title: C-Arm Conebeam CT Perfusion Imaging in the Angiographic Suite: A Comparison with Multidetector CT Perfusion Imaging.
abstract: Perfusion imaging in the angiography suite may provide a way to reduce time from stroke onset to endovascular revascularization of patients with large-vessel occlusion. Our purpose was to compare conebeam CT perfusion with multidetector CT perfusion.
  
  
  
  Data from 7 subjects with both multidetector CT perfusion and conebeam CT perfusion were retrospectively processed and analyzed. Two algorithms were used to enhance temporal resolution and temporal sampling density and reduce the noise of conebeam CT data before generating perfusion maps. Two readers performed qualitative image-quality evaluation on maps by using a 5-point scale. ROIs indicating CBF/CBV abnormalities were drawn. Quantitative analyses were performed by using the Sørensen-Dice coefficients to quantify the similarity of abnormalities. A noninferiority hypothesis was tested to compare conebeam CT perfusion against multidetector CT perfusion.
  
  
  
  Average image-quality scores for multidetector CT perfusion and conebeam CT perfusion images were 2.4 and 2.3, respectively. The average confidence score in diagnosis was 1.4 for both multidetector CT and conebeam CT; the average confidence scores for the presence of a CBV/CBF mismatch were 1.7 (κ = 0.50) and 1.5 (κ = 0.64). For multidetector CT perfusion and conebeam CT perfusion maps, the average scores of confidence in making treatment decisions were 1.4 (κ = 0.79) and 1.3 (κ = 0.90). The area under the visual grading characteristic for the above 4 qualitative quality scores showed an average area under visual grading characteristic of 0.50, with 95% confidence level cover centered at the mean for both readers. The Sørensen-Dice coefficient for CBF maps was 0.81, and for CBV maps, 0.55.
  
  
  
  After postprocessing methods were applied to enhance image quality for conebeam CT perfusion maps, the conebeam CT perfusion maps were not inferior to those generated from multidetector CT perfusion.
authors.affiliation: From the Departments of Medical Physics (K.N., Y.W., G.-H.C.).
authors.forename: K
authors.identifier: 0000-0002-6367-1798
authors.initials: K
authors.lastname: Niu
authors.affiliation: Radiology (P.Y., C.S., G.-H.C.), University of Wisconsin-Madison, Madison, Wisconsin Department of Neurosurgery (P.Y.), Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: P
authors.identifier: 0000-0002-6154-3602
authors.initials: P
authors.lastname: Yang
authors.affiliation: From the Departments of Medical Physics (K.N., Y.W., G.-H.C.).
authors.forename: Y
authors.identifier: 0000-0002-7669-6919
authors.initials: Y
authors.lastname: Wu
authors.affiliation: University of Erlangen-Nuremberg (T.S., A.D.), Erlangen, Germany.
authors.forename: T
authors.identifier: 0000-0002-8708-597X
authors.initials: T
authors.lastname: Struffert
authors.affiliation: University of Erlangen-Nuremberg (T.S., A.D.), Erlangen, Germany.
authors.forename: A
authors.identifier: 0000-0002-3076-3231
authors.initials: A
authors.lastname: Doerfler
authors.affiliation: Siemens Medical Solutions USA (S.S., K.R.), Hoffman Estates, Illinois.
authors.forename: S
authors.identifier: 0000-0002-6989-5215
authors.initials: S
authors.lastname: Schafer
authors.affiliation: Siemens Medical Solutions USA (S.S., K.R.), Hoffman Estates, Illinois.
authors.forename: K
authors.identifier: 0000-0002-5035-7193
authors.initials: K
authors.lastname: Royalty
authors.affiliation: Radiology (P.Y., C.S., G.-H.C.), University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: C
authors.identifier: 0000-0002-4235-8081
authors.initials: C
authors.lastname: Strother
authors.affiliation: From the Departments of Medical Physics (K.N., Y.W., G.-H.C.) Radiology (P.Y., C.S., G.-H.C.), University of Wisconsin-Madison, Madison, Wisconsin gchen7@wisc.edu.
authors.forename: G-H
authors.identifier: 0000-0002-2263-1028
authors.initials: GH
authors.lastname: Chen
mesh_terms: D000368:Aged; D000465:Algorithms; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D059906:Neuroimaging / Q000379:methods*; D055420:Perfusion Imaging / Q000379:methods*; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods