Toward objective quantification of perfusion-weighted computed tomography in subarachnoid hemorrhage: quantification of symmetry and automated delineation of vascular territories.
OBJECTIVE
Perfusion-weighted computed tomography (CTP) is a relatively recent innovation that estimates a value for cerebral blood flow (CBF) using a series of axial head CT images tracking the time course of a signal from an intravenous contrast bolus.


METHODS
CTP images were obtained using a standard imaging protocol and were analyzed using commercially available software. A novel computer-based method was used for objective quantification of side-to-side asymmetries of CBF values calculated from CTP images.


RESULTS
Our method corrects for the inherent variability of the CTP methodology seen in the subarachnoid hemorrhage (SAH) patient population to potentially aid in the diagnosis of cerebral vasospasm (CVS). This method analyzes and quantifies side-to-side asymmetry of CBF and presents relative differences in a construct termed a Relative Difference Map (RDM). To further automate this process, we have developed a unique methodology that enables a computer to delineate vascular territories within a brain image, regardless of the size and shape of the brain.


CONCLUSIONS
While both the quantification of image symmetry using RDMs and the automated assignment of vascular territories were initially designed for the analysis of CTP images, it is likely that they will be useful in a variety of applications.
Imielinska
Celina
C
Department of Biomedical Informatics, Columbia University, New York, NY, USA. ci42@columbia.edu
Liu
Xin
X
Rosiene
Joel
J
Sughrue
Michael E
ME
Komotar
Ricardo J
RJ
Mocco
J
J
Ransom
Evan R
ER
Lignelli
Angela
A
Zacharia
Brad E
BE
Connolly
E Sander
ES
D'Ambrosio
Anthony L
AL
D000328:Adult; D000368:Aged; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging* / Q000473:pathology
D003287:Contrast Media