Pengfei Yang1, Kai Niu2, Yijing Wu2, Tobias Struffert2, Arnd Dorfler2, Sebastian Schafer2, Kevin Royalty2, Charles Strother2, Guang-Hong Chen1. 1. From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (P.Y.); Departments of Radiology (P.Y., C.S., G.-H.C.) and Medical Physics (K.N., Y.W., G.-H.C.), University of Wisconsin-Madison; Department of Neuroradiology, University of Erlangen-Nuremberg, Erlangen, Germany (T.S., A.D.); and Department of Research Collaboration, Siemens Medical Solutions, USA, Inc, Hoffman Estates, IL (S.S., K.R.). 15921196312@163.com gchen7@wisc.edu. 2. From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (P.Y.); Departments of Radiology (P.Y., C.S., G.-H.C.) and Medical Physics (K.N., Y.W., G.-H.C.), University of Wisconsin-Madison; Department of Neuroradiology, University of Erlangen-Nuremberg, Erlangen, Germany (T.S., A.D.); and Department of Research Collaboration, Siemens Medical Solutions, USA, Inc, Hoffman Estates, IL (S.S., K.R.).
Abstract
BACKGROUND AND PURPOSE: Multimodal imaging using cone beam C-arm computed tomography (CT) may shorten the delay from ictus to revascularization for acute ischemic stroke patients with a large vessel occlusion. Largely because of limited temporal resolution, reconstruction of time-resolved CT angiography (CTA) from these systems has not yielded satisfactory results. We evaluated the image quality and diagnostic value of time-resolved C-arm CTA reconstructed using novel image processing algorithms. METHODS: Studies were done under an Institutional Review Board approved protocol. Postprocessing of data from 21 C-arm CT dynamic perfusion acquisitions from 17 patients with acute ischemic stroke were done to derive time-resolved C-arm CTA images. Two observers independently evaluated image quality and diagnostic content for each case. ICC and receiver-operating characteristic analysis were performed to evaluate interobserver agreement and diagnostic value of this novel imaging modality. RESULTS: Time-resolved C-arm CTA images were successfully generated from 20 data sets (95.2%, 20/21). Two observers agreed well that the image quality for large cerebral arteries was good but was more limited for small cerebral arteries (distal to M1, A1, and P1). receiver-operating characteristic curves demonstrated excellent diagnostic value for detecting large vessel occlusions (area under the curve=0.987-1). CONCLUSIONS: Time-resolved CTAs derived from C-arm CT perfusion acquisitions provide high quality images that allowed accurate diagnosis of large vessel occlusions. Although image quality of smaller arteries in this study was not optimal ongoing modifications of the postprocessing algorithm will likely remove this limitation. Adding time-resolved C-arm CTAs to the capabilities of the angiography suite further enhances its suitability as a one-stop shop for care for patients with acute ischemic stroke.
BACKGROUND AND PURPOSE: Multimodal imaging using cone beam C-arm computed tomography (CT) may shorten the delay from ictus to revascularization for acute ischemic strokepatients with a large vessel occlusion. Largely because of limited temporal resolution, reconstruction of time-resolved CT angiography (CTA) from these systems has not yielded satisfactory results. We evaluated the image quality and diagnostic value of time-resolved C-arm CTA reconstructed using novel image processing algorithms. METHODS: Studies were done under an Institutional Review Board approved protocol. Postprocessing of data from 21 C-arm CT dynamic perfusion acquisitions from 17 patients with acute ischemic stroke were done to derive time-resolved C-arm CTA images. Two observers independently evaluated image quality and diagnostic content for each case. ICC and receiver-operating characteristic analysis were performed to evaluate interobserver agreement and diagnostic value of this novel imaging modality. RESULTS: Time-resolved C-arm CTA images were successfully generated from 20 data sets (95.2%, 20/21). Two observers agreed well that the image quality for large cerebral arteries was good but was more limited for small cerebral arteries (distal to M1, A1, and P1). receiver-operating characteristic curves demonstrated excellent diagnostic value for detecting large vessel occlusions (area under the curve=0.987-1). CONCLUSIONS: Time-resolved CTAs derived from C-arm CT perfusion acquisitions provide high quality images that allowed accurate diagnosis of large vessel occlusions. Although image quality of smaller arteries in this study was not optimal ongoing modifications of the postprocessing algorithm will likely remove this limitation. Adding time-resolved C-arm CTAs to the capabilities of the angiography suite further enhances its suitability as a one-stop shop for care for patients with acute ischemic stroke.
Authors: A Brehm; I Tsogkas; I L Maier; H J Eisenberger; P Yang; J-M Liu; J Liman; M-N Psychogios Journal: AJNR Am J Neuroradiol Date: 2019-07-11 Impact factor: 3.825
Authors: Johanna Rosemarie Leyhe; Ioannis Tsogkas; Amélie Carolina Hesse; Daniel Behme; Katharina Schregel; Ismini Papageorgiou; Jan Liman; Michael Knauth; Marios-Nikos Psychogios Journal: J Neurointerv Surg Date: 2016-12-20 Impact factor: 5.836
Authors: Santiago Ortega-Gutierrez; Darko Quispe-Orozco; Sebastian Schafer; Mudassir Farooqui; Cynthia B Zevallos; Sudeepta Dandapat; Alan Mendez-Ruiz; Beverly Aagaard-Kienitz; Nils Petersen; Colin P Derdeyn Journal: J Neuroimaging Date: 2022-03-21 Impact factor: 2.324