Flat-panel Detector Perfusion Imaging and Conventional Multidetector Perfusion Imaging in Patients with Acute...

Area of Science:

• Neuroimaging
• Radiology
• Stroke Imaging

Background:

• Flat-panel detector computed tomography (FDCT) is increasingly utilized in neurointerventional angiography.
• Assessing perfusion is crucial for managing acute ischemic stroke.

Purpose of the Study:

• To compare flat-panel detector computed tomography perfusion (FDCTP) with multidetector computed tomography perfusion (MDCTP) in patients with acute ischemic stroke.
• To evaluate the performance of FDCTP against MDCTP for quantifying hypoperfused tissue volumes.

Main Methods:

• 19 patients with large vessel occlusion undergoing mechanical thrombectomy were included.
• Hypoperfused tissue and core infarct volumes were manually segmented on Tmax and TTP maps from both MDCTP and FDCTP.
• Absolute and relative thresholds were applied to delineate penumbra and core volumes.

Main Results:

• Strong correlations and agreement were observed between manually segmented Tmax and TTP volumes from FDCTP and MDCTP.
• Direct quantitative comparisons using thresholding showed lower correlations and agreement.
• Normalization techniques improved quantitative agreement for Tmax maps.
• Bland-Altman analysis indicated slight systematic differences in volume measurements.

Conclusions:

• FDCTP and MDCTP provide qualitatively comparable volumetric results for acute ischemic stroke assessment.
• Direct quantitative measurements of infarct core and hypoperfused tissue volumes using thresholding show lower agreement between FDCTP and MDCTP.
• Further research may be needed to optimize quantitative analysis with FDCTP.