OBJECTIVES: To evaluate the accuracy and reproducibility of CT-perfusion (CTP) by finding the optimal artery for the arterial input function (AIF) and re-evaluating the necessity of the venous output function (VOF). METHODS: Forty-four acute ischaemic stroke patients who underwent non-enhanced CT, CTP and CT-angiography using 256-slice multidetector computed tomography (MDCT) were evaluated. The anterior cerebral artery (ACA), middle cerebral artery (MCA), internal carotid artery (ICA) and basilar artery were selected as the AIF. Subsequently the resulting area under the time-enhancement curve of the AIF (AUCAIF) and quantitative perfusion measurements were analysed by repeated measures ANOVA and subsequently the paired t test. To evaluate reproducibility we examined if the VOF could be deleted by comparing the perfusion measurements using versus not using the VOF (paired t test). RESULTS: The AUCAIF and perfusion measurements resulting from the different AIFs showed significant group differences (all P < 0.0001). The ICA had the largest AUCAIF and resulted in the highest mean transient time (MTT) and lowest cerebral blood flow (CBF), whereas the basilar artery showed the lowest cerebral blood volume (CBV). Not using the VOF showed significantly higher CBV and CBF in 66 % of patients on the ipsilateral (P < 0.0001 and P = 0.007, respectively) and contralateral hemisphere (P < 0.0001 and P = 0.019, respectively). CONCLUSION: Selecting the ICA as the AIF and continuing the use of the VOF would improve the accuracy of CTP. KEY POINTS: • Perfusion imaging is an increasingly important aspect of multidetector computed tomography (MDCT). • Vascular input functions were evaluated for CT-perfusion using 256-slice MDCT. • Selecting different arterial input functions (AIFs) leads to variation in quantitative values. • Using the internal carotid artery for AIF provides optimal perfusion values. • Deleting the venous output function would be detrimental for validity.
OBJECTIVES: To evaluate the accuracy and reproducibility of CT-perfusion (CTP) by finding the optimal artery for the arterial input function (AIF) and re-evaluating the necessity of the venous output function (VOF). METHODS: Forty-four acute ischaemic strokepatients who underwent non-enhanced CT, CTP and CT-angiography using 256-slice multidetector computed tomography (MDCT) were evaluated. The anterior cerebral artery (ACA), middle cerebral artery (MCA), internal carotid artery (ICA) and basilar artery were selected as the AIF. Subsequently the resulting area under the time-enhancement curve of the AIF (AUCAIF) and quantitative perfusion measurements were analysed by repeated measures ANOVA and subsequently the paired t test. To evaluate reproducibility we examined if the VOF could be deleted by comparing the perfusion measurements using versus not using the VOF (paired t test). RESULTS: The AUCAIF and perfusion measurements resulting from the different AIFs showed significant group differences (all P < 0.0001). The ICA had the largest AUCAIF and resulted in the highest mean transient time (MTT) and lowest cerebral blood flow (CBF), whereas the basilar artery showed the lowest cerebral blood volume (CBV). Not using the VOF showed significantly higher CBV and CBF in 66 % of patients on the ipsilateral (P < 0.0001 and P = 0.007, respectively) and contralateral hemisphere (P < 0.0001 and P = 0.019, respectively). CONCLUSION: Selecting the ICA as the AIF and continuing the use of the VOF would improve the accuracy of CTP. KEY POINTS: • Perfusion imaging is an increasingly important aspect of multidetector computed tomography (MDCT). • Vascular input functions were evaluated for CT-perfusion using 256-slice MDCT. • Selecting different arterial input functions (AIFs) leads to variation in quantitative values. • Using the internal carotid artery for AIF provides optimal perfusion values. • Deleting the venous output function would be detrimental for validity.
Authors: James D Eastwood; Michael H Lev; Tarek Azhari; Ting-Yim Lee; Daniel P Barboriak; David M Delong; Clemens Fitzek; Michael Herzau; Max Wintermark; Reto Meuli; David Brazier; James M Provenzale Journal: Radiology Date: 2002-01 Impact factor: 11.105
Authors: Jan Willem Dankbaar; Nicolien Karen de Rooij; Mienke Rijsdijk; Birgitta K Velthuis; Catharine J M Frijns; Gabriel J E Rinkel; Irene C van der Schaaf Journal: Stroke Date: 2010-08-05 Impact factor: 7.914
Authors: A D Horsch; J W Dankbaar; J M Niesten; T van Seeters; I C van der Schaaf; Y van der Graaf; W P Th M Mali; B K Velthuis Journal: AJNR Am J Neuroradiol Date: 2015-04-23 Impact factor: 3.825
Authors: Joris M Niesten; Irene C van der Schaaf; Alan J Riordan; Hugo W A M de Jong; Alexander D Horsch; Daniel Eijspaart; Ewoud J Smit; Willem P T M Mali; Birgitta K Velthuis Journal: Eur Radiol Date: 2013-10-15 Impact factor: 5.315
Authors: Alexander D Horsch; Jan Willem Dankbaar; Tom van Seeters; Joris M Niesten; Merel J A Luitse; Pieter C Vos; Irene C van der Schaaf; Geert-Jan Biessels; Yolanda van der Graaf; L Jaap Kappelle; Willem P Th M Mali; Birgitta K Velthuis Journal: Clin Neuroradiol Date: 2015-02-27 Impact factor: 3.649
Authors: Alexander D Horsch; Jan Willem Dankbaar; Yolanda van der Graaf; Joris M Niesten; Tom van Seeters; Irene C van der Schaaf; L Jaap Kappelle; Birgitta K Velthuis Journal: Neuroradiology Date: 2015-09-04 Impact factor: 2.804