Abstract
Head movement is common during CT brain perfusion (CTP) acquisition of patients with acute ischemic stroke. The effects of this movement on the accuracy of CTP analysis has not been studied previously. The purpose of this study was to quantify the effects of head movement on CTP analysis summary maps using simulated phantom data. A dynamic digital CTP phantom dataset of 25 time frames with a simulated infarct volume was generated. Head movement was simulated by specific translations and rotations of the phantom data. Summary maps from this transformed phantom data were compared to the original data using the volumetric dice similarity coefficient (DSC). DSC for both penumbra and core strongly decreased for rotation angles larger than approximately 1°, 2°, and 7° for, respectively, pitch, roll, and yaw. The accuracy is also sensitive for small translations in the z-direction only. Sudden movements introduced larger errors than gradual movement. These results indicate that CTP summary maps are sensitive to head movement, even for small rotations and translations. CTP scans with head movement larger than the presented values should be interpreted with extra care.
Similar content being viewed by others
References
Allmendinger AM, Tang ER, Lui YW, Spektor V (2012) Imaging of stroke: part 1, perfusion CT—overview of imaging technique, interpretation pearls, and common pitfalls. AJR Am J Roentgenol 198(1):52–62
Beyer T, Tellmann L, Nickel I, Pietrzyk U (2005) On the use of positioning aids to reduce misregistration in the head and neck in whole-body PET/CT studies. J Nucl Med 46(4):596–602
Bloomfield PM, Spinks TJ, Reed J, Schnorr L, Westrip AM, Livieratos L, Fulton R, Jones T (2003) The design and implementation of a motion correction scheme for neurological PET. Phys Med Biol 48(8):959–978
Fahmi F, Beenen LF, Streekstra GJ, De Jong HW, Riordan AJ, Roos YB, Majoie CB, Vanbavel E, Marquering HA (2013) Head movement during CT brain perfusion acquisition of patients with acute ischemic stroke. Eur J Radiol. doi:10.1016/j.ejrad.2013.08.039
Green MV, Seidel J, Stein SD, Tedder TE, Kempner KM, Kertzman C, Zeffiro TA (1994) Head movement in normal subjects during simulated PET brain imaging with and without head restraint. J Nucl Med 35(9):1538–1546
Janjua N (2012) Use of neuroimaging to guide the treatment of patients beyond the 8-hour time window. Neurology 79(13 Suppl 1):S95–S99
Klein S, Staring M, Murphy K, Viergever MA, Pluim JP (2009) Elastix: a toolbox for intensity-based medical image registration. IEEE Trans Med Imaging 29(1):196–205
Konstas AA, Wintermark M, Lev MH (2011) CT perfusion imaging in acute stroke. Neuroimaging Clin N Am 21(2):215–238
Montgomery AJ, Thielemans K, Mehta MA, Turkheimer F, Mustafovic S, Grasby PM (2006) Correction of head movement on PET studies: comparison of methods. J Nucl Med 47(12):1936–1944
Murphy BD, Fox AJ, Lee DH, Sahlas DJ, Black SE, Hogan MJ, Coutts SB, Demchuk AM, Goyal M, Aviv RI, Symons S, Gulka IB, Beletsky V, Pelz D, Hachinski V, Chan R, Lee TY (2006) Identification of penumbra and infarct in acute ischemic stroke using computed tomography perfusion-derived blood flow and blood volume measurements. Stroke 37(7):1771–1777
Riordan AJ, Prokop M, Viergever MA, Dankbaar JW, Smit EJ, de Jong HW (2011) Validation of CT brain perfusion methods using a realistic dynamic head phantom. Med Phys 38(6):3212–3221
Sandhu GS, Sunshine JL (2012) Advanced neuroimaging to guide acute stroke therapy. Curr Cardiol Rep 14(6):741–753
Schaefer PW, Barak ER, Kamalian S, Gharai LR, Schwamm L, Gonzalez RG, Lev MH (2008) Quantitative assessment of core/penumbra mismatch in acute stroke: CT and MR perfusion imaging are strongly correlated when sufficient brain volume is imaged. Stroke 39(11):2986–2992
Shang T, Yavagal DR (2012) Application of acute stroke imaging: selecting patients for revascularization therapy. Neurology 79(13 Suppl 1):S86–S94
Wagner A, Schicho K, Kainberger F, Birkfellner W, Grampp S, Ewers R (2003) Quantification and clinical relevance of head motion during computed tomography. Invest Radiol 38(11):733–741
Wintermark M, Flanders AE, Velthuis B, Meuli R, van Leeuwen M, Goldsher D, Pineda C, Serena J, van der Schaaf I, Waaijer A, Anderson J, Nesbit G, Gabriely I, Medina V, Quiles A, Pohlman S, Quist M, Schnyder P, Bogousslavsky J, Dillon WP, Pedraza S (2006) Perfusion-CT assessment of infarct core and penumbra: receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke. Stroke 37(4):979–985
Zou KH, Warfield SK, Bharatha A, Tempany CMC, Kaus MR, Haker SJ, Wells WM, Jolesz FA, Kikinis R (2004) Statistical validation of image segmentation quality based on a spatial overlap index1: scientific reports. Acad Radiol 11(2):178–189
Acknowledgments
This work has been supported by LP3M University of Sumatera Utara and RS Pendidikan USU through Directorate General of Higher Education (DIKTI) Scholarship, Ministry of National Education Indonesia.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fahmi, F., Riordan, A., Beenen, L.F.M. et al. The effect of head movement on CT perfusion summary maps: simulations with CT hybrid phantom data. Med Biol Eng Comput 52, 141–147 (2014). https://doi.org/10.1007/s11517-013-1125-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11517-013-1125-7