CT Assessment of Cerebral Perfusion: Experimental Validation and Initial Clinical Experience

Abstract

Dynamic single-section CT scanning to measure CBV and CBF on the basis of a noncarotid input is a highly accessible and cost-effective blood flow measurement technique.

Role of Perfusion CT in Glioma Grading and Comparison with Conventional MR Imaging Features

“…The values for the lowgrade gliomas in our study are in concordance with other perfusion studies; however, the values for the high-grade tumors are less than the values observed with MR perfusion in the literature. Similar lesser CBV and CBF values were described with PCT by Eastwood and Provenzale 49 and were hypothesized to be due to differences in microvascularity of the tumors, scaling factor differences, and better correction for the effects of contrast leakage with PCT 43 and probably erroneous overestimation of the CBF and CBV with MR perfusion. The same factors could be at play in our study, giving us lower nCBV compared with previous MR perfusion studies.…”

“…[41][42][43][44] The increasing number of publications reporting a correlation between hemodynamic parameters and histologic measurements of angiogenesis, such as microvessel density, validate the use of PCT as a marker of angiogenesis. [41][42][43][44][45] Perfusion imaging of brain tumors, which has mostly used various MR perfusion techniques, can also be used for stereotactic biopsy guidance, 11 better delineation of tumor margins, 9,38 and also for assessing treatment response. 15,46 PCT shares the advantages of MR perfusion and potentially has advantages over MR perfusion because of easy accessibility, measurement of absolute perfusion values, and relatively easy postprocessing.…”

Increasing Contrast Agent Concentration Improves Enhancement in First-Pass CT Perfusion

“…Functional maps of tissue perfusion are then constructed from the acquired temporal data to visualize blood flow, blood volume, and mean transit time. 6,7 This calculation is a noise-sensitive process, 8 and better signal-intensity enhancement will necessarily result in more robust analysis. 9 Because tissue enhancement at any given time during the passage of contrast through the cerebral vasculature depends on the actual amount of contrast agent in the intravascular space, one approach to improve signal-intensity visibility would be to increase the iodine concentration of the contrast material used.…”

CT Perfusion Identifies Increased Salvage of Tissue in Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator within 3 Hours of Stroke Onset

“…It is this functional information that is being sought by using perfusion imaging and mapping of vascular physiology. [1][2][3][4][5] In the literature, it has been shown that lesion volumes on physiologic maps constructed from initial perfusion imaging in patients assessed in the 6-to 72-hour time window predict the final infarct volume. [6][7][8][9] Furthermore, several authors have shown that the volume of the initial CBV deficit approximates the final infarct size and likely represents already irreversibly infarcted tissue.…”