RT Journal Article
SR Electronic
T1 Optimal Duration of Acquisition for Dynamic Perfusion CT Assessment of Blood-Brain Barrier Permeability Using the Patlak Model
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1366
OP 1370
DO 10.3174/ajnr.A1592
VO 30
IS 7
A1 J. Hom
A1 J.W. Dankbaar
A1 T. Schneider
A1 S.-C. Cheng
A1 J. Bredno
A1 M. Wintermark
YR 2009
UL http://www.ajnr.org/content/30/7/1366.abstract
AB BACKGROUND AND PURPOSE: A previous study demonstrated the need to use delayed acquisition rather than first-pass data for accurate blood-brain barrier permeability surface product (BBBP) calculation from perfusion CT (PCT) according to the Patlak model, but the optimal duration of the delayed acquisition has not been established. Our goal was to determine the optimal duration of the delayed PCT acquisition to obtain accurate BBBP measurements while minimizing potential motion artifacts and radiation dose.MATERIALS AND METHODS: We retrospectively identified 23 consecutive patients with acute ischemic anterior circulation stroke who underwent a PCT study with delayed acquisition. The Patlak model was applied for the full delayed acquisition (90–240 seconds) and also for truncated analysis windows (90–210, 90–180, 90–150, 90–120 seconds). Linear regression of Patlak plots was performed separately for the full and truncated analysis windows, and the slope of these regression lines was used to indicate BBBP. The full and truncated analysis windows were compared in terms of the resulting BBBP values and the quality of the Patlak fitting.RESULTS: BBBP values in the infarct and penumbra were similar for the full 90- to 240-second acquisition (95% confidence intervals for the infarct and penumbra: 1.62–2.47 and 1.75–2.41 mL ×100 g−1 × min−1, respectively) and the 90- to 210-second analysis window (1.82–2.76 and 2.01–2.74 mL × 100 g−1 × min−1, respectively). BBBP values increased significantly with shorter acquisitions. The quality of the Patlak fit was excellent for the full 90- to 240-second and 90- to 210-second acquisitions, but it degraded with shorter acquisitions.CONCLUSIONS: The duration for the delayed PCT acquisition should be at least 210 seconds, because acquisitions shorter than 210 seconds lead to significantly overestimated BBBP values.