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Updated: Jan 17, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Optimal Scanning Protocol of Whole-Brain CT Perfusion in Patients With Acute Ischemic Stroke
Sentaro Takada1, Hiroyuki Uetani1, Zaw Aung Khant2
1Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto.
Objective:
Whole-brain computed tomography perfusion (CTP) imaging is a dose-intensive imaging technique. We aimed to investigate optimal scanning protocol of the whole-brain CTP using a 320-detector row CT in reducing radiation dose for acute ischemic stroke (AIS) patients.
Methods:
This study included 54 consecutive AIS patients who underwent whole-brain CTP on a 320-detector row CT scanner. We evaluated the penumbra and ischemic core volumes of CTP full , CTP 3/4 , and CTP 1/2 , created using full, 3/4 and 1/2 scanning data, respectively. Wilcoxon signed-rank test, Spearman correlation coefficient, and Bland-Altman analysis were used for the statistical analysis. In addition, hypothetical treatment decisions based on the DEFUSE-3 criteria were also evaluated to determine whether there were any differences in the treatment decisions when using reduced sampling data (CTP 3/4 and CTP 1/2 ) compared with full data to assess its clinical efficacy.
Results:
The penumbra and ischemic core median volumes on CTP full , CTP 3/4 , and CTP 1/2 were 111.5 mL [interquartile range (IQR): 52.0-173.0] and 5.5 mL (IQR: 0 to 24.0), 106.5 mL (IQR: 47.0 to 170.0) and 6.5 mL (IQR: 0 to 24.0), 106.5 mL (IQR: 48.0 to 178.0), and 5.5 mL (IQR: 0 to 23.0), respectively. There were no significant differences in penumbra ( P >0.05) and ischemic core ( P >0.05) volumes between CTP full , CTP 3/4 , and CTP 1/2 . Spearman correlation analysis showed significant correlations between CTP full and CTP 3/4 and CTP 1/2 for both penumbra ( r =0.989 to 0.998, P <0.001) and ischemic core ( r =0.997 to 0.982, P <0.001) volumes. The hypothetical treatment strategies determined using reduced sampling data (CTP 3/4 , and CTP 1/2 ) were largely consistent compared with those using CTP full .
Conclusions:
The use of half-scanning data for the whole-brain CTP image with a 320-detector row CT may help to lower the radiation exposure to AIS patients without significant loss of perfusion information.
