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Wu H, Wang J, Zhou M, Wang Y, Cui C, Zhou C, Chen X, Wang Z. Application of bolus tracking: The effect of ROI positions on the images quality of cervicocerebral CT angiography. Heliyon 2024; 10:e29260. [PMID: 38617933 PMCID: PMC11015132 DOI: 10.1016/j.heliyon.2024.e29260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024] Open
Abstract
Background Cervicocerebral CT angiography (CTA) using the bolus tracking technique has been widely used for the assessment of cerebrovascular diseases. Regions of interest (ROI) can be placed in the descending aorta, ascending aorta, and the aortic arch. However, no study has compared the arteries and veins display when when the region of interest (ROI) is placed at different sites. In this study, we showed the impact of ROI positions on the image quality of cervicocerebral CTA. Methods Two hundred and seventy patients who underwent cervicocerebral CTA with bolus tracking technique were randomly divided into three groups based on the position of the ROI placement: ascending aorta (Group 1, n = 90), aortic arch (Group 2, n = 90), and descending aorta (Group 3, n = 90). The scanning parameters and contrast agent injection protocols were consistent across all groups. Three observers independently assessed the objective image quality, while two observers jointly assessed the subjective image quality using a grade scale: poor (grade 1), average (grade 2), good (grade 3), and excellent (grade 4). The differences in intravascular CT values, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), AVCR (arterial venous contrast ratio), and subjective image quality scores were compared among the three groups. Results The CT values of the intracranial veins (superior sagittal sinus, ethmoid sinus and great cerebral vein) in group 1 were significantly lower than those in group 3 (p < 0.001). However, no significant differences were observed in CT values, SNR and CNR in the internal carotid artery and middle cerebral artery among the three groups. The proportion of images with grade 4 was significantly higher in group 1 than group 2 and 3 (41.1% vs 15.6% and 13.3%, p < 0.001). The proportion of images with grade 1 was significantly lower in group 1 than group 2 and 3 (1.1% vs 6.6% and 17.8%, p < 0.001). Conclusion The ROI positions for cervicocerebral CTA did not affect the arterial image quality, but venous structures imaging was affected when the ROI was placed in the ascending aorta.
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Affiliation(s)
- Huiming Wu
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Jianhua Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Maodong Zhou
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Yajie Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Can Cui
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Changsheng Zhou
- Department of Radiology, Jinling Hospital Nanjing University, 305 Zhongshan East road, Nanjing, 210029, China
| | - Xiao Chen
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Zhongqiu Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
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Kanaya K, Ichinohe F, Kitamura S, Aonuma T, Kaneko T, Yokota A, Horiuchi T. Contrast-enhanced CT rim sign may predict vestibular schwannoma adhesion and postoperative complications. Clin Radiol 2024; 79:e287-e294. [PMID: 37989668 DOI: 10.1016/j.crad.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 10/02/2023] [Accepted: 10/18/2023] [Indexed: 11/23/2023]
Abstract
AIM To investigate the clinical and radiological features to predict adhesion between vestibular schwannoma (VS) and brain tissue which is a critical risk factor for postoperative infarction and residual tumour. MATERIAL AND METHODS One hundred and seven consecutive VS surgeries were analysed. After excluding cases without contrast-enhanced (CE) computed tomography (CT), Koos grades 1 and 2, and cases with incomplete clinical data, 44 patients were finally included in the study. Enhancement of the tumour capsule on the brainstem side on CE-CT was defined as the CE-CT rim sign, which was analysed along with clinical characteristics, including tumour adhesion and postoperative complications. RESULTS Eight patients exhibited CE-CT rim signs; 17 had tumour adhesions. Four patients had postoperative infarction at the ipsilateral middle cerebellar peduncle; 18 exhibited postoperative infarction and/or residual tumour at the middle cerebellar peduncle. The CE-CT rim sign significantly correlated with tumour adhesion, postoperative infarction, and postoperative infarction and/or residual tumour in the cerebellar peduncle. Univariate regression analysis revealed that the CE-CT rim sign significantly correlated with tumour adhesion (odds ratio [OR] 6.81, 95% confidence interval [CI] 1.18-39.25, p=0.032) and postoperative infarction and/or residual tumour at the cerebellar peduncle (OR 6.00, 95% CI 1.04-34.31, p=0.044). CONCLUSION The CE-CT rim sign was identified in 18.2% of patients with VS and significantly correlated with tumour adhesion and postoperative complications, such as postoperative infarction and residual tumour. This study highlights the importance of the preoperative CE-CT rim sign in VS, which is predictive of tumour adhesion and postoperative complications.
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Affiliation(s)
- K Kanaya
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
| | - F Ichinohe
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - S Kitamura
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - T Aonuma
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - T Kaneko
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - A Yokota
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - T Horiuchi
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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Ito Y, Hosoo H, Sato M, Marushima A, Hayakawa M, Matsumaru Y, Ishikawa E. Evaluation of Venous Structures that Are Involved in Transsylvian Approach Using 3D Rotational Venography. Neurol Med Chir (Tokyo) 2023; 63:555-562. [PMID: 37743508 PMCID: PMC10788483 DOI: 10.2176/jns-nmc.2022-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/24/2023] [Indexed: 09/26/2023] Open
Abstract
In the transsylvian (TS) approach, as characterized by clipping surgery, the presurgical visualization of the superficial middle cerebral vein (SMCV) can help change the surgical approach to ensure safe microsurgery. Nevertheless, identifying preoperatively the venous structures that are involved in this approach is difficult. In this study, we investigated the venous structures that are involved in the TS approach using three-dimensional (3D) rotational venography (3D-RV) and evaluated the effectiveness of this method for presurgical simulation. Patients who underwent 3D-RV between August 2018 and June 2020 were involved in this retrospective study. The 3D-RV and partial maximum intensity projection images with a thickness of 5 mm were computationally reconstructed. The venous structures were subdivided into the following three portions according to the anatomic location: superficial, intermediate, and basal portions. In the superficial portion, predominant frontosylvian veins were observed on 31 (41%) sides, predominant temporosylvian veins on seven (9%) sides, and equivalent fronto- and temporosylvian veins on 28 (37%) sides. The veins in the intermediate (deep middle cerebral and uncal veins) and basal portions (frontobasal bridging veins) emptied into the SMCV on 57 (75%) and 34 (45%) sides, respectively. The 3D-RV images were highly representative of the venous structures observed during microsurgery. In this study, 3D-RV was utilized to capture the details of the venous structures from the superficial to the deep portions. Presurgical simulation of the venous structures that are involved in the TS approach using 3D-RV may increase the safety of microsurgical approaches.
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Affiliation(s)
- Yoshiro Ito
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
| | - Hisayuki Hosoo
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
| | - Masayuki Sato
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
| | - Aiki Marushima
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
| | - Mikito Hayakawa
- Division of Stroke Prevention, Faculty of Medicine, University of Tsukuba
| | - Yuji Matsumaru
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
- Division of Stroke Prevention, Faculty of Medicine, University of Tsukuba
| | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
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Yuan D, Li L, Zhang Y, Qi K, Zhang M, Zhang W, Lyu P, Zhang Y, Gao J, Liu J. Image quality improvement in head and neck CT angiography: Individualized post-trigger delay versus fixed delay. Eur J Radiol 2023; 168:111142. [PMID: 37832195 DOI: 10.1016/j.ejrad.2023.111142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
PURPOSE To compare the contrast media opacification of head and neck CT angiography (CTA) between conventional fixed trigger delay and individualized post-trigger delay (PTD). METHODS In this prospective study (April-October 2022), 196 consecutive participants were randomly divided into two groups to perform head and neck CTA in bolus tracking with either an individualized PTD (Group A) or a fixed 4-second PTD (Group B). All CT and contrast media protocol parameters were consistent between the two groups. One reader evaluated objective image quality, while two readers rated subjective image quality. Objective image quality was compared between groups via two-sample t-test, while the subjective ratings were compared with chi-square analysis. RESULTS Participants' clinical information including sex, age, weight, body weight index (BMI), and heart rate were not statistically different between two groups (all p > 0.05). Individualized PTD ranging from 3.5 to 7.9 s (average 5.6 s), which is shorter than fixed delays (p < 0.05). Both readers rated better subjective image quality for the Group A (p < 0.05). The mean vessel enhancement was significantly higher in Group A in all vessels (all p < 0.05). CONCLUSIONS Compared to the fixed post-trigger delay in bolus tracking technique, individualized post-trigger delay could achieve reliable scan timing, optimize vessel opacification and obtain better image quality for head and neck CT angiography.
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Affiliation(s)
- Dian Yuan
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Linfeng Li
- Siemens Healthineers GmbH, Forchheim, Germany
| | - Yicun Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Ke Qi
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Mengyuan Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Weiting Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Peijie Lyu
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Yonggao Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Jianbo Gao
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Jie Liu
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China.
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Yuan D, Wang Y, Lin S, Gutjahr R, Lyu P, Zhang Y, Gao J, Liu J. Patient-specific post-trigger delay in coronary CT angiography: A prospective study comparing with fixed delay. Eur J Radiol 2023; 163:110813. [PMID: 37043884 DOI: 10.1016/j.ejrad.2023.110813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES To validate the peak enhancement timing of a patient-specific post-trigger delay (PTD) in Coronary CT angiography (CCTA) and compare its image quality against a fixed PTD. METHODS In this prospective study, 204 consecutive participants were randomly divided into two groups to perform CCTA in bolus tracking with either a fixed 5-second PTD (Group A) or a patient-specific PTD (Group B). Test bolus was also performed in Group B to determine the reference peak enhancement timing. One reader evaluated objective image quality, while two readers rated subjective image quality. The predicted PTD was validated through correlation and agreement analysis with the reference measurement. Objective image quality was compared between groups via two-sample t-test and linear regression, while the subjective ratings were compared with chi-square analysis. RESULTS The two groups each had 102 participants with comparable characteristics (52.9 ± 11.3 versus 52.1 ± 11.3 years of age, and 53 versus 52 males). The scan timing from patient-specific PTD demonstrated strong correlation (R = 0.77) and consistency (ICC = 0.618) with the reference peak timing. Both readers rated better subjective image quality for the Group B (p < 0.001). The mean vessel enhancement was significantly higher in Group B in all coronary vessels (all p < 0.05). After adjusting for the participant variation, the patient-specific PTD strategy was associated with an average of 33.5 HU higher enhancement compared to the fixed PTD. CONCLUSIONS Patient-specific delay could achieve reliable scan timing, optimize vessel opacification and obtain better image quality in CCTA.
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Affiliation(s)
- Dian Yuan
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Yiran Wang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Shushen Lin
- Siemens Healthineers GmbH, Forchheim, Germany
| | | | - Peijie Lyu
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Yonggao Zhang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Jianbo Gao
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China
| | - Jie Liu
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China.
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Watanabe R, Zensho A, Ohishi Y, Funama Y. Image-quality characteristics in the longitudinal direction from different image-reconstruction algorithms during single-rotation volume acquisition on head computed tomography: A phantom study. Acta Radiol Open 2023; 12:20584601231168986. [PMID: 37089818 PMCID: PMC10116848 DOI: 10.1177/20584601231168986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/23/2023] [Indexed: 04/08/2023] Open
Abstract
Background A multi detector computed tomography (CT) scanner with wide-area coverage enables whole-brain volumetric scanning in a single rotation. Purpose To investigate variations in image-quality characteristics in the longitudinal direction for different image-reconstruction algorithms and strengths with phantoms. Material and methods Single-rotation volume scans were performed on a 320-row multidetector CT volume scanner using three types of phantoms. Tube current was set to 200 mA (standard dose) and 50 mA (low dose). All images were reconstructed with filtered back projection (FBP), mild and strong levels with hybrid iterative reconstruction (HIR), and model-based IR (MBIR). Computed tomography numbers, image noise, noise power spectrum (NPS), task-based transfer function (TTF), and visual spatial resolution were used to evaluate uniformity of image quality in the longitudinal direction ( Z-axis). Results The MBIR images showed smaller variation in CT numbers in the Z-axis. The difference in the highest and lowest CT numbers was smaller (5.0 Hounsfield units [HU]) for MBIR than for FBP (6.6 HU) and HIR (6.8 HU). The variations in image noise were the smallest for strong MBIR and the largest for FBP. The low-frequency component at NPS0.2 was lower for strong MBIR than for other algorithms. The high-frequency component at NPS0.8 was low in all reconstructions. For MBIR, the image resolution and TTFs were higher in the outer portion than in the center. Conclusion Model-based IR is the optimal image-reconstruction algorithm for single-volume scan of spherical subjects owing to its high in-plane resolution and uniformity of CT numbers, image noise, and NPS in the Z-axis.
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Affiliation(s)
- Ryo Watanabe
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Ayako Zensho
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshitaka Ohishi
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Lu H, Meng T, You Y, Liu Y, He K, Kan Y, Zhang H. PHANTOM EXPERIMENTAL STUDY ON PATIENT DOSES OBTAINED FROM 320-MULTIDETECTOR-ROW COMPUTED TOMOGRAPHY IN WHOLE-BRAIN PERFUSION SCAN. RADIATION PROTECTION DOSIMETRY 2022; 198:1424-1434. [PMID: 36125221 DOI: 10.1093/rpd/ncac178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/28/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to precisely evaluate organ dose and effective dose (E) obtained from a 320-multidetector-row computed tomography (CT) scanner in brain perfusion scans and to estimate the conversion factor (k) between E and dose length product (DLP). A total of 270 thermoluminescent dosemeters were implanted in a male anthropomorphic phantom to measure air kerma. The ratios of mass-energy absorption coefficients were used to convert air kerma into organ doses. The organ doses ranged from 0.01 to 150 mGy. Doses in brain, salivary glands and red bone marrow were relatively high, and dose in eye lens reached about 110 mGy. The resulting effective dose was 5.30 mSv. The resulting conversion factor k = (0.0022 ± 0.0002) mSv·(mGy·cm)-1 was not significantly different from that of 0.0021 mSv·(mGy·cm)-1 reported for head CT scan in ICRP Publication 102.
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Affiliation(s)
- Heqing Lu
- Department of Medical Equipment, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Ting Meng
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Yang You
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Ying Liu
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Kai He
- Department of Logistics Support, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Yandong Kan
- Department of Logistics Support, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Haowei Zhang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
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El Hadji S, Bonilauri A, De Momi E, Castana L, Macera A, Berta L, Cardinale F, Baselli G. Validation of SART 3.5D algorithm for cerebrovascular dynamics and artery versus vein classification in presurgical 3D digital subtraction angiographies. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac8c7f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/24/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Classification of arteries and veins in cerebral angiograms can increase the safety of neurosurgical procedures, such as StereoElectroEncephaloGraphy, and aid the diagnosis of vascular pathologies, as arterovenous malformations. We propose a new method for vessel classification using the contrast medium dynamics in rotational digital subtraction angiography (DSA). After 3D DSA and angiogram segmentation, contrast enhanced projections are processed to suppress soft tissue and bone structures attenuation effect and further enhance the CM flow. For each voxel labelled as vessel, a time intensity curve (TIC) is obtained as a linear combination of temporal basis functions whose weights are addressed by simultaneous algebraic reconstruction technique (SART 3.5D), expanded to include dynamics. Each TIC is classified by comparing the areas under the curve in the arterial and venous phases. Clustering is applied to optimize the classification thresholds. On a dataset of 60 patients, a median value of sensitivity (90%), specificity (91%), and accuracy (92%) were obtained with respect to annotated arterial and venous voxels up to branching order 4–5. Qualitative results are also presented about CM arrival time mapping and its distribution in arteries and veins respectively. In conclusion, this study shows a valuable impact, at no protocol extra-cost or invasiveness, concerning surgical planning related to the enhancement of arteries as major organs at risk. Also, it opens a new scope on the pathophysiology of cerebrovascular dynamics and its anatomical relationships.
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Park S, Jang M, Lee K, Choi H, Lee Y, Park I, Choi S. Optimal placement of the region of interest for bolus tracking on brain computed tomography angiography in Beagle dogs. J Vet Med Sci 2021; 83:1196-1201. [PMID: 34162782 PMCID: PMC8437732 DOI: 10.1292/jvms.20-0724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to determine the optimal placement of the region of interest (ROI) among four anatomical sites-pulmonary artery (PA), pulmonary vein (PV), aortic arch (AA), and carotid artery (CA)-in computed tomography (CT) brain angiography with automatic bolus tracking in healthy beagle dogs. Six beagles were included, and CT brain angiography was performed four times for each dog, to cover each ROI. The scan parameters, amount, and injection rate of the contrast medium were the same. The major intracranial arteries were selected for quantitative and qualitative evaluation: caudal cerebellar artery (CcA), basilar artery (BA), rostral cerebellar artery (RcA), caudal cerebral artery (CCA), middle cerebral artery (MCA), and rostral cerebral artery (RCA). Quantitative evaluation showed significantly higher CT attenuation values for the RcA, CCA, and MCA in the PA group and RcA and MCA in the PV group than in the CA group. Qualitative analysis revealed significantly higher scores for the BA, CCA, and MCA in the PA and PV groups than in the CA group. Venous contamination did not differ significantly among the ROIs, but the mean scores of the AA and CA groups were higher than those of the PA and PV groups. CT brain angiography using bolus tracking in the beagle dogs showed that the ROI should be placed at the PA or PV rather than at the CA for optimal images with strong contrast enhancement of the BA, RcA, CCA, and MCA and minimal venous contamination.
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Affiliation(s)
- Sieun Park
- College of Veterinary Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
| | - Min Jang
- College of Veterinary Medicine, Kyungpook National University, 80 Daehak-ro, Daegu 41566, Republic of Korea
| | - Kija Lee
- College of Veterinary Medicine, Kyungpook National University, 80 Daehak-ro, Daegu 41566, Republic of Korea
| | - Hojung Choi
- College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Daejeon 34134, Republic of Korea
| | - Youngwon Lee
- College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Daejeon 34134, Republic of Korea
| | - Inchul Park
- College of Veterinary Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
| | - Sooyoung Choi
- College of Veterinary Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
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"Trapped labelled spins"-related signal on arterial spin labelling in the assessment of flow-diverted aneurysms: preliminary experience. Neuroradiology 2021; 64:77-93. [PMID: 34128085 DOI: 10.1007/s00234-021-02721-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate ASL-MRI features of flow-diverted aneurysms, review their haemodynamic surrogates, and discuss their pertinent clinical implications. METHODS Retrospective single institutional analysis was performed on the clinical and imaging data of patients who underwent digital subtraction angiography (DSA) and ASL-MRI after endovascular flow diversion for cerebral aneurysms. Pseudo-continuous ASL-MRI was performed with post-label delays of 1525-1800 ms. Intra-aneurysmal "trapped labelled spins" (TLS)-related hypersignal, as seen on cerebral blood flow (CBF)-weighted maps of ASL-MRI, was investigated. Intermodality equivalence with DSA [O'Kelly-Marotta (OKM) grading for occlusion], 3D-TOF-MRA, and 3D spin-echo T1-weighted ("black-blood") images was assessed. RESULTS Ten cases were included. "TLS" signal was demonstrable in 7/8 (87.5%) of the DSA-visible flow-diverted aneurysms (OKM grade B3, n = 6; OKM grade A3, n = 2). No TLS was seen in both OKM-D (excluded) aneurysms. TLS was not visualised in an OKM-B3 aneurysm with < 3 mm opacifying remnant. 3D-TOF-MRA and ASL-MRI were discordant at 5 instances (45.4%; TOF-MRA false negative, n = 4; false positive, n = 1). Loss of flow void on black-blood images corresponded to the absence of TLS and vice versa in all cases but one. CONCLUSION "Trapped labelled spins"-related signal on ASL-MRI occurs in patent large aneurysms that have undergone successful endovascular flow diversion. This phenomenon likely represents an interplay of a multitude of haemodynamic factors including decelerated intra-aneurysmal inflow and outflow restriction. Serial intra-saccular TLS signal changes may hold diagnostic value, including contexts where 3D-TOF-MRA interpretation becomes dubious. "Trapped labelled spins"-related signal as a non-invasive proxy marker of aneurysm patency can possibly obviate unnecessary DSA.
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Kato N, Kan I, Abe Y, Otani K, Narikiyo M, Nagayama G, Nishimura K, Mori R, Kodama T, Ishibashi T, Murayama Y. Visualization of extracranial-intracranial bypass in moyamoya patients using intraoperative three-dimensional digital subtraction angiography with intravenous contrast injection and robotic C-arm: patient series. JOURNAL OF NEUROSURGERY. CASE LESSONS 2021; 1:CASE2057. [PMID: 36131586 PMCID: PMC9628098 DOI: 10.3171/case2057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/19/2020] [Indexed: 06/15/2023]
Abstract
BACKGROUND The authors describe a noninvasive intraoperative imaging strategy of three-dimensional (3D) digital subtraction angiography (DSA) with intravenous (IV) contrast injection, using indocyanine green (ICG) as a test bolus, during extracranial-intracranial (EC-IC) bypass surgery for moyamoya disease. OBSERVATIONS Four patients underwent EC-IC bypass surgery in a hybrid operating room. During the surgery, bypass patency was verified using ICG videoangiography and Doppler ultrasonography. After skin closure, the patients under anesthesia underwent IV 3D-DSA with a robotic C-arm in which the scan delay time for the 3D-DSA scan was estimated from the arrival time of ICG during the ICG videoangiography. One day after the surgery, the patients underwent magnetic resonance angiography (MRA). The IV 3D-DSA images were retrospectively compared with those obtained with other modalities. Good bypass patency was confirmed on IV 3D-DSA, ICG videoangiography, Doppler ultrasonography, and postoperative MRA in all cases. The delay time determined using ICG videoangiography as a test bolus resulted in IV 3D-DSA with adequate image quality, allowing assessment of the spatial relationships between the vessels and anastomoses from all directions. LESSONS To evaluate bypass patency and anatomical relationships immediately after EC-IC bypass surgery, IV 3D-DSA may be a useful modality. ICG videoangiography can be used to determine the scan delay time.
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Affiliation(s)
- Naoki Kato
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Issei Kan
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Yukiko Abe
- Department of Radiology, The Jikei University Hospital, Tokyo, Japan
| | - Katharina Otani
- Siemens Healthcare K.K., Advanced Therapies Innovation Department, Tokyo, Japan; and
| | - Michihisa Narikiyo
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kanagawa, Japan
| | - Gota Nagayama
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Kengo Nishimura
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Ryosuke Mori
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Tomonobu Kodama
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Toshihiro Ishibashi
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Yuichi Murayama
- Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Tokyo, Japan
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Meijs M, Pegge SAH, Vos MHE, Patel A, van de Leemput SC, Koschmieder K, Prokop M, Meijer FJA, Manniesing R. Cerebral Artery and Vein Segmentation in Four-dimensional CT Angiography Using Convolutional Neural Networks. Radiol Artif Intell 2020; 2:e190178. [PMID: 33937832 DOI: 10.1148/ryai.2020190178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 12/15/2022]
Abstract
Purpose To implement and test a deep learning approach for the segmentation of the arterial and venous cerebral vasculature with four-dimensional (4D) CT angiography. Materials and Methods Patients who had undergone 4D CT angiography for the suspicion of acute ischemic stroke were retrospectively identified. A total of 390 patients evaluated in 2014 (n = 113) or 2018 (n = 277) were included in this study, with each patient having undergone one 4D CT angiographic scan. One hundred patients from 2014 were randomly selected, and the arteries and veins on their CT scans were manually annotated by five experienced observers. The weighted temporal average and weighted temporal variance from 4D CT angiography were used as input for a three-dimensional Dense-U-Net. The network was trained with the fully annotated cerebral vessel artery-vein maps from 60 patients. Forty patients were used for quantitative evaluation. The relative absolute volume difference and the Dice similarity coefficient are reported. The neural network segmentations from 277 patients who underwent scanning in 2018 were qualitatively evaluated by an experienced neuroradiologist using a five-point scale. Results The average time for processing arterial and venous cerebral vasculature with the network was less than 90 seconds. The mean Dice similarity coefficient in the test set was 0.80 ± 0.04 (standard deviation) for the arteries and 0.88 ± 0.03 for the veins. The mean relative absolute volume difference was 7.3% ± 5.7 for the arteries and 8.5% ± 4.8 for the veins. Most of the segmentations (n = 273, 99.3%) were rated as very good to perfect. Conclusion The proposed convolutional neural network enables accurate artery and vein segmentation with 4D CT angiography with a processing time of less than 90 seconds.© RSNA, 2020.
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Affiliation(s)
- Midas Meijs
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
| | - Sjoert A H Pegge
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
| | - Maria H E Vos
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
| | - Ajay Patel
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
| | - Sil C van de Leemput
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
| | - Kevin Koschmieder
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
| | - Mathias Prokop
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
| | - Frederick J A Meijer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
| | - Rashindra Manniesing
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Nijmegen 6500 HB, the Netherlands
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Hashimoto Y, Matsushige T, Ogawa T, Sakuragouchi H, Shimonaga K, Takahashi H, Yoshiyama M, Ono C, Sakamoto S. Impact of Cone-Beam Computed Tomography Angiography on Visualization of Sylvian Veins. World Neurosurg 2020; 143:e206-e214. [PMID: 32712404 DOI: 10.1016/j.wneu.2020.07.118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND A detailed understanding of the anatomy of Sylvian veins preoperatively is needed for venous-preserving Sylvian dissection. Better visualization of the venous architecture will facilitate surgical strategies for Sylvian dissection. This study evaluated and compared the image quality of the Sylvian veins and their tributaries using high-resolution cone-beam computed tomography angiography (CBCT-A) and three-dimensional computed tomography angiography (3D-CTA). METHODS Twenty-four patients who underwent 3D-CTA and CBCT-A as a preoperative simulation for clipping of unruptured intracranial aneurysms were retrospectively reviewed. In comparisons with intraoperative inspections, 3 raters evaluated the image quality of the Sylvian veins by 3D-CTA and CBCT-A with a 5-point scale. Visualization of the Sylvian veins and their tributaries by the 2 imaging modalities was compared using Wilcoxon signed rank test. RESULTS CBCT-A showed superior image quality to 3D-CTA in evaluations of the discrimination of adjacent superficial Sylvian veins (2.8 ± 0.80 vs. 4.6 ± 0.37, P < 0.0001), adjacent Sylvian veins at the sphenoid wing (3.1 ± 0.71 vs. 4.1 ± 0.56, P = 0.0001), and visualization of the tributaries of the Sylvian veins (2.5 ± 0.70 vs. 4.4 ± 0.37, P < 0.0001). CONCLUSIONS CBCT-A was superior to 3D-CTA for visualizing the Sylvian veins and their tributaries. CBCT-A will provide important information on the anatomy of the Sylvian veins preoperatively.
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Affiliation(s)
- Yukishige Hashimoto
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
| | - Toshinori Matsushige
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Taichi Ogawa
- Department of Radiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | | | - Koji Shimonaga
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Hiroki Takahashi
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Michitsura Yoshiyama
- Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Chiaki Ono
- Department of Radiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Shigeyuki Sakamoto
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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14
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Fitsiori A, Martin SP, Juillet De Saint Lager A, Gariani J, Lovblad KO, Montet X, Vargas MI. Iterative Algorithms Applied to Treated Intracranial Aneurysms. Clin Neuroradiol 2018; 29:741-749. [DOI: 10.1007/s00062-018-0701-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/31/2018] [Indexed: 12/25/2022]
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