The Anterior Cerebral Artery (ACA) or middle cerebral artery (MCA

The Anterior Cerebral Artery (ACA) or middle cerebral artery (MCA) was selected as input artery, and a large venous structure, such as the torcular herophili is chosen as the input vein. Particular attention was given to the selection of the arterial and venous input functions and to the choice of the cut-off values for unenhanced and enhanced images. To avoid partial volume effects a reference vessel large enough and sufficiently orthogonal

to the scan section was selected. The elaborated images are represented by 11 parametric maps: a standard set including the Maximum Intensity Projection (MIP), Cerebral Metabolism inhibitor Blood Volume (CBV), Cerebral Blood Flow (CBF) and Time to Peak (Tpeak) maps and an optional set including the Average Perfusion (Pmean), Peak Enhancement

(PeakEnh), Time to Start (Tstart), Permeability (PS = permeability-surface area product), Patlak Rsquare (PatRsq), Patlak Residual Perfusion (PatRes)and Patlak Blood Volume (PBV). The Peak Enhancement, Time to Start and to Peak Perfusion, Average Perfusion are semi-quantitative parameters, readily obtained from the tumor attenuation curve that reflects the tumor vascularity. It is known that the perfusion can be calculated either from the maximal slope of the tissue concentration-time curve or from its peak height, normalized to the arterial input

function [13]. The modelling Inositol monophosphatase 1 used by the commercial software is based on compartmental analysis: a two Fludarabine compartment model (intravascular equivalent to blood and extravascular equivalent to tissue extracellular fluid) is used by assuming the back flux of contrast medium from extravascular to intravascular compartments to be negligible for the first 1 to 2 min (a Everolimus solubility dmso technique known as Patlak analysis [14]). On the basis of this theoretical model, the exchange between the blood and the tissue can be well described by the Patlak plot, representing the ratio of tissue to blood concentration against the ratio of the AUC (area under curve) of the blood curve to the blood concentration for various time values. If the data are consistent with this theoretical model then the plot is linear (PatRsq R2 → 1 e PatRes σ2 → 0), with a slope equal to the blood clearance per unit volume (Permeability) and an intercept equal to the tissue’s relative blood volume (PBV). Both the elaborated and row images were exported by means of the Digital Imaging and Communications in Medicine (DICOM) protocol to a personal computer for a post-processing procedure. This consists of a manual selection of a ROI by an expert radiologist on the unenhanced CT scan, according to the alternative functional imaging exams (MR or PET). In Fig.

Comments are closed.