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CT perfusion

Carolina Rodriguez-Tirado, Takanori Kitamura, Yu Kato, Jeffery W Pollard, John S Condeelis, David Entenberg
Metastasis to secondary sites such as the lung, liver and bone is a traumatic event with a mortality rate of approximately 90% (1). Of these sites, the lung is the most difficult to assess using intravital optical imaging due to its enclosed position within the body, delicate nature and vital role in sustaining proper physiology. While clinical modalities (positron emission tomography (PET), magnetic resonance imaging (MRI) and computed tomography (CT)) are capable of providing noninvasive images of this tissue, they lack the resolution necessary to visualize the earliest seeding events, with a single pixel consisting of nearly a thousand cells...
October 6, 2016: Journal of Visualized Experiments: JoVE
Søren Hess, Evan C Frary, Oke Gerke, Poul Henning Madsen
Pulmonary embolism (PE) is a common, ubiquitous, and potentially lethal disease. As symptoms and clinical findings are notoriously nonspecific, diagnostic imaging is essential to avoid undertreatment as well as overtreatment. Controversies remain regarding first-line imaging in suspected PE. The two main contemporary contenders are ventilation/perfusion scintigraphy with single-photon emission computed tomography (V/Q SPECT) with or without additional low-dose CT (SPECT/CT) and CT angiography (CTA). We present our results from a systematic review and meta-analysis of the diagnostic performances of these modalities: V/Q SPECT, V/Q SPECT/CT, and CTA are all viable options, but we consider V/Q SPECT/CT to be superior in most clinical settings with better overall diagnostic performance, that is, pooled sensitivities (97...
October 20, 2016: Seminars in Thrombosis and Hemostasis
Osman Melih Topcuoğlu, Muşturay Karçaaltıncaba, Deniz Akata, Mustafa Nasuh Özmen
PURPOSE: We aimed to determine the intra- and interobserver agreement on the software analysis of very low dose hepatic perfusion CT (pCT). METHODS: A total of 53 pCT examinations were obtained from 21 patients (16 men, 5 women; mean age, 60.4 years) with proven liver metastasis from various primary cancers. The pCT examinations were analyzed by two readers independently and perfusion parameters were noted for whole liver, whole metastasis, metastasis wall, and normal-looking liver (liver tissue without metastasis) in regions of interest (ROIs)...
October 19, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
S Dehkharghani, M Bowen, D C Haussen, T Gleason, A Prater, Q Cai, J Kang, R G Nogueira
BACKGROUND AND PURPOSE: The neuronal substrate is highly sensitive to temperature elevation; however, its impact on the fate of the ischemic penumbra has not been established. We analyzed interactions between temperature and penumbral expansion among successfully reperfused patients with acute ischemic stroke, hypothesizing infarction growth and worse outcomes among patients with fever who achieve full reperfusion. MATERIALS AND METHODS: Data from 129 successfully reperfused (modified TICI 2b/3) patients (mean age, 65 ± 15 years) presenting within 12 hours of onset were examined from a prospectively collected acute ischemic stroke registry...
October 6, 2016: AJNR. American Journal of Neuroradiology
Kazuyuki Shimada
Stroke is known to frequently recur in patients with a history of cerebrovascular disease, and the control of hypertension is extremely important for the treatment of those patients. The robust relationship between the recurrent cerebrovascular disease and blood pressure control has been demonstrated in large-scale clinical studies. The antihypertensive drug therapy significantly reduces the recurrence rate of all types of cerebrovascular disease, incidences of myocardial infarction and all vascular events...
September 2016: Journal of Hypertension
Kazuhiro Murayama, Kazuhiro Katada, Motoharu Hayakawa, Hiroshi Toyama
OBJECTIVE: We aimed to clarify the cause of shortened mean transit time (MTT) in acute ischemic cerebrovascular disease and examined its relationship with reperfusion. METHODS: Twenty-three patients with acute ischemic cerebrovascular disease underwent whole-brain computed tomography perfusion (CTP). The maximum MTT (MTTmax), minimum MTT (MTTmin), ratio of maximum and minimum MTT (MTTmin/max), and minimum cerebral blood volume (CBV) (CBVmin) were measured by automatic region of interest analysis...
October 7, 2016: Journal of Computer Assisted Tomography
Kerstin Mueller, Rebecca Fahrig, Michael Manhart, Yu Deuerling-Zheng, Jarrett Rosenberg, Teri Moore, Arundhuti Ganguly, Nishita Kothary
RATIONALE AND OBJECTIVES: Intra-procedural measurement of hepatic perfusion following liver embolization continues to be a challenge. Blood volume imaging before and after interventional procedures would allow identifying the treatment end point or even allow predicting treatment outcome. Recent liver oncology studies showed the feasibility of parenchymal blood volume (PBV) imaging using an angiographic C-arm system. This study was done to evaluate the reproducibility of PBV measurements using cone beam computed tomography (CBCT) before and after embolization of the liver in a swine model...
October 10, 2016: Academic Radiology
Brent Griffith, Rajan Jain
Perfusion imaging is a method for assessing the flow of blood occurring at the tissue level and can be accomplished by both CT and MR perfusion techniques. The use of perfusion imaging has increased substantially in the past decade, particularly in neuro-oncologic imaging, where it is has been used for brain tumor grading and directing biopsies or targeted therapy, as well as for the evaluation of treatment response and disease progression. This article discusses the basic principles and techniques of perfusion imaging, as well as its applications in neuro-oncology...
November 2016: Magnetic Resonance Imaging Clinics of North America
Arnav Mehta, Ketan Ghaghada, Srinivasan Mukundan
The first generation of cross-sectional brain imaging using computed tomography (CT), ultrasonography, and eventually MR imaging focused on determining structural or anatomic changes associated with brain disorders. The current state-of-the-art imaging, functional imaging, uses techniques such as CT and MR perfusion that allow determination of physiologic parameters in vivo. In parallel, tissue-based genomic, transcriptomic, and proteomic profiling of brain tumors has created several novel and exciting possibilities for molecular targeting of brain tumors...
November 2016: Magnetic Resonance Imaging Clinics of North America
Alexandra Zvereva, Nina Petoussi-Henss, Wei Bo Li, Helmut Schlattl, Uwe Oeh, Maria Zankl, Frank Philipp Graner, Christoph Hoeschen, Stephan G Nekolla, Katia Parodi, Markus Schwaiger
The objective of this work was to investigate the influence of the definition of blood as a distinct source on organ doses, associated with the administration of a novel radiopharmaceutical for positron emission tomography-computed tomography (PET/CT) imaging-(S)-4-(3-(18)F-fluoropropyl)-L-glutamic acid ((18)F-FSPG). Personalised pharmacokinetic models were constructed based on clinical PET/CT images from five healthy volunteers and blood samples from four of them. Following an identifiability analysis of the developed compartmental models, person-specific model parameters were estimated using the commercial program SAAM II...
October 14, 2016: Physics in Medicine and Biology
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
Firas Yassin, Chris Sawh, Pankaj Garg
There is increasing role of computed tomographic (CT) in the assessment of acute chest pain in the emergency department especially when the diagnosis is not clear. We report a case where non ECG gated contrast enhanced CT in the emergency department for rule-out of pulmonary embolus guided to the actual diagnosis, which was, acute coronary event, as evidenced by the presence of perfusion defect.
2016: Open Cardiovascular Medicine Journal
Lucio Urbani, Riccardo Balestri, Francesco Sidoti, Juri Riccardo Bernardini, Francesco Arces, Gabriella Licitra, Chiara Leoni, Francesco Forfori, Piero Colombatto, Piero Boraschi, Maura Castagna, Piero Buccianti
BACKGROUND: Parenchyma-sparing liver surgery allows resecting hepatic veins (HV) at the hepatocaval confluence with minor (<3 adjacent segments) liver resections. PTFE graft can be used as a bridge to communicating-veins maturation to ensure the correct outflow of the spared liver. We present a video of an intrahepatic cholangiocarcinoma (IC) involving the three HV at the hepatocaval confluence treated with this approach. METHODS: In a 50-year old obese (BMI 44...
October 11, 2016: Annals of Surgical Oncology
Saeed Elojeimy, Irene Cruite, Stephen Bowen, Jing Zeng, Hubert Vesselle
OBJECTIVE: In this article, we describe the concepts of ventilation-perfusion planar, SPECT, and SPECT/CT and outline the advantages of integrated ventilation-perfusion SPECT/CT over planar imaging. We present an overview of the traditional and new applications of ventilation-perfusion scintigraphy. CONCLUSION: SPECT/CT has improved the diagnostic accuracy of ventilation-perfusion imaging and opened the door for a new spectrum of applications.
October 11, 2016: AJR. American Journal of Roentgenology
Atsushi Sasahara, Kazufumi Suzuki, Yuichi Takahashi, Hirokazu Koseki, Kengo Hirota, Hidenori Ohbuchi, Hidetoshi Kasuya
No abstract text is available yet for this article.
October 2016: World Neurosurgery
Wolfgang G Kunz, Wieland H Sommer, Lukas Havla, Franziska Dorn, Felix G Meinel, Olaf Dietrich, Grete Buchholz, Birgit Ertl-Wagner, Kolja M Thierfelder
OBJECTIVES: To determine the detection rate of intracranial vessel occlusions using CT perfusion-based wavelet-transformed angiography (waveletCTA) in acute ischemic stroke patients, in whom single-phase CTA (spCTA) failed to detect an occlusion. METHODS: Subjects were selected from a cohort of 791 consecutive patients who underwent multiparametric CT including whole-brain CT perfusion. Inclusion criteria were (1) significant cerebral blood flow (CBF) deficit, (2) no evidence of vessel occlusion on spCTA and (3) follow-up-confirmed acute ischemic infarction...
October 8, 2016: European Radiology
Christopher J François, Mark L Schiebler
Multimodality, noninvasive imaging is increasingly used in the identification and management of pulmonary hypertension (PH). Chest radiography, ventilation-perfusion scintigraphy, and Doppler echocardiography are frequently the initial studies used to evaluate patients suspected of having PH. However, their ability to evaluate the right ventricle (RV) and pulmonary vasculature is limited. Computed tomography (CT) and magnetic resonance (MR) imaging are increasingly used to identify causes of PH and assess the effect of PH on RV function...
November 2016: Radiologic Clinics of North America
Jesper J Linde, Mathias Sørgaard, Jørgen T Kühl, Jens D Hove, Henning Kelbæk, Walter B Nielsen, Klaus F Kofoed
The prognostic implications of myocardial computed tomography perfusion (CTP) analyses are unknown. In this sub-study to the CATCH-trial we evaluate the ability of adenosine stress CTP findings to predict mid-term major adverse cardiac events (MACE). In 240 patients with acute-onset chest pain, yet normal electrocardiograms and troponins, a clinically blinded adenosine stress CTP scan was performed in addition to conventional diagnostic evaluation. A reversible perfusion defect (PD) was found in 38 patients (16 %) and during a median follow-up of 19 months (range 12-22 months) 25 patients (10 %) suffered a MACE (cardiac death, non-fatal myocardial infarction and revascularizations)...
October 7, 2016: International Journal of Cardiovascular Imaging
Marcel T H Oei, Frederick J A Meijer, Willem-Jan van der Woude, Ewoud J Smit, Bram van Ginneken, Mathias Prokop, Rashindra Manniesing
OBJECTIVES: We present a novel One-Step-Stroke protocol for wide-detector CT scanners that interleaves cerebral CTP with volumetric neck CTA (vCTA). We evaluate whether the resulting time gap in CTP affects the accuracy of CTP values. METHODS: Cerebral CTP maps were retrospectively obtained from 20 patients with suspicion of acute ischemic stroke and served as the reference standard. To simulate a 4 s gap for interleaving CTP with vCTA, we eliminated one acquisition at various time points of CTP starting from the bolus-arrival-time(BAT)...
October 7, 2016: European Radiology
Adriaan Coenen, Marisa M Lubbers, Akira Kurata, Atsushi Kono, Admir Dedic, Raluca G Chelu, Marcel L Dijkshoorn, Alexia Rossi, Robert-Jan M van Geuns, Koen Nieman
OBJECTIVES: To investigate the additional value of transmural perfusion ratio (TPR) in dynamic CT myocardial perfusion imaging for detection of haemodynamically significant coronary artery disease compared with fractional flow reserve (FFR). METHODS: Subjects with suspected or known coronary artery disease were prospectively included and underwent a CT-MPI examination. From the CT-MPI time-point data absolute myocardial blood flow (MBF) values were temporally resolved using a hybrid deconvolution model...
October 4, 2016: European Radiology
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