title: Dynamic Angiography and Perfusion Imaging Using Flat Detector CT in the Angiography Suite: A Pilot Study in Patients with Acute Middle Cerebral Artery Occlusions.
abstract: OBJECTIVE
  Perfusion and angiographic imaging using intravenous contrast application to evaluate stroke patients is now technically feasible by flat detector CT performed by the angiographic system. The aim of this pilot study was to show the feasibility and qualitative comparability of a novel flat detector CT dynamic perfusion and angiographic imaging protocol in comparison with a multimodal stroke MR imaging protocol.
  
  
  METHODS
  In 12 patients with acute stroke, MR imaging and the novel flat detector CT protocol were performed before endovascular treatment. Perfusion parameter maps (MTT, TTP, CBV, CBF) and MIP/volume-rendering technique images obtained by using both modalities (MR imaging and flat detector CT) were compared.
  
  
  RESULTS
  Comparison of MIP/volume-rendering technique images demonstrated equivalent visibility of the occlusion site. Qualitative comparison of perfusion parameter maps by using ASPECTS revealed high Pearson correlation coefficients for parameters CBF, MTT, and TTP (0.95-0.98), while for CBV, the coefficient was lower (0.49).
  
  
  CONCLUSIONS
  We have shown the feasibility of a novel dynamic flat detector CT perfusion and angiographic protocol for the diagnosis and triage of patients with acute ischemic stroke. In a qualitative comparison, the parameter maps and MIP/volume-rendering technique images compared well with MR imaging. In our opinion, this flat detector CT application may substitute for multisection CT imaging in selected patients with acute stroke so that in the future, patients with acute stroke may be directly referred to the angiography suite, thereby avoiding transportation and saving time.
authors.affiliation: From the Department of Neuroradiology (T.S., S.K., T.E., S.L., A.M., M.M., A.D.) tobias.struffert@uk-erlangen.de.
authors.forename: T
authors.initials: T
authors.lastname: Struffert
authors.affiliation: Siemens AG, Healthcare Sector (Y.D.-Z.), Forchheim, Germany.
authors.forename: Y
authors.initials: Y
authors.lastname: Deuerling-Zheng
authors.affiliation: From the Department of Neuroradiology (T.S., S.K., T.E., S.L., A.M., M.M., A.D.).
authors.forename: S
authors.initials: S
authors.lastname: Kloska
authors.affiliation: From the Department of Neuroradiology (T.S., S.K., T.E., S.L., A.M., M.M., A.D.).
authors.forename: T
authors.initials: T
authors.lastname: Engelhorn
authors.affiliation: From the Department of Neuroradiology (T.S., S.K., T.E., S.L., A.M., M.M., A.D.).
authors.forename: S
authors.initials: S
authors.lastname: Lang
authors.affiliation: From the Department of Neuroradiology (T.S., S.K., T.E., S.L., A.M., M.M., A.D.).
authors.forename: A
authors.initials: A
authors.lastname: Mennecke
authors.affiliation: From the Department of Neuroradiology (T.S., S.K., T.E., S.L., A.M., M.M., A.D.) Pattern Recognition Lab (M.M.).
authors.forename: M
authors.initials: M
authors.lastname: Manhart
authors.affiliation: Department of Radiology (C.M.S.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: C M
authors.initials: CM
authors.lastname: Strother
authors.affiliation: Department of Neurology (S.S.), University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schwab
authors.affiliation: From the Department of Neuroradiology (T.S., S.K., T.E., S.L., A.M., M.M., A.D.).
authors.forename: A
authors.initials: A
authors.lastname: Doerfler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000295:instrumentation* / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging*; D018810:Magnetic Resonance Angiography / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000295:instrumentation* / Q000379:methods*; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*