title: C-arm CT measurement of cerebral blood volume and cerebral blood flow using a novel high-speed acquisition and a single intravenous contrast injection.
abstract: OBJECTIVE
  Assessment of perfusion parameters is important in the selection of patients who are most likely to benefit from revascularization after an acute ischemic stroke. The aim of this study was to evaluate the feasibility of measuring cerebral perfusion parameters with the use of a novel high-speed C-arm CT acquisition in conjunction with a single intravenous injection of contrast.
  
  
  METHODS
  Seven canines had experimentally induced focal ischemic regions confirmed by CT perfusion imaging. Four hours after ischemic injury creation, each subject underwent cerebral perfusion measurements with the use of standard perfusion CT, immediately followed by the use of C-arm CT. Cerebral blood flow and cerebral blood volume maps measured by C-arm CT were quantitatively and qualitatively compared with those measured by perfusion CT for 6 of the 7 canine subjects.
  
  
  RESULTS
  Results from independent observer evaluations of perfusion CT and C-arm perfusion maps show strong agreement between observers for identification of ischemic lesion location. Significant percentage agreement between observers for lesion detection and identification of perfusion mismatch between CBV and CBF maps indicate that the maps for both perfusion CT and C-arm are easy to interpret. Quantitative region of interest-based evaluation showed a strong correlation between the perfusion CT and C-arm CBV and CBF maps (R(2) = 0.68 and 0.85). C-arm measurements for both CBV and CBF were consistently overestimated when compared with perfusion CT.
  
  
  CONCLUSIONS
  Qualitative and quantitative measurements of CBF and CBV with the use of a C-arm CT acquisition and a single intravenous injection of contrast agent are feasible. Future improvements in flat detector technology and software algorithms probably will enable more accurate quantitative perfusion measurements with the use of C-arm CT.
authors.affiliation: Department of Biomedical Engineering.
authors.forename: K
authors.initials: K
authors.lastname: Royalty
authors.forename: M
authors.initials: M
authors.lastname: Manhart
authors.forename: K
authors.initials: K
authors.lastname: Pulfer
authors.forename: Y
authors.initials: Y
authors.lastname: Deuerling-Zheng
authors.forename: C
authors.initials: C
authors.lastname: Strother
authors.forename: A
authors.initials: A
authors.lastname: Fieselmann
authors.forename: D
authors.initials: D
authors.lastname: Consigny
mesh_terms: D000465:Algorithms; D000818:Animals; D001783:Blood Flow Velocity; D001810:Blood Volume; D001811:Blood Volume Determination / Q000379:methods; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002533:Cerebral Angiography / Q000379:methods*; D002560:Cerebrovascular Circulation; D003287:Contrast Media / Q000008:administration & dosage; D004285:Dogs; D007275:Injections, Intravenous; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media