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Article

Cerebral CT Perfusion in Acute Stroke: The Effect of Lowering the Tube Load and Sampling Rate on the Reproducibility of Parametric Maps

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Computational BioMedicine Laboratory (CBML), Foundation for Research and Technology—Hellas (FORTH), 70013 Heraklion, Greece
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Department of Radiology, Medical School, University of Crete, 70013 Heraklion, Greece
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GrayNumber Analytics, 23435 Lomma, Sweden
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Department of Medical Physics, University of Crete, 70013 Heraklion, Greece
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Department of Radiology, Aristotle Medical School of Thessaloniki, 54124 Thessaloniki, Greece
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Department of Medical Imaging, University Hospital, 70013 Heraklion, Greece
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Artorg Center, University of Bern, 3008 Bern, Switzerland
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Department of Neurology, Stanford University, Stanford, CA 94305, USA
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Department of Electrical & Computer Engineering, Hellenic Mediterranean University, 71410 Heraklion, Greece
*
Author to whom correspondence should be addressed.
Academic Editor: Matthias S. May
Diagnostics 2021, 11(6), 1121; https://doi.org/10.3390/diagnostics11061121
Received: 28 May 2021 / Revised: 17 June 2021 / Accepted: 18 June 2021 / Published: 19 June 2021
(This article belongs to the Special Issue Radiation Dose and Image Quality in CT Imaging)
The aim of this study was to define lower dose parameters (tube load and temporal sampling) for CT perfusion that still preserve the diagnostic efficiency of the derived parametric maps. Ninety stroke CT examinations from four clinical sites with 1 s temporal sampling and a range of tube loads (mAs) (100–180) were studied. Realistic CT noise was retrospectively added to simulate a CT perfusion protocol, with a maximum reduction of 40% tube load (mAs) combined with increased sampling intervals (up to 3 s). Perfusion maps from the original and simulated protocols were compared by: (a) similarity using a voxel-wise Pearson’s correlation coefficient r with in-house software; (b) volumetric analysis of the infarcted and hypoperfused volumes using commercial software. Pearson’s r values varied for the different perfusion metrics from 0.1 to 0.85. The mean slope of increase and cerebral blood volume present the highest r values, remaining consistently above 0.7 for all protocol versions with 2 s sampling interval. Reduction of the sampling rate from 2 s to 1 s had only modest impacts on a TMAX volume of 0.4 mL (IQR −1–3) (p = 0.04) and core volume of −1.1 mL (IQR −4–0) (p < 0.001), indicating dose savings of 50%, with no practical loss of diagnostic accuracy. The lowest possible dose protocol was 2 s temporal sampling and a tube load of 100 mAs. View Full-Text
Keywords: Pearson’s correlation; cerebral CT perfusion; quantitative CT perfusion; lower mAs simulation Pearson’s correlation; cerebral CT perfusion; quantitative CT perfusion; lower mAs simulation
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MDPI and ACS Style

Ioannidis, G.S.; Christensen, S.; Nikiforaki, K.; Trivizakis, E.; Perisinakis, K.; Hatzidakis, A.; Karantanas, A.; Reyes, M.; Lansberg, M.; Marias, K. Cerebral CT Perfusion in Acute Stroke: The Effect of Lowering the Tube Load and Sampling Rate on the Reproducibility of Parametric Maps. Diagnostics 2021, 11, 1121. https://doi.org/10.3390/diagnostics11061121

AMA Style

Ioannidis GS, Christensen S, Nikiforaki K, Trivizakis E, Perisinakis K, Hatzidakis A, Karantanas A, Reyes M, Lansberg M, Marias K. Cerebral CT Perfusion in Acute Stroke: The Effect of Lowering the Tube Load and Sampling Rate on the Reproducibility of Parametric Maps. Diagnostics. 2021; 11(6):1121. https://doi.org/10.3390/diagnostics11061121

Chicago/Turabian Style

Ioannidis, Georgios S., Søren Christensen, Katerina Nikiforaki, Eleftherios Trivizakis, Kostas Perisinakis, Adam Hatzidakis, Apostolos Karantanas, Mauricio Reyes, Maarten Lansberg, and Kostas Marias. 2021. "Cerebral CT Perfusion in Acute Stroke: The Effect of Lowering the Tube Load and Sampling Rate on the Reproducibility of Parametric Maps" Diagnostics 11, no. 6: 1121. https://doi.org/10.3390/diagnostics11061121

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