C-Arm CT Measurement of Cerebral Blood Volume in Ischemic Stroke: An Experimental Study in Canines

Abstract

BACKGROUND AND PURPOSE:CBV is a key parameter in distinguishing penumbra from ischemic core. The purpose of this study was to compare CBV measurements acquired with standard PCT with ones obtained with C-arm CT in a canine stroke model.

Angiographic CT after Intravenous Contrast Agent Application: A Noninvasive Follow-Up Tool after Intracranial Angioplasty and Stenting

“…This would facilitate the assessment of hemodynamic relevance of the stenotic lesion in addition to quantification of restenosis. 28 In our study, ivACT showed a high sensitivity and specificity for the detection of ISR compared with iaDSA. We could successfully detect and quantify ISR on ACT images in all 5 patients presenting an ISR at follow-up iaDSA.…”

C-Arm CT Measurement of Cerebral Blood Volume Using Intra-Arterial Injection of Contrast Medium: An Experimental Study in Canines

“…This then offers a potential alternative to the use of an IV injection of contrast when CBV measurements are made using C-arm CT. 6,7 We have also shown that, in the canines with acute ischemia, regional measurement of CBV in conjunction with either a CCA or a VA injection of contrast was not a reliable method for providing CBV maps. In normal canines, however, the CCA and VA injection routes did provide regional CBV maps that were comparable with ones obtained with standard PCT.…”

“…24 Third, it has been demonstrated, in animals and in humans, that by using C-arm CT, measurements of CBV can be obtained that compare well with those made by using standard PCT. [6][7][8][9] Finally, as we, and others, have previously noted, the potential to perform repeated assessments of perfusion parameters during an intervention seemingly would improve the ability of an operator to not only assess the effectiveness of treatment in an ongoing fashion-that is, whether a CBV abnormality is stable or whether it is becoming smaller-but also provide some insight into the benefit and risk of continuing an intervention, that is, whether the CBV abnormality is larger despite the intervention. The ability to perform these measurements on a regional basis, using injections of contrast through an existing catheter upstream from ischemic tissue, would seemingly further enhance the value of this capability.…”

“…The reconstruction algorithm has been previously described in detail. 6,7 In brief, after reconstruction and subtraction of the mask run and the fill run, an algorithm was applied to further segment out air and bone from the image volume. In the PCT postprocessing, vascular inputs were selected manually.…”

“…[1][2][3] A key parameter in trying to identify those patients who have ischemic, but potentially viable, brain parenchyma (who thus might benefit from revascularization) from ones who have ischemic brain tissue that is not salvageable is CBV. 4,5 Animal and human studies have recently demonstrated the feasibility and possible advantage of measuring CBV in the angiographic suite using C-arm CT. [6][7][8][9] As emphasized by Harris and colleagues, 10 both the rate and the amount of ischemic core growing into a region of penumbra varies greatly in each patient. Thus, as is the case for perfusion parameters measured with other techniques, the ability to obtain serial C-arm CT measurements of CBV before and then during an intervention could add value in determining the effectiveness of revascularization and also in determining the time when the risk of injury from treatment exceeds further possible benefit.…”