A scan protocol that combines computed tomography perfusion (CTP) with head-and-neck angiography (CTA) can reduce both acquisition times and radiation doses for acute stroke patients.
And the “one-stop-shop" stroke protocol does not come at the expense of deteriorated image quality, according to work published recently in the European Journal of Radiology. In the paper, experts shared how they were able to combine CTP and CTA protocols on a 256-detector CT system to the benefit of their patients.
Elaborating on the need for more adequate protocols when imaging someone who is suspected of having suffered an acute stroke, Demao Deng, of the Department of Radiology at The People’s Hospital of Guangxi Zhuang Autonomous Region in China, and colleagues explained the shortcomings of current imaging procedures:
“NCCT, brain CTP, and head-and-neck CTA are only performed separately with 2 adequate doses of contrast injection due to the limitation of scanner capability, resulting in increased imaging time and contrast dosage. The longer the imaging time is, the later the diagnosis of stroke is made and the more radiation the patient receives.”
To test the protocol, the experts evenly divided a group of 60 patients with suspected acute stroke into two groups: Group A underwent a traditional scan protocol with a separate brain CTP and head-and-neck CT examination, both with and without contrast; Group B received the “one-stop-shop" protocol with head-and-neck CTA data inserted into brain CTP scans at the peak time (PT) of the arterial phase, which was determined by a test bolus.
Group B received 40% less contrast than group A (60 mL vs 100 mL) and also recorded a 43% reduction in acquisition times. Encouragingly, there were no significant differences in image quality between the two groups.
Though the authors did acknowledge that their protocol is not suitable for all scanners, they determined that there are clear benefits when their method is viable.
“Our “one-stop-shop” scan protocol of incorporating head-and-neck CTA data into brain CTP scans using a 256-detector CT system is feasible and can reduce the examination time and contrast dose without sacrificing image quality or the accuracy of perfusion calculation compared with the traditional approach of 2 separate examinations.”
More on stroke imaging:
New CT protocol uses scout images to expedite stroke patients' path to MRI
Radiologists must change their approach to stroke care in the AI era
VA telestroke program prevents unnecessary hospital transfers and improves rural outcomes
Expansion of open-source neuroimaging dataset aims to boost stroke research
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.