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A Bayesian estimation method for cerebral blood flow measurement by area-detector CT perfusion imaging

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Purpose

Bayesian estimation with advanced noise reduction (BEANR) in CT perfusion (CTP) could deliver more reliable cerebral blood flow (CBF) measurements than the commonly used reformulated singular value decomposition (rSVD). We compared the efficacy of CBF measurement by CTP using BEANR and rSVD, evaluating both relative to N-isopropyl-p-[(123) I]- iodoamphetamine (123I-IMP) single-photon emission computed tomography (SPECT) as a reference standard, in patients with cerebrovascular disease.

Methods

Thirty-one patients with suspected cerebrovascular disease underwent both CTP on a 320 detector-row CT system and SPECT. We applied rSVD and BEANR in the ischemic and contralateral regions to create CBF maps and calculate CBF ratios from the ischemic side to the healthy contralateral side (CBF index). The analysis involved comparing the CBF index between CTP methods and SPECT using Pearson’s correlation and limits of agreement determined with Bland–Altman analyses, before comparing the mean difference in the CBF index between each CTP method and SPECT using the Wilcoxon matched pairs signed-rank test.

Results

The CBF indices of BEANR and 123I-IMP SPECT were significantly and positively correlated (r = 0.55, p < 0.0001), but there was no significant correlation between the rSVD method and SPECT (r = 0.15, p > 0.05). BEANR produced smaller limits of agreement for CBF than rSVD. The mean difference in the CBF index between BEANR and SPECT differed significantly from that between rSVD and SPECT (p < 0.001).

Conclusions

BEANR has a better potential utility for CBF measurement in CTP than rSVD compared to SPECT in patients with cerebrovascular disease.

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Data availability

Data generated or analyzed during the study are available from the corresponding author by request.

Code availability

Software application: Vitrea workstation (Brain Perfusion 4D, Vital Images, Minnetonka, MN, USA).

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Funding

This work was supported by Canon Medical Systems Corporation.

Author information

Authors and Affiliations

  1. Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho Toyoake, Aichi, 470-1101, Japan

    Kazuhiro Murayama, Satomu Hanamatsu, Kazuhiro Katada, Yoshiharu Ohno & Hiroshi Toyama

  2. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands

    Ewoud J. Smit & Mathias Prokop

  3. Canon Medical Systems Corporation, 1385 Shimoishigami, Otawara, Tochigi, 325-8550, Japan

    Yoshihiro Ikeda & Kenji Fujii

  4. Department of Comprehensive Strokology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho Toyoake, Aichi, 470-1101, Japan

    Ichiro Nakahara

Authors
  1. Kazuhiro Murayama
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  10. Hiroshi Toyama
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Ichiro Nakahara, and analysis was performed by Satomu Hanamatsu. The first draft of the manuscript was written by Kazuhiro Murayama, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kazuhiro Murayama.

Ethics declarations

Ethics approval

This retrospective study was approved by the Institutional Review Board of Fujita Health University (Toyoake, Japan).

Consent to participate

Written informed consents were waived for all subjects in this retrospective study according to the approval of the local ethics committee (Fujita Health University, Toyoake, Japan).

Consent for publication

Written informed consents were waived for all subjects in this retrospective study according to the approval of the local ethics committee (Fujita Health University, Toyoake, Japan).

Conflict of interest

Kazuhiro Murayama, Kazuhiro Katada, Yoshiharu Ohno, and Hiroshi Toyama have received a research grant from Canon Medical Systems Corporation, which also supported this work technically. Ewoud J. Smit has received speaker honorarium from Canon Medical Systems Corporation. Mathias Prokop has received personal fees from Bracco, Bayer, Canon Medical Systems, and Siemens Healthineers and grants from Canon Medical Systems and Siemens Healthineers. Kazuhiro Katada is consultant to Canon Medical Systems Corporation. Yoshihiro Ikeda and Kenji Fujii are employees of Canon Medical Systems. The other authors declare that they have no conflict of interest.

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Murayama, K., Smit, E.J., Prokop, M. et al. A Bayesian estimation method for cerebral blood flow measurement by area-detector CT perfusion imaging. Neuroradiology 65, 65–75 (2023). https://doi.org/10.1007/s00234-022-03013-9

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