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High-resolution dynamic angiography using flat-panel volume CT: feasibility demonstration for neuro and lower limb vascular applications

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Abstract

Objective

This paper evaluates a prototype flat-panel volume CT (fpVCT) for dynamic in vivo imaging in a variety of neurovascular and lower limb applications.

Methods

Dynamic CTA was performed on 12 patients (neuro = 8, lower limb = 4) using an fpVCT with 120 kVp, 50 mA, rotation time varying from 8 to 19 s, and field of view of 25 × 25 × 18 cm3. Four-dimensional data sets (i.e. 3D images over time) were reconstructed and reviewed.

Results

Dynamic CTA demonstrated sufficient spatio-temporal resolution to elucidate first-pass and recirculation dynamics of contrast bolus through neurovasclaur pathologies and phasic blood flow though lower-limb vasculature and grafts. The high spatial resolution of fpVCT resulted in reduced partial volume and metal beam-hardening artefacts. This facilitated assessment of vascular lumen in the presence of calcified plaque and evaluation of fractures, especially in the presence of fixation hardware. Evaluation of arteriovenous malformation using dynamic fpVCT angiography was of limited utility.

Conclusions

Dynamic CTA using fpVCT can visualize time-varying phenomena in neuro and lower limb vascular applications and has suffcient diagnostic imaging quality to evaluate a number of pathologies affecting these regions.

Key Points

• CTA using fpVCT has sufficient spatial and temporal resolution to study phasic blood flow.

• CTA using fpVCT reveals recurrence of aneurysms even after clipping/coiling.

• fpVCT has reduced partial volume and metal beam-hardening artefacts.

• fpVCT can show vessel lumen in the presence of calcified plaque.

• CTA using fpVCT can demonstrate vascular supply to transplanted grafts.

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Abbreviations

CTA:

CT angiogram

DSA:

Digital subtraction angiography

fpVCT:

Flat-panel volume CT

MDCT:

Multi-detector computer-assisted tomography

References

  1. Konstas AA, Goldmakher GV, Lee T-Y, Lev MH (2009) Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 2: technical implementations. AJNR Am J Neuroradiol 30:885–892

    Article  CAS  PubMed  Google Scholar 

  2. Gupta R, Mani S, Mehndiratta A et al (2011) In: Law M, Som PM, Naidich TP (eds) Multi-detector computed tomography as a problem solving tool in neuroradiology. Problem solving in neuroradiology. Saunders, Philadelphia

    Google Scholar 

  3. Gupta R, Mehndiratta A, Mitha AP et al (2011) Temporal resolution of dynamic angiography using flat panel volume CT: in vivo evaluation of time-dependent vascular pathologies. AJNR Am J Neuroradiol 32:1688–1696

    Article  CAS  PubMed  Google Scholar 

  4. Mitha AP, Reichardt B, Grasruck M et al (2009) Dynamic imaging of a model of intracranial saccular aneurysms using ultra-high-resolution flat-panel volumetric computed tomography. Laboratory investigation. J Neurosurg 111:947–957

    Article  PubMed  Google Scholar 

  5. Gupta R, Grasruck M, Suess C et al (2006) Ultra-high resolution flat-panel volume CT: fundamental principles, design architecture, and system characterization. Eur Radiol 16:1191–1205

    Article  PubMed  Google Scholar 

  6. Bartling S, Kuntz J, Mehndiratta A et al (2012) Prior image constrained compressed sensing (PICCS) on a flat-panel cone-beam CT: a new method for low dose, 4D human angiography. Radiol Soc N Am, pp SSQ19–09

  7. Feldkamp LA, Davis LC, Kress JW (1984) Practical cone-beam algorithm. J Opt Soc Am 1:612–619

    Article  Google Scholar 

  8. Grasruck M, Suess C, Stierstorfer K et al (2005) Evaluation of image quality and dose on a flat-panel CT-scanner. Proc SPIE 5745:179–188

    Google Scholar 

  9. Shrimpton PC, Hillier MC, Lewis MA, Dunn M (2006) National survey of doses from CT in the UK: 2003. Br J Radiol 79:968–980

    Article  CAS  PubMed  Google Scholar 

  10. Jessen K, Panzer W, Shrimpton P et al (2000) EUR 16262: European guidelines on quality criteria for computed tomography. Office for Official Publications of the European Communities, Luxembourg

    Google Scholar 

  11. Ikram S, Leesar M, Fahsah I (2009) Peripheral angiography. In: Dieter RS, Dieter RA III, Dieter RA Jr (eds) Peripheral artery disease, 1st edn. McGraw-Hill, New York, pp 341–373

    Google Scholar 

  12. Grzyska U, Freitag J, Zeumer H (1990) Selective cerebral intraarterial DSA. Complication rate and control of risk factors. Neuroradiology 32:296–299

    Article  CAS  PubMed  Google Scholar 

  13. Agid R, Willinsky RA, Lee S-K et al (2008) Characterization of aneurysm remnants after endovascular treatment: contrast-enhanced MR angiography versus catheter digital subtraction angiography. AJNR Am J Neuroradiol 29:1570–1574

    Article  CAS  PubMed  Google Scholar 

  14. Reichardt B, Sarwar A, Bartling SH et al (2008) Musculoskeletal applications of flat-panel volume CT. Skeletal Radiol 37:1069–1076

    Article  PubMed  Google Scholar 

  15. Cheung AC, Bredella MA, Al Khalaf M et al (2009) Reproducibility of trabecular structure analysis using flat-panel volume computed tomography. Skeletal Radiol 38:1003–1008

    Article  PubMed  Google Scholar 

  16. Phan CM, Macklin EA, Bredella MA et al (2011) Trabecular structure analysis using C-arm CT: comparison with MDCT and flat-panel volume CT. Skeletal Radiol 40:1065–1072

    Article  PubMed  Google Scholar 

  17. Fritzsche SD (2001) Comorbid risk factors in TRAM flap failure. Plast Surg Nurs 21:178, 181–183; quiz 184

    Article  CAS  PubMed  Google Scholar 

  18. Molina AR, Jones ME, Hazari A et al (2012) Correlating the deep inferior epigastric artery branching pattern with type of abdominal free flap performed in a series of 145 breast reconstruction patients. Ann R Coll Surg Engl 94:493–495

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Sbitany H, Mirzabeigi MN, Kovach SJ et al (2012) Strategies for recognizing and managing intraoperative venous congestion in abdominally based autologous breast reconstruction. Plast Reconstr Surg 129:809–815

    Article  CAS  PubMed  Google Scholar 

  20. Scheufler O, Exner K, Andresen R (2004) Investigation of TRAM flap oxygenation and perfusion by near-infrared reflection spectroscopy and color-coded duplex sonography. Plast Reconstr Surg 113:141–152, discussion 153–155

    Article  PubMed  Google Scholar 

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Acknowledgements

We want to thank Drs. B.H. Sapkota, C. Phan, and S. Iqbal for their help in patient recruitment and scanning, Dr. C. Leidecker for technical support, and Ms. J. Miller for proofreading this paper.

The scientific guarantor of this publication is Dr. Rajiv Gupta, Radiology, MGH, Boston. R. Gupta’s research was partially supported by a research grant from Siemens Healthcare (MGH-2010-CT-35702), Defense Advanced Research Projects Agency (N66001-11-1-4204), and US Army Medical Research Acquisitions (W81XWH-09-2-0001). Michael Grasruck is an employee at Siemens Healthcare, Forchheim, Germany. Amit Mehndiratta, James D. Rabinov, Eric C. Liao, and David Crandell declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, GRB-273A, Boston, MA, 02114, USA

    Amit Mehndiratta & Rajiv Gupta

  2. Institute of Biomedical Engineering and Keble College, University of Oxford, Oxford, UK

    Amit Mehndiratta

  3. Centre for Biomedical Engineering, Indian Institute of Technology Delhi and All India Institute of Medical Science, New Delhi, India

    Amit Mehndiratta

  4. Interventional Neuroradiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    James D. Rabinov

  5. Siemens Medical Solutions, Forchheim, Germany

    Michael Grasruck

  6. Department of Plastic and Reconstructive Surgery and Center for Regenerative Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Eric C. Liao

  7. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA, USA

    David Crandell

Authors
  1. Amit Mehndiratta
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  2. James D. Rabinov
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  3. Michael Grasruck
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  4. Eric C. Liao
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  5. David Crandell
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  6. Rajiv Gupta
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Correspondence to Amit Mehndiratta.

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Mehndiratta, A., Rabinov, J.D., Grasruck, M. et al. High-resolution dynamic angiography using flat-panel volume CT: feasibility demonstration for neuro and lower limb vascular applications. Eur Radiol 25, 1901–1910 (2015). https://doi.org/10.1007/s00330-015-3612-8

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  • DOI: https://doi.org/10.1007/s00330-015-3612-8

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