I Corcuera-Solano1, A M McLellan1, A H Doshi1, P S Pawha1, L N Tanenbaum2. 1. From the Department of Neuroradiology, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, New York. 2. From the Department of Neuroradiology, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, New York. nuromri@gmail.com.
Abstract
BACKGROUND AND PURPOSE: Despite common use of CTP to assess cerebral hemodynamics in the setting of ischemia, concerns over radiation exposure remain. Our aim was to evaluate the efficacy of an adaptive 70-kVp (peak) whole-brain CTP protocol with variable sampling intervals and extended duration against an established fixed-sampling, limited-period protocol at 80 kVp. MATERIALS AND METHODS: A retrospective analysis of 37 patients with stroke scanned with conventional (n = 17) and variant-protocol (n = 20) whole-brain CTP was performed. We compared radiation dose, parametric map quality, and consistency of full-contrast circulation capture between a modified 70-kVp protocol, with 20 whole-brain passes at variable sampling intervals over an extended sampling period, and a conventional 80-kVp CTP examination with 24 passes at fixed-sampling intervals and a more limited scanning window. Mann-Whitney U test analysis was used to compare both protocols. RESULTS: The 70-kVp CTP scan provided superior image quality at a 45% lower CT dose index volume and 13% lower dose-length product/effective dose compared with the conventional 80-kVp scan. With respect to the consistency of contrast-passage capture, 95% of the adaptive, extended protocol continued through the venous return to baseline, compared with only 47% by using the conventional limited-length protocol. Rapid sampling during the critical arterial arrival and washout period was accomplished in nearly 95% with both the variable and fixed-sampling-interval protocols. CONCLUSIONS: Seventy-kilovolt (peak) CTP with variable and extended sampling produces improved image quality at lower radiation doses with greater consistency of full contrast passage capture.
BACKGROUND AND PURPOSE: Despite common use of CTP to assess cerebral hemodynamics in the setting of ischemia, concerns over radiation exposure remain. Our aim was to evaluate the efficacy of an adaptive 70-kVp (peak) whole-brain CTP protocol with variable sampling intervals and extended duration against an established fixed-sampling, limited-period protocol at 80 kVp. MATERIALS AND METHODS: A retrospective analysis of 37 patients with stroke scanned with conventional (n = 17) and variant-protocol (n = 20) whole-brain CTP was performed. We compared radiation dose, parametric map quality, and consistency of full-contrast circulation capture between a modified 70-kVp protocol, with 20 whole-brain passes at variable sampling intervals over an extended sampling period, and a conventional 80-kVp CTP examination with 24 passes at fixed-sampling intervals and a more limited scanning window. Mann-Whitney U test analysis was used to compare both protocols. RESULTS: The 70-kVp CTP scan provided superior image quality at a 45% lower CT dose index volume and 13% lower dose-length product/effective dose compared with the conventional 80-kVp scan. With respect to the consistency of contrast-passage capture, 95% of the adaptive, extended protocol continued through the venous return to baseline, compared with only 47% by using the conventional limited-length protocol. Rapid sampling during the critical arterial arrival and washout period was accomplished in nearly 95% with both the variable and fixed-sampling-interval protocols. CONCLUSIONS: Seventy-kilovolt (peak) CTP with variable and extended sampling produces improved image quality at lower radiation doses with greater consistency of full contrast passage capture.
Authors: Mark Page; Dee Nandurkar; Marcus Peter Crossett; Stephen L Stuckey; Kenneth P Lau; Nicholas Kenning; John M Troupis Journal: Eur Radiol Date: 2009-12-16 Impact factor: 5.315
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Authors: Xiao Kun Fang; Qian Qian Ni; U Joseph Schoepf; Chang Sheng Zhou; Guo Zhong Chen; Song Luo; Stephen R Fuller; Carlo N De Cecco; Long Jiang Zhang; Guang Ming Lu Journal: Eur Radiol Date: 2016-02-06 Impact factor: 5.315
Authors: K D Vo; A J Yoo; A Gupta; Y Qiao; A S Vagal; J A Hirsch; D M Yousem; C Lum Journal: AJNR Am J Neuroradiol Date: 2015-10-01 Impact factor: 3.825