Extended Multimodal Flat Detector CT Imaging in Acute Ischemic Stroke: A Pilot Study

Hölter P, Lang S, Beuscher V, Kallmünzer B, Manhart M, Schwab S, Dörfler A (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Journal of Digital Imaging Springer Verlag (Germany)

Abstract

By using Flat detector computed tomography (FD-CT), a one-stop-shop approach in the diagnostic workup of acute ischemic stroke (AIS) might be achieved. Although information on upstream vessels is warranted, dedicated FD-CT protocols which include the imaging of the cervical vasculature are still lacking. We aimed to prospectively evaluate the implementation of a new multimodal FD-CT protocol including cervical vessel imaging in AIS patients. In total, 16 patients were included in this study. Eight patients with AIS due to large vessel occlusion (LVO) prospectively received a fully multimodal FD-CT imaging, including non-enhanced flat detector computed tomography (NE-FDCT), dynamic perfusion flat detector computed tomography (FD-CTP) and flat detector computed tomography angiography (FD-CTA) including cervical imaging. For comparison of time metrics and image quality, eight AIS patients, which received multimodal CT imaging, were included retrospectively. Although image quality of NE-FDCT and FD-CTA was rated slightly lower than NE-CT and CTA, all FD-CT datasets were of diagnostic quality. Intracerebral hemorrhage exclusion and LVO detection was reliably possible. Median door-to-image time was comparable for the FD-CT group and the control group (CT:30 min, IQR27-58; FD-CT:44.5 min, IQR31-55, p = 0.491). Door-to-groin-puncture time (CT:79.5 min, IQR65-90; FD-CT:59.5 min, IQR51-67; p = 0.016) and image-to-groin-puncture time (CT:44 min, IQR30-50; FD-CT:14 min, IQR12-18; p < 0.001) were significantly shorter, when patients were directly transferred to the angiosuite, where FD-CT took place. Our study indicates that using a new fully multimodal FD-CT approach including imaging of cervical vessels for first-line imaging in AIS patients is feasible and comparable to multimodal CT imaging with substantial potential to streamline the stroke workflow.

Authors with CRIS profile

Philip Hölter Department of Neuroradiology Stefan Lang Department of Neuroradiology Vanessa Beuscher Department of Psychiatry and Psychotherapy Bernd Kallmünzer Department of Neurology Stefan Schwab Lehrstuhl für Neurologie Arnd Dörfler Department of Neuroradiology

How to cite

APA:

Hölter, P., Lang, S., Beuscher, V., Kallmünzer, B., Manhart, M., Schwab, S., & Dörfler, A. (2023). Extended Multimodal Flat Detector CT Imaging in Acute Ischemic Stroke: A Pilot Study. Journal of Digital Imaging. https://doi.org/10.1007/s10278-022-00699-4

MLA:

Hölter, Philip, et al. "Extended Multimodal Flat Detector CT Imaging in Acute Ischemic Stroke: A Pilot Study." Journal of Digital Imaging (2023).

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