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The effect of varying user-selected input parameters on quantitative values in CT perfusion maps
Pina C Sanelli1, Michael H Lev, James D Eastwood
1Department of Radiology, Weill Medical College of Cornell University, New York Presbyterian Hospital, 520 East 68th Street, Starr Pavilion, Starr-630, New York, NY 10021, USA. pcs9001@med.cornell.edu
Academic Radiology
|November 9, 2004
Summary
User input variations significantly impact quantitative computed tomography perfusion (CTP) maps for acute stroke. While arterial region-of-interest (ROI) placement and size are robust, venous ROI placement and cutoff values critically affect cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) results.
Area of Science:
- Neuroradiology
- Medical Imaging Analysis
- Quantitative Perfusion Imaging
Background:
- Deconvolution software quantifies cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) from computed tomography perfusion (CTP) data.
- Accurate quantitative values depend on user-selected input variables within the software.
Purpose of the Study:
- To assess the impact of user-defined input variations on quantitative CTP map values.
- To determine which input parameters most significantly influence CBF, CBV, and MTT calculations.
Main Methods:
- Quantitative CTP maps (CBF, CBV, MTT) were generated for three acute stroke patients using standard deconvolution software.
- Parameters including ROI placement/size and cutoff values were systematically varied.
- Quantitative values were compared at the infarct core using identical ROIs.
Main Results:
- Major variations in arterial ROI placement or ROI size did not significantly affect mean CBF, CBV, or MTT.
- Minor variations in venous ROI placement or pre/post-enhancement cutoff values significantly altered CTP map values, up to threefold.
- Quantitative CTP analysis was robust to arterial ROI choices but sensitive to venous ROI and cutoff value selections.
Conclusions:
- User-defined inputs, particularly venous ROI placement and cutoff values, critically influence quantitative CTP map accuracy in acute stroke.
- Clinicians must be aware of these sensitivities for reliable CTP map interpretation.
- Quantitation of CBF, CBV, and MTT is highly dependent on specific user-defined parameters.