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Proceedings Paper

Simulation-based validation and arrival-time correction for Patlak analyses of perfusion-CT scans
Author(s): Jörg Bredno; Jason Hom; Thomas Schneider; Max Wintermark
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Paper Abstract

Blood-brain-barrier (BBB) breakdown is a hypothesized mechanism for hemorrhagic transformation in acute stroke. The Patlak analysis of a Perfusion Computed Tomography (PCT) scan measures the BBB permeability, but the method yields higher estimates when applied to the first pass of the contrast bolus compared to a delayed phase. We present a numerical phantom that simulates vascular and parenchymal time-attenuation curves to determine the validity of permeability measurements obtained with different acquisition protocols. A network of tubes represents the major cerebral arteries ipsi- and contralateral to an ischemic event. These tubes branch off into smaller segments that represent capillary beds. Blood flow in the phantom is freely defined and simulated as non-Newtonian tubular flow. Diffusion of contrast in the vessels and permeation through vessel walls is part of the simulation. The phantom allows us to compare the results of a permeability measurement to the simulated vessel wall status. A Patlak analysis reliably detects areas with BBB breakdown for acquisitions of 240s duration, whereas results obtained from the first pass are biased in areas of reduced blood flow. Compensating for differences in contrast arrival times reduces this bias and gives good estimates of BBB permeability for PCT acquisitions of 90-150s duration.

Paper Details

Date Published: 27 February 2009
PDF: 11 pages
Proc. SPIE 7262, Medical Imaging 2009: Biomedical Applications in Molecular, Structural, and Functional Imaging, 72620G (27 February 2009); doi: 10.1117/12.810959
Show Author Affiliations
Jörg Bredno, Philips Research (United States)
Univ. of California, San Francisco (United States)
Jason Hom, Univ. of California, San Francisco (United States)
Thomas Schneider, Univ. of California, San Francisco (United States)
Philips Healthcare (United States)
Max Wintermark, Univ. of California, San Francisco (United States)


Published in SPIE Proceedings Vol. 7262:
Medical Imaging 2009: Biomedical Applications in Molecular, Structural, and Functional Imaging
Xiaoping P. Hu; Anne V. Clough, Editor(s)

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