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Updated: Apr 14, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Effects of radiation dose reduction in Volume Perfusion CT imaging of acute ischemic stroke
Ahmed E Othman1,2, Carolin Brockmann3, Zepa Yang4,5
1Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, 52074, Aachen, Germany. ahmed.e.othman@googlemail.com.
Purpose:
To examine the influence of radiation dose reduction on image quality and sensitivity of Volume Perfusion CT (VPCT) maps regarding the detection of ischemic brain lesions.
Methods And Materials:
VPCT data of 20 patients with suspected ischemic stroke acquired at 80 kV and 180 mAs were included. Using realistic reduced-dose simulation, low-dose VPCT datasets with 144 mAs, 108 mAs, 72 mAs and 36 mAs (80 %, 60 %, 40 % and 20 % of the original levels) were generated, resulting in a total of 100 datasets. Perfusion maps were created and signal-to-noise-ratio (SNR) measurements were performed. Qualitative analyses were conducted by two blinded readers, who also assessed the presence/absence of ischemic lesions and scored CBV and CBF maps using a modified ASPECTS-score.
Results:
SNR of all low-dose datasets were significantly lower than those of the original datasets (p < .05). All datasets down to 72 mAs (40 %) yielded sufficient image quality and high sensitivity with excellent inter-observer-agreements, whereas 36 mAs datasets (20 %) yielded poor image quality in 15 % of the cases with lower sensitivity and inter-observer-agreements.
Conclusion:
Low-dose VPCT using decreased tube currents down to 72 mAs (40 % of original radiation dose) produces sufficient perfusion maps for the detection of ischemic brain lesions.
Key Points:
• Perfusion CT is highly accurate for the detection of ischemic brain lesions • Perfusion CT results in high radiation exposure, therefore low-dose protocols are required • Reduction of tube current down to 72 mAs produces sufficient perfusion maps.
