KEYWORDS: Simulation of CCA and DLA aggregates, Image segmentation, Imaging systems, Arteries, Angiography, Computed tomography, Visualization, Brain, Neuroimaging, Silver
Brain perfusion CT using a C-arm angiography system capable of CT-like imaging could optimize patient treatment
during stroke therapy procedures. For this application, an intra-arterial contrast bolus injection at the
aortic arch could be used provided that the location of the injection catheter enables uniform distribution of the
bolus into the two common carotid arteries (CCA). In this work, we present a novel method to support optimal
injection catheter placement by providing additional quantitative information about the distribution of the contrast
bolus into the CCAs. Our fully automatic method uses 2-D digital subtraction angiography (DSA) images
following a test bolus injection. It segments both CCAs and computes the relative contrast distribution. We
have tested the method in DSA data sets from 5 healthy pigs and our method achieved successful segmentation
of both CCAs in all data sets. The results showed that the contrast is uniformly distributed (mean relative
difference less or equal than 10%) if the injection location is properly chosen.
While perfusion imaging is a well established diagnostic imaging technique, until now, it could not be performed
using angiographic equipment. The ability to assess information about tissue perfusion in the angiographic suite
should help to optimize management of patients with neurovascular diseases. We present a technique to measure
cerebral blood volume (CBV) for the entire brain using an angiographic C-arm system. Combining a rotational
acquisition protocol similar to that used for standard three-dimensional rotational angiography (3D DSA) in
conjunction with a modified injection protocol providing a steady state of tissue contrast during the acquisition
the data necessary to calculate CBV is acquired. The three-dimensional (3D) CBV maps are generated using a
special reconstruction scheme which includes the automated detection of an arterial input function and several
correction steps. For evaluation we compared this technique with standard perfusion CT (PCT) measurements
in five healthy canines. Qualitative comparison of the CBV maps as well as quantitative comparison using 12
ROIs for each map showed a good correlation between the new technique and traditional PCT. In addition we
evaluated the technique in a stroke model in canines. The presented technique provides the first step toward
providing information about tissue perfusion available during the treatment of neurovascular diseases in the
angiographic suite.
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