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CT perfusion

P Iu Orekhov, A V Troitskiĭ, A V Chupin
Critical lower-limb ischaemia (CLLI) is associated with high risk of limb loss and a lethal outcome, as well as with decreased quality of life. The underlying cause of the disease is imbalance between blood supply of ischaemized tissues and their metabolic demands. Restoration of adequate perfusion with the help of standard medicamentous therapy or operative treatment is often inefficient or impossible. Cell therapy (CT) is a novel strategy making it possible to stimulate the growth of the microvascular bed and the mechanisms of molecular-cellular repair...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Marvin Grossmann, Andreas A Giannopoulos, Fabiola A Bechtiger, Michael Messerli, Moritz Schwyzer, Dominik C Benz, Ken Kudura, Catherine Gebhard, Christoph Gräni, Aju P Pazhenkottil, Philipp A Kaufmann, Ronny R Buechel
BACKGROUND: The applicability of ultra-low-dose computed tomography (CT) for attenuation correction (AC) of single-photon-emission computed tomography myocardial perfusion imaging (SPECT-MPI) remains elusive. METHODS AND RESULTS: One-hundred patients underwent one-day 99m Tc-tetrofosmin stress-rest MPI and non-contrast enhanced cardiac CT with 120, 80, and 70 kilovolt peak (kVp) tube voltage and tube current of 200 milliamperes for creation of AC maps. Normalized percent myocardial uptake from SPECT-MPI using 80 kVp scans for AC showed excellent correlation vs AC from 120 kVp scans for stress [intraclass correlation (ICC) = 0...
June 19, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Katharina Brehmer, Torkel B Brismar, Fabian Morsbach, Anders Svensson, Per Stål, Antonios Tzortzakakis, Nikolaos Voulgarakis, Michael A Fischer
Purpose To develop and evaluate a triple arterial phase CT liver protocol with a similar radiation dose to that of standard single arterial phase CT in study subjects suspected of having hepatocellular carcinoma (HCC). Materials and Methods The study consisted of a retrospective part A for protocol development (n = 15) and a prospective part B to evaluate diagnostic accuracy (n = 38). All 53 participants underwent perfusion CT with 50 mL contrast material between August 2013 and September 2014. Group B underwent an additional standard multiphasic liver CT examination with 120 mL of contrast material (range, 70-143 mL)...
June 19, 2018: Radiology
Veronika Mandlik, Lukas Prantl, Andreas G Schreyer
BACKGROUND:  Contrast extravasation events in daily radiological routine may lead to serious complications, especially during CT examinations. The resulting symptoms may vary from local pain up to skin ulcers, necrosis or even acute compartment syndrome.There are no uniformly accepted radiological guidelines or recommendations regarding detection and treatment of extravasation events and immanent complications in a timely manner. METHOD:  Systematic literature research considering the last 35 years via PubMed using search terms "contrast medium extravasation/paravasation"...
June 18, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Niels Peter Rønnow Sand, Karsten Tange Veien, Søren Steen Nielsen, Bjarne Linde Nørgaard, Pia Larsen, Allan Johansen, Søren Hess, Lone Deibjerg, Majed Husain, Anders Junker, Kristian Korsgaard Thomsen, Allan Rohold, Lisette Okkels Jensen
OBJECTIVES: This study sought to compare the per-patient diagnostic performance of coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT ) with that of single-photon emission computed tomography (SPECT), using a fractional flow reserve (FFR) value of ≤0.80 as the reference for diagnosing at least 1 hemodynamically significant stenosis in a head-to-head comparison of patients with intermediate coronary stenosis as determined by coronary CTA. BACKGROUND: No previous study has prospectively compared the diagnostic performance of FFRCT and myocardial perfusion imaging by SPECT in symptomatic patients with intermediate range coronary artery disease (CAD)...
June 9, 2018: JACC. Cardiovascular Imaging
Felix G Meinel, U Joseph Schoepf, Jacob C Townsend, Brian A Flowers, Lucas L Geyer, Ullrich Ebersberger, Aleksander W Krazinski, Wolfgang G Kunz, Kolja M Thierfelder, Deborah W Baker, Ashan M Khan, Valerian L Fernandes, Terrence X O'Brien
We aimed to determine the diagnostic yield and accuracy of coronary CT angiography (CCTA) in patients referred for invasive coronary angiography (ICA) based on clinical concern for coronary artery disease (CAD) and an abnormal nuclear stress myocardial perfusion imaging (MPI) study. We enrolled 100 patients (84 male, mean age 59.6 ± 8.9 years) with an abnormal MPI study and subsequent referral for ICA. Each patient underwent CCTA prior to ICA. We analyzed the prevalence of potentially obstructive CAD (≥50% stenosis) on CCTA and calculated the diagnostic accuracy of ≥50% stenosis on CCTA for the detection of clinically significant CAD on ICA (defined as any ≥70% stenosis or ≥50% left main stenosis)...
June 15, 2018: Scientific Reports
Anita Gohel, Masafumi Oda, Amol S Katkar, Osamu Sakai
Multidetector row CT (MDCT) offers superior soft tissue characterization and is useful for diagnosis of odontogenic and nonodontogenic cysts and tumors, fibro-osseous lesions, inflammatory, malignancy, metastatic lesions, developmental abnormalities, and maxillofacial trauma. The rapid advances in MDCT technology, including perfusion CT, dual-energy CT, and texture analysis, will be an integrated anatomic and functional high-resolution scan, which will help in diagnosis of maxillofacial lesions and overall patient care...
July 2018: Dental Clinics of North America
Robert Bujila, Love Kull, Mats Danielsson, Jonas Andersson
PURPOSE: The weighted CT dose index (CTDIw ) has been extended for a nominal total collimation width (nT) greater than 40 mm and relies on measurements of CTDIfreeair. The purpose of this work was to compare three methods of measuring CTDIfreeair and subsequent calculations of CTDIw to investigate their clinical appropriateness. METHODS: The CTDIfreeair, for multiple nTs up to 160 mm, was calculated from (1) high-resolution air kerma profiles from a step-and-shoot translation of a liquid ionization chamber (LIC) (considered to be a dosimetric reference), (2) pencil ionization chamber (PIC) measurements at multiple contiguous positions, and (3) air kerma profiles obtained through the continuous translation of a solid-state detector...
June 14, 2018: Journal of Applied Clinical Medical Physics
Tanja Schneider, André Kemmling, Julian Schroeder, Klaus Pantel, Markus Glatzel, Gerhard Schoen, Malte Mohme, Jens Fiehler, Susanne Gellißen
Background and Aims: Vascular border zones and the gray-white matter junction are preferred sites for the development of brain metastases (BM), whereas microvascular lesions are known to be a protective factor. In this proof of concept study, we aim to study the relationship of blood perfusion and the spatial distribution of BM. Materials and Methods: An average CT perfusion atlas of 107 healthy patients was created. Voxel-wise reference perfusion values were extracted from BM-negative and BM-positive regions in a second cohort of 100 untreated patients harboring 809 BM confirmed by MRI...
2018: Frontiers in Neurology
Tianye Niu, Pengfei Yang, Xiaonan Sun, Tingyu Mao, Lei Xu, Ning Jeff Yue, Yu Kuang, Liming Shi, Ke Nie
Tumor angiogenesis is considered as an important prognostic factor. With an increasing emphasis on imaging evaluation of the tumor microenvironment, dynamic contrast enhanced (DCE) CT has evolved as an important functional technique in this setting. Yet many questions remain as how and when these functional measurements should be performed for each agent and tumor type, and what quantitative models should be used in the fitting process. In this study, we evaluated the variations of perfusion measurement on DCE-CT for rectal cancer patients from (1) different tracer kinetic models, (2) different scan acquisition lengths and (3) different scan intervals...
June 11, 2018: Physics in Medicine and Biology
Constantin Roder, Eva Bürkle, Florian Heinrich Ebner, Marcos Tatagiba, Ulrike Ernemann, Alfred Buck, Philipp T Meyer, Nadia Khan
BACKGROUND: and Purpose: Moyamoya disease is a stenoocclusive disease of the circle of Willis with growth of pathological collaterals. We studied the indispensability of functional perfusion imaging (H2 15 O-PET with Acetazolamide (AZA) challenge) compared to conventional MRI and angiography for indication of cerebral revascularization of Moyamoya patients. METHODS: We performed a retrospective blinded analysis of individual imaging modalities (MRI, angiogram, PET) and scored each modality for the severity of disease in 21 untreated Moyamoya patients with 78 affected vascular territories...
June 7, 2018: World Neurosurgery
Lulu Zhang, Stephanie P Yen, Marc A Seltzer, George P Thomas, Kristen Willis, Alan Siegel
Rationale: Cerebral perfusion SPECT and 18 F-FDG PET/CT are commonly performed diagnostic procedures for patients suffering from epilepsy. Individuals receiving these tests are often in-patients undergoing examinations with EEG leads. We have routinely removed these leads before these tests due to concerns that they would lead to imaging artifacts. The leads would then be replaced at the conclusion of the scan. The goal of our study was to determine if the EEG leads actually do cause artifacts that could lead to erroneous scan interpretation or make the scan uninterpretable...
June 8, 2018: Journal of Nuclear Medicine Technology
Wei Chen, Li Li, Hongyuan Zhang, Yan Li, Xu Chen, Yue Zhang
BACKGROUND: High myopia, a cause of serious visual impairment, is a significant global public health concern. We investigate longitudinal changes in macular choroidal thickness (CT) during pregnancy and 6-months postpartum in women with high myopia (HM). METHODS: A prospective longitudinal study was conducted in HM-pregnant women during the course of pregnancy (n = 42 eyes, 42 patients) and 6 months postpartum (n = 40 eyes, 40 patients, two cases lost)...
June 8, 2018: BMC Pregnancy and Childbirth
Marc G Stevenson, Lukas B Been, Harald J Hoekstra, Albert J H Suurmeijer, Ronald Boellaard, Adrienne H Brouwers
BACKGROUND: This study explores various volume of interest (VOI) delineation techniques for fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (18 F-FDG PET-CT) scans during neoadjuvant extremity soft tissue sarcoma (ESTS) treatment. RESULTS: During neoadjuvant treatment, hyperthermic isolated limb perfusion (HILP) and preoperative external beam radiotherapy (EBRT), 11 patients underwent three 18 F-FDG PET-CT scans. The first scan was made prior to the HILP, the second after the HILP but prior to the start of the EBRT, and the third prior to surgical resection...
June 7, 2018: EJNMMI Research
David B Douglas, Jonathan L Muldermans, Max Wintermark
PURPOSE OF REVIEW: The purpose of this review is to provide an update on advanced neuroimaging techniques in traumatic brain injury (TBI). We will focus this review on recent literature published within the last 18 months and the advanced neuroimaging techniques of perfusion imaging and diffusion tensor imaging (DTI). RECENT FINDINGS: In the setting of a moderate or severe acute closed head injury (Glasgow Coma Scale <13), the most appropriate neuroimaging study is a noncontrast computed tomography (CT) scan...
June 6, 2018: Current Opinion in Neurology
Jaspreet Sandhu, Charles La Punzina, Ravi Kothuru
This is a case report describing the delayed presentation of injury to all three lower extremity infrapopliteal arteries after a 34 year old male sustained multiple gunshot wounds, including one to his left lower extremity. As part of his initial assessment, ankle brachial index was performed and was found to be abnormal. Further work up for this was delayed due to need for emergent trauma laparotomy. After this procedure, more detailed evaluation with CT angiography of the extremity injury was performed...
June 2018: Trauma Case Reports
Fan Fu, Binbin Sui, Liping Liu, Yaping Su, Shengjun Sun, Yingying Li
Background Positive "dynamic spot sign" has been proven to be a potential risk factor for acute intracerebral hemorrhage (ICH) expansion, but local perfusion change has not been quantitatively investigated. Purpose To quantitatively evaluate perfusion changes at the ICH area using computed tomography perfusion (CTP) imaging. Material and Methods Fifty-three patients with spontaneous ICH were recruited. Unenhanced computed tomography (NCCT), CTP within 6 h, and follow-up NCCT were performed for 21 patients in the "spot sign"-positive group and 32 patients in the control group...
January 1, 2018: Acta Radiologica
Anja Braune, Martin Scharffenberg, Anne Naumann, Thomas Bluth, Marcelo Gama de Abreu, Jörg Kotzerke
AIM: We compared 68 Gallium (68 Ga)- and fluorescence-labeled microspheres for measurement of pulmonary perfusion distribution in anesthetized pigs without lung injury. METHODS: In two mechanically ventilated pigs, the distribution of pulmonary perfusion was marked in vivo with 68 Ga- and fluorescence-labeled microspheres in supine and prone position. After each injection, the distribution of 68 Ga-labeled microspheres was measured in vivo with positron emission tomography/ computed tomography (PET/CT) in the position in which microspheres were injected and vice versa...
June 2018: Nuklearmedizin. Nuclear Medicine
Carl Schümichen, Matthias Schmidt, Thomas Krause
The S1 guideline for lung scintigraphy has been updated and extended in order to emphasize the advantages oft the method in detecting acute pulmonary embolism (PE) in the periphery oft the lung (subsegmental PE), in underlying subacute and chronic pulmonary disorders, as well as in detecting chronic LE (CTEPH). Method of choice is ventilation / perfusion (V/P) SPECT or V/P SPECT/CT with even higher specificity. Because of its high sensitivity, a threshold (V/P mismatch in at least one segment or two subsegments) is introduced to avoid overtreatment...
June 2018: Nuklearmedizin. Nuclear Medicine
A Y Demchenkova, T N Veselova, T V Martynyuk, N M Danilov, K V Mershin, S K Ternovoy, I E Chazova
AIM: to assess the state of vascular bed, parenchyma, and perfusion of lungs in patients with chronic thromboembolic pulmonary hypertension (CTEPH) using the method of subtraction computed tomography (CT). METHODS: CT pulmonary angiography (CTPA) was performed in 45 patients with verified CTEPH (18 men, 27 women, age 26-79 years) by CT scanner using the "Lung subtraction" standard protocol. Parameters analyzed were characteristics of the state of main pulmonary artery (MPA) and the right ventricle (RV), and calculated CT angiographic (CTA) obstruction and perfusion defect scores...
May 2018: Kardiologiia
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