PT  - JOURNAL ARTICLE
AU  - A. Ganguly
AU  - A. Fieselmann
AU  - M. Marks
AU  - J. Rosenberg
AU  - J. Boese
AU  - Y. Deuerling-Zheng
AU  - M. Straka
AU  - G. Zaharchuk
AU  - R. Bammer
AU  - R. Fahrig
TI  - Cerebral CT Perfusion Using an Interventional C-Arm Imaging System: Cerebral Blood Flow Measurements
AID  - 10.3174/ajnr.A2518
DP  - 2011 Sep 01
TA  - American Journal of Neuroradiology
PG  - 1525--1531
VI  - 32
IP  - 8
4099  - http://www.ajnr.org/content/32/8/1525.short
4100  - http://www.ajnr.org/content/32/8/1525.full
SO  - Am. J. Neuroradiol.2011 Sep 01; 32
AB  - BACKGROUND AND PURPOSE: CTP imaging in the interventional suite could reduce delays to the start of image-guided interventions and help determine the treatment progress and end point. However, C-arms rotate slower than clinical CT scanners, making CTP challenging. We developed a cerebral CTP protocol for C-arm CBCT and evaluated it in an animal study. MATERIALS AND METHODS: Five anesthetized swine were imaged by using C-arm CBCT and conventional CT. The C-arm rotates in 4.3 seconds plus a 1.25-second turnaround, compared with 0.5 seconds for clinical CT. Each C-arm scan had 6 continuous bidirectional sweeps. Multiple scans each with a different delay to the start of an aortic arch iodinated contrast injection and a novel image reconstruction algorithm were used to increase temporal resolution. Three different scan sets (consisting of 6, 3, or 2 scans) and 3 injection protocols (3-mL/s 100%, 3-mL/s 67%, and 6-mL/s 50% contrast concentration) were studied. CBF maps for each scan set and injection were generated. The concordance and Pearson correlation coefficients (ρ and r) were calculated to determine the injection providing the best match between the following: the left and right hemispheres, and CT and C-arm CBCT. RESULTS: The highest ρ and r values (both 0.92) for the left and right hemispheres were obtained by using the 6-mL 50% iodinated contrast concentration injection. The same injection gave the best match for CT and C-arm CBCT for the 6-scan set (ρ = 0.77, r = 0.89). Some of the 3-scan and 2-scan protocols provided matches similar to those in CT. CONCLUSIONS: This study demonstrated that C-arm CBCT can produce CBF maps that correlate well with those from CTP. AIFarterial input functionCBCTconebeam CTCBFcerebral blood flowCBVcerebral blood volumeCCAcommon carotid arteryCCCconcordance correlation coefficientCTPCT perfusionMTTmean transit timeDSAdigital subtraction angiographyDWIdiffusion-weighted imagingFLAIRfluid-attenuated inversion recoveryHClhydrchloric acidIAintra-arterialIVintravenousmAsmilliampere secondpCO2end-tidal partial pressure of CO2PWIperfusion-weighted imagingROIregion of interestTDCtime-density curveTmaxtime-to-maximumTTPtime-to-peak