title: Evaluation of Collaterals and Clot Burden Using Time-Resolved C-Arm Conebeam CT Angiography in the Angiography Suite: A Feasibility Study.
abstract: The assessment of collaterals and clot burden in patients with acute ischemic stroke provides important information about treatment options and clinical outcome. Time-resolved C-arm conebeam CT angiography has the potential to provide accurate and reliable evaluations of collaterals and clot burden in the angiographic suite. Experience with this technique is extremely limited, and feasibility studies are needed to validate this technique. Our purpose was to present such a feasibility study.
  
  
  
  Ten C-arm conebeam CT perfusion datasets from 10 subjects with acute ischemic stroke acquired before endovascular treatment were retrospectively processed to generate time-resolved conebeam CTA. From time-resolved conebeam CTA, 2 experienced readers evaluated the clot burden and collateral flow in consensus by using previously reported scoring systems and assessed the clinical value of this novel imaging technique independently. Interobserver agreement was analyzed by using the intraclass correlation analysis method.
  
  
  
  Clot burden and collateral flow can be assessed by using the commonly accepted scoring systems for all eligible cases. Additional clinical information (eg, the quantitative dynamic information of collateral flow) can be obtained from this new imaging technique. Two readers agreed that time-revolved C-arm conebeam CTA is the preferred method for evaluating the clot burden and collateral flow compared with other conventional imaging methods.
  
  
  
  Comprehensive evaluations of clot burden and collateral flow are feasible by using time-resolved C-arm conebeam CTA data acquired in the angiography suite. This technique further enriches the imaging tools in the angiography suite to enable a "one-stop- shop" imaging workflow for patients with acute ischemic stroke.
authors.affiliation: From the Department of Neurosurgery (P.Y.), Changhai Hospital, Second Military Medical University, Shanghai, China.|Departments of Radiology (P.Y., B.A.-K., C.S., G.-H.C.).
authors.forename: P
authors.identifier: 0000-0002-6154-3602
authors.initials: P
authors.lastname: Yang
authors.affiliation: Medical Physics (K.N., Y.W., G.-H.C.), School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: K
authors.identifier: 0000-0002-6367-1798
authors.initials: K
authors.lastname: Niu
authors.affiliation: Medical Physics (K.N., Y.W., G.-H.C.), School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Y
authors.identifier: 0000-0002-7669-6919
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Neuroradiology (T.S., A.D., P.H.), University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: T
authors.identifier: 0000-0002-8708-597X
authors.initials: T
authors.lastname: Struffert
authors.affiliation: Department of Neuroradiology (T.S., A.D., P.H.), University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: A
authors.identifier: 0000-0002-3076-3231
authors.initials: A
authors.lastname: Doerfler
authors.affiliation: Department of Neuroradiology (T.S., A.D., P.H.), University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: P
authors.identifier: 0000-0001-9768-9630
authors.initials: P
authors.lastname: Holter
authors.affiliation: Departments of Radiology (P.Y., B.A.-K., C.S., G.-H.C.).
authors.forename: B
authors.identifier: 0000-0002-3609-9394
authors.initials: B
authors.lastname: Aagaard-Kienitz
authors.affiliation: Departments of Radiology (P.Y., B.A.-K., C.S., G.-H.C.) Strother@wisc.edu gchen7@wisc.edu.
authors.forename: C
authors.identifier: 0000-0002-4235-8081
authors.initials: C
authors.lastname: Strother
authors.affiliation: Departments of Radiology (P.Y., B.A.-K., C.S., G.-H.C.) Strother@wisc.edu gchen7@wisc.edu.|Medical Physics (K.N., Y.W., G.-H.C.), School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: G-H
authors.identifier: 0000-0002-2263-1028
authors.initials: GH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000000981:diagnostic imaging; D002533:Cerebral Angiography / Q000379:methods; D003097:Collateral Circulation; D000072226:Computed Tomography Angiography / Q000295:instrumentation / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D017281:Cost of Illness; D057510:Endovascular Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000000981:diagnostic imaging