Document Detail


Optimal duration of acquisition for dynamic perfusion CT assessment of blood-brain barrier permeability using the Patlak model.
MedLine Citation:
PMID:  19369610     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: A previous study demonstrated the need to use delayed acquisition rather than first-pass data for accurate blood-brain barrier permeability surface product (BBBP) calculation from perfusion CT (PCT) according to the Patlak model, but the optimal duration of the delayed acquisition has not been established. Our goal was to determine the optimal duration of the delayed PCT acquisition to obtain accurate BBBP measurements while minimizing potential motion artifacts and radiation dose. MATERIALS AND METHODS: We retrospectively identified 23 consecutive patients with acute ischemic anterior circulation stroke who underwent a PCT study with delayed acquisition. The Patlak model was applied for the full delayed acquisition (90-240 seconds) and also for truncated analysis windows (90-210, 90-180, 90-150, 90-120 seconds). Linear regression of Patlak plots was performed separately for the full and truncated analysis windows, and the slope of these regression lines was used to indicate BBBP. The full and truncated analysis windows were compared in terms of the resulting BBBP values and the quality of the Patlak fitting. RESULTS: BBBP values in the infarct and penumbra were similar for the full 90- to 240-second acquisition (95% confidence intervals for the infarct and penumbra: 1.62-2.47 and 1.75-2.41 mL x100 g(-1) x min(-1), respectively) and the 90- to 210-second analysis window (1.82-2.76 and 2.01-2.74 mL x 100 g(-1) x min(-1), respectively). BBBP values increased significantly with shorter acquisitions. The quality of the Patlak fit was excellent for the full 90- to 240-second and 90- to 210-second acquisitions, but it degraded with shorter acquisitions. CONCLUSIONS: The duration for the delayed PCT acquisition should be at least 210 seconds, because acquisitions shorter than 210 seconds lead to significantly overestimated BBBP values.
Authors:
J Hom; J W Dankbaar; T Schneider; S-C Cheng; J Bredno; M Wintermark
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-04-15
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  30     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1366-70     Citation Subset:  IM    
Affiliation:
Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif 94143-0628, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood-Brain Barrier / radiography*
Brain Ischemia / radiography*
Cerebral Angiography / methods*
Contrast Media
Female
Humans
Iohexol / diagnostic use*
Male
Middle Aged
Perfusion Imaging / methods*
Radiographic Image Enhancement / methods*
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Grant Support
ID/Acronym/Agency:
KL2 RR024130/RR/NCRR NIH HHS; UL1 RR024131/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media; 66108-95-0/Iohexol

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