scholarly journals Flat Panel Computed Tomography Pooled Blood Volume and Infarct Prediction in Endovascular Stroke Treatment

Stroke ◽  
2019 ◽  
Vol 50 (11) ◽  
pp. 3274-3276 ◽  
Author(s):  
Aneka Mueller ◽  
Marlies Wagner ◽  
Elke Hattingen ◽  
Alexander Seiler ◽  
Se-Jong You ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endovascular Treatment ◽  
Blood Volume ◽  
Cerebral Artery ◽  
Clinical Decision Making ◽  
Infarct Volume ◽  
Multislice Ct ◽  
Flat Panel ◽  
Flat Panel Detector ◽  
Angiography Suite

Background and Purpose— Patients with large-vessel stroke frequently need to be transferred to comprehensive stroke centers for endovascular treatment. An update of physiological perfusion parameters and stroke progression on arrival is desirable. We examined the reliability of preinterventional pooled blood volume (PBV)-maps acquired by flat-panel detector computed tomography (CT) in the interventional angiography suite. Methods— The volumes of preinterventional perfusion deficit in flat-panel detector CT-PBV source images were compared with final infarct volume on follow-up multislice-CT after endovascular treatment of 29 consecutive patients with occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA). Results— Endovascular treatment was successful in 26 patients (Thrombolysis in Cerebral Infarction, 2b-3). Overall, the median preinterventional PBV-deficit was 9×larger than median final infarct volume on multislice-CT (86.4 mL [10.3; 111.6] versus 9.6 mL [3.6; 36.8]). This was especially evident in the subgroup of successful recanalization (PBV-deficit: 87.5 mL [10.6; 115.1], final infarct: 8.7 mL [3.6; 29]). In futile recanalization, the final infarct tended to be underestimated (PBV-deficit: 86.4 mL [5.9; –] and final infarct: 116.4 mL [3.5; –]). Conclusions— Flat panel detector CT-PBV is not reliable in predicting the final infarct volume and should not be used in clinical decision making for endovascular treatment of acute cerebral artery occlusions.

Feasibility and potential value of flat-panel detector–based computed tomography in myelography after spinal surgery

2009 ◽  
Vol 10 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Thomas Kau ◽  
Egon Rabitsch ◽  
Stefan Celedin ◽  
Barbara Jeschofnig ◽  
Herbert Illiasch ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mr Imaging ◽  
Spinal Surgery ◽  
Multislice Ct ◽  
Flat Panel ◽  
Metal Artifacts ◽  
Disc Space ◽  
Flat Panel Detector ◽  
Imaging Results ◽  
History Of

Object The purpose of this study was to assess the value of myelography using flat-panel detector–based computed tomography (fpCT) in 5 patients in whom the image quality of multislice CT (MSCT) or MR imaging was limited by metal artifacts. Methods The application of fpCT to myelographic imaging of the lumbar spine and cervicothoracic junction after surgery was feasible. Multiplanar, preferably sagittal, and 3D reconstructions adequately depicted disc space implants and provided high resolution images of osseous structures. Results The images obtained with fpCT allowed evaluation of anatomical details such as single nerve roots and proved especially valuable in a patient with impaired MR imaging results caused by metal artifacts from an intraoperative abrasion. In a case of recurrent disc herniation, imaging results of myelographic fpCT and MSCT scanning were in good agreement. Conclusions The novel imaging technique the authors describe yielded adequate results in patients with a history of spinal surgery, may be superior to MSCT scanning in depicting osseous structures and metallic implants, and has the potential to provide multilevel spinal images. Myelographic fpCT scanning may be the preferred modality in patients with expected or known metal artifacts on myelographic MSCT scans and/or MR images.

Flat-panel detector CT assessment in stroke to reduce times to intra-arterial treatment: A study of multiphase computed tomography angiography in the angiography suite to bypass conventional imaging

2020 ◽  
pp. 174749301989565 ◽  
Author(s):  
Mehdi Bouslama ◽  
Diogo C Haussen ◽  
Jonathan A Grossberg ◽  
Clara M Barreira ◽  
Imramsjah Martijn J van der Bom ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Treatment Group ◽  
Endovascular Therapy ◽  
Computed Tomography Angiography ◽  
Flat Panel ◽  
Imaging Protocol ◽  
Flat Panel Detector ◽  
Angiography Suite ◽  
Baseline Characteristics

Background Bypassing the emergency department and the computed tomography suite by directly transporting to the neuroangiography suite for imaging assessment and treatment may shorten reperfusion times while maintaining proper patient selection. Objective To determine whether flat-panel detector multiphase computed tomography angiography protocol is associated with reduced treatment times and a similar safety profile as the standard imaging protocol. Methods Single-center prospective study of consecutive patients with anterior circulation large vessel occlusion strokes transferred to our facility for consideration of endovascular therapy from May 2016 to December 2017. Those with basilar strokes and/or presenting to the emergency department were excluded. Patients were categorized into two groups: (1) flat-panel detector CT assessment in stroke to reduce times to intra-arterial treatment group, with patients transferred directly to the suite for multiphase computed tomography angiography; and (2) patients undergoing standard protocol including computed tomography ± computed tomography angiography/CT perfusion. The groups were matched for age, baseline National Institute of Health Stroke Scale, and pretreatment glucose. Baseline characteristics, time metrics, and outcomes were compared. Results Out of 419 patients who underwent endovascular therapy over the study period, 210 patients fit inclusion criteria, with 54 (25.7%) in the flat-panel detector CT assessment in stroke to reduce times to intra-arterial treatment group. After matching, 49 flat-panel detector CT assessment in stroke to reduce times to intra-arterial treatment/control pairs were generated and analyzed. Baseline characteristics were well balanced. Flat-panel detector CT assessment in stroke to reduce times to intra-arterial treatment patients had significantly shorter median door-to-puncture (33 [26.5-47] vs. 55 [44.5–66] min, p < 0.001), door-to-reperfusion (85 [57.5–115.5] vs. 110 [80–153], p = 0.005) and picture-to-puncture (18 [13.5–22.5] vs. 42 [32–47.5] min, p < 0.001) times. There were no differences in rates of successful reperfusion (modified thrombolysis in cerebral infarction 2b-3, 95.9% vs. 100%, p = 0.5), parenchymal hematomas type-2 (4.1% vs. 2%, p = 1.00), good outcome (90-day modified Rankin Scale 0–2, 44.9% vs. 40.8%, p = 0.68), and 90-day mortality (14.3% vs. 22.4%, p = 0.30). Conclusion Directly transferring patients to angiography and using multiphase computed tomography angiography to determine the eligibility for endovascular therapy is safe and may result in a significant reduction in treatment times. Future larger studies are warranted.

Planar cone-beam computed tomography with a flat-panel detector

2015 ◽  
Vol 10 (12) ◽  
pp. T12004-T12004 ◽  
Author(s):  
S.H. Kim ◽  
D.W. Kim ◽  
H. Youn ◽  
D. Kim ◽  
S. Kam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Flat Panel ◽  
Flat Panel Detector

scholarly journals Diagnostic accuracy of flat-panel computed tomography in assessing cerebral perfusion in comparison with perfusion computed tomography and perfusion magnetic resonance: a systematic review

2019 ◽  
Vol 61 (12) ◽  
pp. 1457-1468 ◽  
Author(s):  
Ernst L. Stille ◽  
Ilaria Viozzi ◽  
Mark ter Laan ◽  
Frederick J.A. Meijer ◽  
Jurgen J. Futterer ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Cerebrovascular Disease ◽  
Blood Volume ◽  
Perfusion Imaging ◽  
Cerebral Perfusion ◽  
Flat Panel ◽  
Perfusion Computed Tomography

Abstract Purpose Flat-panel computed tomography (FP-CT) is increasingly available in angiographic rooms and hybrid OR’s. Considering its easy access, cerebral imaging using FP-CT is an appealing modality for intra-procedural applications. The purpose of this systematic review is to assess the diagnostic accuracy of FP-CT compared with perfusion computed tomography (CTP) and perfusion magnetic resonance (MRP) in cerebral perfusion imaging. Methods We performed a systematic literature search in the Cochrane Library, MEDLINE, Embase, and Web of Science up to June 2019 for studies directly comparing FP-CT with either CTP or MRP in vivo. Methodological quality was assessed using the QUADAS-2 tool. Data on diagnostic accuracy was extracted and pooled if possible. Results We found 11 studies comparing FP-CT with CTP and 5 studies comparing FP-CT with MRP. Most articles were pilot or feasibility studies, focusing on scanning and contrast protocols. All patients studied showed signs of cerebrovascular disease. Half of the studies were animal trials. Quality assessment showed unclear to high risks of bias and low concerns regarding applicability. Five studies reported on diagnostic accuracy; FP-CT shows good sensitivity (range 0.84–1.00) and moderate specificity (range 0.63–0.88) in detecting cerebral blood volume (CBV) lesions. Conclusions Even though FP-CT provides similar CBV values and reconstructed blood volume maps as CTP in cerebrovascular disease, additional studies are required in order to reliably compare its diagnostic accuracy with cerebral perfusion imaging.

TH-D-L100J-04: Dose and Image Quality of Flat-Panel Detector Volume Computed Tomography for Sinus Imaging

2007 ◽  
Vol 34 (6Part23) ◽  
pp. 2634-2634 ◽  
Author(s):  
J Alspaugh ◽  
E Christodoulou ◽  
M Goodsitt ◽  
J Stayman
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Flat Panel ◽  
Flat Panel Detector ◽  
Volume Computed Tomography ◽  
Detector Volume
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