Abstract
Background: X-ray digital subtraction angiography (DSA) is the imaging modality for peri-procedural guidance and treatment evaluation in (neuro-) vascular interventions. Perfusion image construction from DSA, as a means of quantitatively depicting cerebral hemodynamics, has been shown feasible. However, the quantitative property of perfusion DSA has not been well studied. Purpose: To comparatively study the independence of deconvolution-based perfusion DSA with respect to varying injection protocols, as well as its sensitivity to alterations in brain conditions. Methods: We developed a deconvolution-based algorithm to compute perfusion parametric images from DSA, including cerebral blood volume (CBV (Figure presented.)), cerebral blood flow (CBF (Figure presented.)), time to maximum (Tmax), and mean transit time (MTT (Figure presented.)) and applied it to DSA sequences obtained from two swine models. We also extracted the time intensity curve (TIC)-derived parameters, that is, area under the curve (AUC), peak concentration of the curve, and the time to peak (TTP) from these sequences. Deconvolution-based parameters were quantitatively compared to TIC-derived parameters in terms of consistency upon variations in injection profile and time resolution of DSA, as well as sensitivity to alterations of cerebral condition. Results: Comparing to TIC-derived parameters, the standard deviation (SD) of deconvolution-based parameters (normalized with respect to the mean) are two to five times smaller, indicating that they are more consistent across different injection protocols and time resolutions. Upon ischemic stroke induced in a swine model, the sensitivities of deconvolution-based parameters are equal to, if not higher than, those of TIC-derived parameters. Conclusions: In comparison to TIC-derived parameters, deconvolution-based perfusion imaging in DSA shows significantly higher quantitative reliability against variations in injection protocols across different time resolutions, and is sensitive to alterations in cerebral hemodynamics. The quantitative nature of perfusion angiography may allow for objective treatment assessment in neurovascular interventions.
| Original language | English |
|---|---|
| Pages (from-to) | 4055-4066 |
| Number of pages | 12 |
| Journal | Medical Physics |
| Volume | 50 |
| Issue number | 7 |
| Early online date | 24 May 2023 |
| DOIs | |
| Publication status | Published - Jul 2023 |
Bibliographical note
Funding Information:The current work on perforation detection was supported by Health-Holland (TKI Life Sciences and Health) through the Q-Maestro project under Grant EMCLSH19006 and Philips Healthcare (Best, The Netherlands). We also acknowledge the financial support of the Netherlands Cardiovascular Research Initiative which is supported by the Dutch Heart Foundation (CVON2015-01: CONTRAST), the support of the Brain Foundation Netherlands (HA2015.01.06), and the support of Health-Holland, Top Sector Life Sciences & Health (LSHM17016), Medtronic, Cerenovus and Stryker European Operations BV. The collaboration project is additionally financed by the Ministry of Economic Affairs by means of the PPP Allowance made available by the Top Sector Life Sciences & Health to stimulate public-private partnerships. We thank Jadey Raben and Romy van Noort for their assistance with the animal experiments.
Funding Information:
We also acknowledge the financial support of the Netherlands Cardiovascular Research Initiative which is supported by the Dutch Heart Foundation (CVON2015‐01: CONTRAST), the support of the Brain Foundation Netherlands (HA2015.01.06), and the support of Health‐Holland, Top Sector Life Sciences & Health (LSHM17016), Medtronic, Cerenovus and Stryker European Operations BV. The collaboration project is additionally financed by the Ministry of Economic Affairs by means of the PPP Allowance made available by the Top Sector Life Sciences & Health to stimulate public‐private partnerships.
Funding Information:
The current work on perforation detection was supported by Health‐Holland (TKI Life Sciences and Health) through the Q‐Maestro project under Grant EMCLSH19006 and Philips Healthcare (Best, The Netherlands).
Publisher Copyright:
© 2023 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.