Evidence map›Paper›PMID 40214769›Full record

ArticleNeuroradiology2025

Contrast bolus timing in CT-angiography and CT-perfusion: insights from a large clinical dataset.

Alexander Rau, Samer Elsheikh, Petra Cimflova, Thomas Stein, Christian A Taschner, Jonas A Hosp, Marco Reisert, Horst Urbach, Elias Kellner

Abstract read
In one paragraph

Article in Neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Alexander RauDepartment of Neuroradiology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany. alexander.rau@uniklinik-freiburg.de.ORCID http://orcid.org/0000-0001-5881-6043
Samer ElsheikhDepartment of Neuroradiology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
Petra CimflovaDepartment of Neuroradiology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
Thomas SteinDepartment of Diagnostic and Interventional Radiology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
Christian A TaschnerDepartment of Neuroradiology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
Jonas A HospDepartment of Neurology and Clinical Neuroscience, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
Marco ReisertMedical Physics, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
Horst UrbachDepartment of Neuroradiology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
Elias KellnerMedical Physics, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCT-Perfusion (CTP) is an essential part of stroke imaging. Incomplete coverage of the contrast bolus in CTP can lead to errors in post-processing that might hamper the identification of the infarct core or tissue at risk. However, the arrival of the contrast bolus depends on various technical and patient individual factors. This study investigated whether timing information from CT-angiography (CTA) can be used to optimize bolus coverage in CTP.

methodsWe retrospectively reviewed cases with a multimodal stroke protocol for suspected ischemic stroke. Information on the contrast injection timing of CTA and CTP was extracted from the DICOM headers. Bolus arrival information were obtained from the CTP scan including peak time, height, and width and correlated with patient age and ejection fraction (the latter available in n = 868). The contrast timing information of the CTA was used to simulate optimized CTP timing.

resultsA total of 1,843 cases were included. CTP bolus peak position was associated with peak width (Pearsons's r = 0.89, p < 0.001), age (Pearsons's r = 0.40, p < 0.001), ejection fraction (Pearsons's r=-0.25, p < 0.001), and time to scan initiation based on triggering in CTA (Pearsons's r = 0.83, p < 0.001). Using information of the CTA timing to adjust the CTP timing, the variance of the AIF peak could significantly be reduced (p < 0.001).

conclusionOur data indicate that patient individual characteristics lead to substantial variances in the contrast bolus arrival which could hamper CTP analysis. To ensure optimized coverage of the contrast bolus. CTP timing can significantly and safely be improved using timing information of preceding CTA.

Indexed as

Cerebral AngiographyComputed Tomography AngiographyContrast MediaIschemic StrokeAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesTime FactorsContrast MediaBolus timingCT angiographyCT perfusionStroke imaging

Identifiers

PMID40214769
PMCPMC12125062

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.