C-Arm Conebeam CT Perfusion Imaging in the Angiographic Suite: A Comparison with Multidetector CT Perfusion Imaging

Area of Science:

• Radiology
• Medical Imaging
• Neuroimaging

Background:

• Perfusion imaging in angiography suites can expedite endovascular revascularization for large-vessel occlusion stroke.
• Comparing conebeam CT perfusion (CBCT-P) with multidetector CT perfusion (MDCT-P) is crucial for optimizing stroke treatment workflows.

Purpose of the Study:

• To compare the diagnostic performance and image quality of conebeam CT perfusion (CBCT-P) against multidetector CT perfusion (MDCT-P) in patients with large-vessel occlusion stroke.

Main Methods:

• Retrospective analysis of perfusion data from 7 patients who underwent both MDCT-P and CBCT-P.
• Application of advanced algorithms to enhance temporal resolution, sampling density, and reduce noise in CBCT-P data.
• Qualitative image quality assessment and quantitative analysis using Sørensen-Dice coefficients to compare perfusion maps.

Main Results:

• Image quality scores were similar for both MDCT-P (2.4) and CBCT-P (2.3).
• Sørensen-Dice coefficients for cerebral blood flow (CBF) and cerebral blood volume (CBV) maps were 0.81 and 0.55, respectively.
• Confidence in diagnosis and treatment decisions showed comparable results between MDCT-P and CBCT-P.

Conclusions:

• Postprocessing techniques significantly improved CBCT-P map quality.
• CBCT-P, after enhancement, demonstrated non-inferiority to MDCT-P for evaluating stroke patients.
• CBCT-P shows promise as a viable alternative for perfusion imaging in the angiography suite.