Flat-panel Detector Perfusion Imaging and Conventional Multidetector Perfusion Imaging in Patients with Acute Ischemic Stroke

Author:

Serrallach Bettina L.ORCID,Mujanovic AdnanORCID,Ntoulias Nikolaos,Manhart Michael,Branca MattiaORCID,Brehm AlexORCID,Psychogios Marios-Nikos,Kurmann Christoph C.ORCID,Piechowiak Eike I.ORCID,Pilgram-Pastor SaraORCID,Meinel ThomasORCID,Seiffge DavidORCID,Mordasini Pasquale,Gralla JanORCID,Dobrocky TomasORCID,Kaesmacher JohannesORCID

Abstract

Abstract Purpose Flat-panel detector computed tomography (FDCT) is increasingly used in (neuro)interventional angiography suites. This study aimed to compare FDCT perfusion (FDCTP) with conventional multidetector computed tomography perfusion (MDCTP) in patients with acute ischemic stroke. Methods In this study, 19 patients with large vessel occlusion in the anterior circulation who had undergone mechanical thrombectomy, baseline MDCTP and pre-interventional FDCTP were included. Hypoperfused tissue volumes were manually segmented on time to maximum (Tmax) and time to peak (TTP) maps based on the maximum visible extent. Absolute and relative thresholds were applied to the maximum visible extent on Tmax and relative cerebral blood flow (rCBF) maps to delineate penumbra volumes and volumes with a high likelihood of irreversible infarcted tissue (“core”). Standard comparative metrics were used to evaluate the performance of FDCTP. Results Strong correlations and robust agreement were found between manually segmented volumes on MDCTP and FDCTP Tmax maps (r = 0.85, 95% CI 0.65–0.94, p < 0.001; ICC = 0.85, 95% CI 0.69–0.94) and TTP maps (r = 0.91, 95% CI 0.78–0.97, p < 0.001; ICC = 0.90, 95% CI 0.78–0.96); however, direct quantitative comparisons using thresholding showed lower correlations and weaker agreement (MDCTP versus FDCTP Tmax 6 s: r = 0.35, 95% CI −0.13–0.69, p = 0.15; ICC = 0.32, 95% CI 0.07–0.75). Normalization techniques improved results for Tmax maps (r = 0.78, 95% CI 0.50–0.91, p < 0.001; ICC = 0.77, 95% CI 0.55–0.91). Bland-Altman analyses indicated a slight systematic underestimation of FDCTP Tmax maximum visible extent volumes and slight overestimation of FDCTP TTP maximum visible extent volumes compared to MDCTP. Conclusion FDCTP and MDCTP provide qualitatively comparable volumetric results on Tmax and TTP maps; however, direct quantitative measurements of infarct core and hypoperfused tissue volumes showed lower correlations and agreement.

Funder

Schweizerische Akademie der Medizinischen Wissenschaften

University of Bern

Publisher

Springer Science and Business Media LLC

Reference38 articles.

1. Brehm A, Tsogkas I, Ospel JM, Appenzeller-Herzog C, Aoki J, Kimura K, Pfaff JAR, Mohlenbruch MA, Requena M, Ribo MJ, Sarraj A, Spiotta AM, Sporns PPsychogios MN. Direct to angiography suite approaches for the triage of suspected acute stroke patients: a systematic review and meta-analysis. Ther Adv Neurol Disord. 2022;15:17562864221078177. https://doi.org/10.1177/17562864221078177.

2. Psychogios MN, Maier IL, Tsogkas I, Hesse AC, Brehm A, Behme D, Schnieder M, Schregel K, Papageorgiou I, Liebeskind DS, Goyal M, Bahr M, Knauth MLiman J. One-Stop Management of 230 Consecutive Acute Stroke Patients: Report of Procedural Times and Clinical Outcome. J Clin Med. 2019;8:12. https://doi.org/10.3390/jcm8122185.

3. Doerfler A, Golitz P, Engelhorn T, Kloska SStruffert T. Flat-Panel Computed Tomography (DYNA-CT) in Neuroradiology. From High-Resolution Imaging of Implants to One-Stop-Shopping for Acute Stroke. Clin Neuroradiol. 2015;25 Suppl 2:291–7. https://doi.org/10.1007/s00062-015-0423-x

4. Psychogios MN, Buhk JH, Schramm P, Xyda A, Mohr AKnauth M. Feasibility of angiographic CT in peri-interventional diagnostic imaging: a comparative study with multidetector CT. AJNR Am J Neuroradiol. 2010;31(7):1226–31. https://doi.org/10.3174/ajnr.A2086.

5. Kurmann CC, Kaesmacher J, Cooke DL, Psychogios M, Weber J, Lopes DK, Albers GWMordasini P. Evaluation of time-resolved whole brain flat panel detector perfusion imaging using RAPID ANGIO in patients with acute stroke: comparison with CT perfusion imaging. J Neurointerv Surg. 2023;15(4):387–92. https://doi.org/10.1136/neurintsurg-2021-018464.

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