Study on a new “One-stop-shop” scan protocol combining brain CT perfusion and head-and-neck CT angiography by using 256-detector CT for stroke patients

Purpose We sought to evaluate the performance of a new “one-stop-shop” scan protocol combining brain computed tomography perfusion (CTP) and head-and-neck CT angiography (CTA) imaging for acute stroke patients using a 256-detector CT scanner. Method From March to August 2020, 60 patients (30 men and 30 women) aged 22–88 years with suspected acute stroke were enrolled and randomly divided into 2 groups to undergo brain CTP and head-and-neck CTA with a 256-detector CT system. Group A used traditional scan protocol with a separate brain CTP and head-and-neck CT examination that included non–contrast-enhanced and contrast-enhanced acquisitions; group B used the new “one-stop-shop” scan protocol with head-and-neck CTA data inserted into brain CTP scans at the peak time (PT) of the arterial phase. The insertion point of the head-and-neck CTA data was determined by a test bolus. The examination time, contrast dose, radiation dose, and image quality were compared between the groups. Results The total contrast dose was reduced by 40% in group B compared to group A (60 mL vs. 100 mL). The imaging time was 52.5 ± 2.6 s in group B and 74.9 ± 3.3 s in group A, showing a reduction of approximately 43% in group B. There was no significant difference in image quality both quantitatively and qualitatively between the groups (all P > 0.05). Group B had a slight reduction in dose length product (1139.0 ± 45.3 vs. 1211.6 ± 31.9 mGy·cm, P < 0.001). Conclusions The proposed “one-stop-shop” scan protocol combining brain CTP and head-and-neck CTA on a 256-detector CT system can reduce imaging time and contrast dose, without affecting image quality or perfusion results, compared to the traditional protocol of separating the examinations.