Whole-brain adaptive 70-kvp perfusion imaging with variable and extended sampling improves quality and consistency while reducing dose

I. Corcuera-Solano, A. M. McLellan, A. H. Doshi, P. S. Pawha, L. N. Tanenbaum

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

BACKGROUND AND PURPOSE: Despite common use of CTP to assess cerebral hemodynamics in the setting of ischemia, concerns over radiation exposure remain. Our aim was to evaluate the efficacy of an adaptive 70-kVp (peak) whole-brain CTP protocol with variable sampling intervals and extended duration against an established fixed-sampling, limited-period protocol at 80 kVp.

MATERIALS AND METHODS: A retrospective analysis of 37 patients with stroke scanned with conventional (n - 17) and variant-protocol (n - 20) whole-brain CTP was performed. We compared radiation dose, parametric map quality, and consistency of full-contrast circulation capture between a modified 70-kVp protocol, with 20 whole-brain passes at variable sampling intervals over an extended sampling period, and a conventional 80-kVp CTP examination with 24 passes at fixed-sampling intervals and a more limited scanning window. Mann-Whitney U test analysis was used to compare both protocols.

RESULTS: The 70-kVp CTP scan provided superior image quality at a 45% lower CT dose index volume and 13% lower dose-length product/effective dose compared with the conventional 80-kVp scan. With respect to the consistency of contrast-passage capture, 95% of the adaptive, extended protocol continued through the venous return to baseline, compared with only 47% by using the conventional limited-length protocol. Rapid sampling during the critical arterial arrival and washout period was accomplished in nearly 95% with both the variable and fixed-sampling-interval protocols.

CONCLUSIONS: Seventy-kilovolt (peak) CTP with variable and extended sampling produces improved image quality at lower radiation doses with greater consistency of full contrast passage capture. Disclosures: Idoia Corcuera-Solano-UNRELATED: Grant: Fundación Alfonso Martín Escudero, Comments: The foundation paid my salary as a research fellow in Mount Sinai when I was conducting research for this article. Lawrence N. Tanenbaum- UNRELATED: Payment for Lectures (including service on Speakers Bureaus): Siemens, GE Healthcare.

Original languageEnglish
Pages (from-to)2045-2051
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume35
Issue number11
DOIs
StatePublished - 1 Nov 2014

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