perfusion imaging of acute stroke. AJNR Am J Neuroradiol 21:1441–1449PubMed Mayer TE, Hamann GF, Baranczyk J, Rosengarten B, Klotz E, Wiesmann M, Missler U, Schulte-Altedorneburg G, Brueckmann HJ (2000) Dynamic CT perfusion imaging of acute stroke. AJNR Am J Neuroradiol 21:1441–1449PubMed
3.
go back to reference Wiesmann M, Bohner G, Klingebiel R (2004) Cerebral perfusion imaging using multislice computed tomography. Clin Neuroradiol 14:92–107CrossRef Wiesmann M, Bohner G, Klingebiel R (2004) Cerebral perfusion imaging using multislice computed tomography. Clin Neuroradiol 14:92–107CrossRef
4.
go back to reference Wiesmann M, Meyer K, Albers T, Seidel G (2004) Parametric perfusion imaging with contrast-enhanced ultrasound in acute ischemic stroke. Stroke 35:508–513PubMedCrossRef Wiesmann M, Meyer K, Albers T, Seidel G (2004) Parametric perfusion imaging with contrast-enhanced ultrasound in acute ischemic stroke. Stroke 35:508–513PubMedCrossRef
5.
go back to reference Wintermark M, Bogousslavsky J (2003) Imaging of acute ischemic brain injury: the return of computed tomography. Curr Opin Neurol 16:59–63PubMedCrossRef Wintermark M, Bogousslavsky J (2003) Imaging of acute ischemic brain injury: the return of computed tomography. Curr Opin Neurol 16:59–63PubMedCrossRef
6.
go back to reference Wintermark M, Maeder P, Verdun FR, Thiran JP, Valley JF, Schnyder P, Meuli R (2000) Using 80 kVp versus 120 kVp in perfusion CT measurement of regional cerebral blood flow. AJNR Am J Neuroradiol 21:1881–1884PubMed Wintermark M, Maeder P, Verdun FR, Thiran JP, Valley JF, Schnyder P, Meuli R (2000) Using 80 kVp versus 120 kVp in perfusion CT measurement of regional cerebral blood flow. AJNR Am J Neuroradiol 21:1881–1884PubMed
7.
go back to reference Fleischmann D, Rubin GD, Bankier AA, Hittmair K (2000) Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography. Radiology 214:363–371PubMed Fleischmann D, Rubin GD, Bankier AA, Hittmair K (2000) Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography. Radiology 214:363–371PubMed
8.
9.
go back to reference Wintermark M, Smith WS, Ko NU, Quist M, Schnyder P, Dillon WP (2004) Dynamic perfusion CT: Optimizing the temporal resolution and contrast volume for calculation of perfusion CT parameters in stroke patients. AJNR Am J Neuroradiol 25:720–729PubMed Wintermark M, Smith WS, Ko NU, Quist M, Schnyder P, Dillon WP (2004) Dynamic perfusion CT: Optimizing the temporal resolution and contrast volume for calculation of perfusion CT parameters in stroke patients. AJNR Am J Neuroradiol 25:720–729PubMed
10.
go back to reference Kämena A, Streitparth F, Grieser C, Lehmkuhl L, Jamil B, Wojtal K, Ricke J, Pech M (2007) Dynamic perfusion CT: Optimizing the temporal resolution for the calculation of perfusion CT parameters in stroke patients. Eur J Radiol 64:111–118PubMedCrossRef Kämena A, Streitparth F, Grieser C, Lehmkuhl L, Jamil B, Wojtal K, Ricke J, Pech M (2007) Dynamic perfusion CT: Optimizing the temporal resolution for the calculation of perfusion CT parameters in stroke patients. Eur J Radiol 64:111–118PubMedCrossRef
11.
go back to reference Nambu K, Takehara R, Terada T (1996) A method of regional cerebral blood perfusion measurement using dynamic CT with an iodinated contrast medium. Acta Neurol Scand Suppl 166:28–31PubMedCrossRef Nambu K, Takehara R, Terada T (1996) A method of regional cerebral blood perfusion measurement using dynamic CT with an iodinated contrast medium. Acta Neurol Scand Suppl 166:28–31PubMedCrossRef
12.
go back to reference Wintermark M, Reichhart M, Thiran JP, Maeder P, Chalaron M, Schnyder P, Bogousslavsky J, Meuli R (2002) Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients. Ann Neurol 51:417–432PubMedCrossRef Wintermark M, Reichhart M, Thiran JP, Maeder P, Chalaron M, Schnyder P, Bogousslavsky J, Meuli R (2002) Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients. Ann Neurol 51:417–432PubMedCrossRef
13.
go back to reference Wintermark M, Maeder P, Verdun FR, Thiran JP, Valley JF, Schnyder P, Meuli R (2000) Using 80 kVp versus 120 kVp in perfusion CT measurement of regional cerebral blood flow. AJNR Am J Neuroradiol 21:1881–1884PubMed Wintermark M, Maeder P, Verdun FR, Thiran JP, Valley JF, Schnyder P, Meuli R (2000) Using 80 kVp versus 120 kVp in perfusion CT measurement of regional cerebral blood flow. AJNR Am J Neuroradiol 21:1881–1884PubMed
14.
go back to reference Imanishi Y, Fukui A, Niimi H, Itoh D, Nozaki K, Nakaji S, Ishizuka K, Tabata H, Furuya Y, Uzura M, Takahama H, Hashizume S, Arima S, Nakajima Y (2005) Radiation-induced temporary hair loss as a radiation damage only occurring in patients who had the combination of MDCT and DSA. Eur Radiol 15:41–46PubMedCrossRef Imanishi Y, Fukui A, Niimi H, Itoh D, Nozaki K, Nakaji S, Ishizuka K, Tabata H, Furuya Y, Uzura M, Takahama H, Hashizume S, Arima S, Nakajima Y (2005) Radiation-induced temporary hair loss as a radiation damage only occurring in patients who had the combination of MDCT and DSA. Eur Radiol 15:41–46PubMedCrossRef
Metadata
Title
Dose reduction in dynamic perfusion CT of the brain: effects of the scan frequency on measurements of cerebral blood flow, cerebral blood volume, and mean transit time
Authors
Martin Wiesmann
Scott Berg
G. Bohner
R. Klingebiel
V. Schöpf
B. M. Stoeckelhuber
I. Yousry
J. Linn
U. Missler
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
European Radiology / Issue 12/2008
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-008-1083-x

Other articles of this Issue 12/2008

European Radiology 12/2008 Go to the issue