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Related Concept Videos

Imaging Studies for Cardiovascular System III: X-Ray01:20

Imaging Studies for Cardiovascular System III: X-Ray

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The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
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Related Experiment Video

Updated: Jan 15, 2026

Author Spotlight: Integrated Photoacoustic, Ultrasound, and Angiographic Tomography (PAUSAT) for NonInvasive Whole-Brain Imaging of Ischemic Stroke
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Author Spotlight: Integrated Photoacoustic, Ultrasound, and Angiographic Tomography (PAUSAT) for NonInvasive Whole-Brain Imaging of Ischemic Stroke

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Intra-operative soft tissue perfusion assessment using X-ray angiography images: ischemic stroke study.

Shalini Subramanian1, W Paul Segars2, Andreia V Faria3

  • 1Department of Biomedical Engineering, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.

Medical Physics
|January 14, 2026
PubMed
Summary

A new method, Intra-operative PErfusion assessment with No gantry rotation (IPEN), accurately estimates brain perfusion using standard X-ray angiography (XA) images. This technique offers real-time volumetric perfusion assessment for improved stroke treatment and patient outcomes.

Keywords:
X‐ray systemcomputed tomographyinterventionperfusion

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Area of Science:

  • Medical Imaging
  • Neuroscience
  • Interventional Radiology

Background:

  • Real-time volumetric perfusion assessment is crucial for guiding interventional procedures but lacks intra-operative imaging capabilities.
  • Current methods rely on 2-D X-ray angiography (XA), which cannot assess soft tissue perfusion.
  • A need exists for real-time, volumetric perfusion imaging during procedures.

Purpose of the Study:

  • To develop and validate Intra-operative PErfusion assessment with No gantry rotation (IPEN), a novel method for volumetric brain perfusion assessment.
  • To utilize standard X-ray angiography (XA) images for this assessment in ischemic stroke patients.
  • To provide real-time perfusion data for improved clinical decision-making.

Main Methods:

  • IPEN models the brain as small regions of interest (ROIs) to estimate time-enhancement curves (TECs).
  • Key perfusion indices, including Tmax (time-to-maximum) and rCBF (relative cerebral blood flow), are computed from TECs.
  • A five-step algorithm was developed and validated using a digital perfusion phantom and simulated ischemic stroke cases with biplane XA imaging.

Main Results:

  • IPEN accurately estimated TEC, Tmax, and rCBF for 3-D ROIs in the brain.
  • Low mean errors were observed: -1.0 HU for TEC, -0.1 s for Tmax, and 4.4% for rCBF.
  • High correlation coefficients (r) were achieved: 0.88 for TEC, 0.67 for Tmax, and 0.81 for rCBF.

Conclusions:

  • IPEN provides accurate and reliable regional brain perfusion index estimation.
  • The method demonstrates potential for real-time perfusion assessment during interventional procedures.
  • IPEN could significantly enhance procedural success and improve patient outcomes in stroke care.