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Neuroradiology

, Volume 56, Issue 3, pp 245–249 | Cite as

Use of time attenuation curves to determine steady-state characteristics before C-arm CT measurement of cerebral blood volume

  • Jildaz Caroff
  • Pakrit Jittapiromsak
  • Daniel Ruijters
  • Nidhal Benachour
  • Cristian Mihalea
  • Aymeric Rouchaud
  • Hiroaki Neki
  • Léon Ikka
  • Jacques Moret
  • Laurent Spelle
Functional Neuroradiology

Abstract

Introduction

Cerebral blood volume (CBV) measurement by flat panel detector CT (FPCT) in the angiography suite seems to be a promising tool for patient management during endovascular therapies. A steady state of contrast agent distribution is mandatory during acquisition for accurate FPCT CBV assessment. To the best of our knowledge, this was the first time that steady-state parameters were studied in clinical practice.

Methods

Before the CBV study, test injections were performed and analyzed to determine a customized acquisition delay from injection for each patient. Injection protocol consisted in the administration of 72 mL of contrast agent material at the injection rate of 4.0 mL/s followed by a saline flush bolus at the same injection rate. Peripheral or central venous accesses were used depending on their availability. Twenty-four patients were treated for different types of neurovascular diseases. Maximal attenuation, steady-state length, and steady-state delay from injection were derived from the test injections’ time attenuation curves.

Results

With a 15 % threshold from maximum attenuation values, average steady-state duration was less than 10 s. Maximum average steady-state duration with minimal delay variation was obtained with central injection protocols.

Conclusion

With clinically acceptable contrast agent volumes, steady state is a brief condition; thus, fast rotation speed acquisitions are needed. The use of central injections decreases the variability of steady-state’s delay from injection. Further studies are needed to optimize and standardize injection protocols to allow a larger diffusion of the FPCT CBV measurement during endovascular treatments.

Keywords

Flat detector computed tomography Perfusion imaging Cerebral blood flow Endovascular therapy Steady state 

Notes

Conflict of interest

DR is employed by Philips Healthcare, Netherlands.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Jildaz Caroff
    • 1
  • Pakrit Jittapiromsak
    • 1
  • Daniel Ruijters
    • 2
  • Nidhal Benachour
    • 1
  • Cristian Mihalea
    • 1
  • Aymeric Rouchaud
    • 1
  • Hiroaki Neki
    • 1
  • Léon Ikka
    • 1
  • Jacques Moret
    • 1
  • Laurent Spelle
    • 1
  1. 1.Beaujon Medical Center, NEURI—Interventional Neuroradiology, Paris Diderot UniversityClichyFrance
  2. 2.Philips Healthcare, Interventional X-Ray InnovationBestNetherlands

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