@article{HU2026, 
author = {Juntao HU and Sui LI and Yun LIU},
title = {Optimizing temporal resolution to reduce radiation dose in cerebral perfusion CT: a feasibility and stability study based on perfusion parameter assessment},
year = {2026},
journal = {Journal of Army Medical University},
volume = {48},
number = {4},
pages = {461-469},
keywords = {stroke, radiation dose, brain perfusion, tomography, X-Ray computed},
url = {https://www.sciopen.com/article/10.16016/j.2097-0927.202511101},
doi = {10.16016/j.2097-0927.202511101},
abstract = {ObjectiveTo investigate the feasibility of reducing radiation dose in cerebral perfusion CT (CTP) while maintaining diagnostic accuracy by optimizing temporal resolution.MethodsThis retrospective cohort study included 117 stroke-suspected patients undergoing CTP at the First Affiliated Hospital of Army Medical University from January to September 2025. Three protocols were designed: Protocol 1 (full temporal resolution, 21-phase acquisition, baseline), Protocol 2 (every-other-phase sampling), Protocol 3 (peak-enhancement+1/-1 phase retention with every-other-phase sampling for remaining phases). Radiation reduction percentages relative to Protocol 1 were calculated. Regions of interest (ROI) were placed in ischemic core/penumbra to measure mean±SD of perfusion parameters: time to maximum of the residue function (Tmax), mean transit time (MTT), cerebral blood volume (CBV) and cerebral blood flow (CBF). Inter-protocol differences were assessed, and ischemic penumbra volume discrepancies were also analyzed.ResultsProtocol 2 and 3 reduced radiation dose by 50.0% and 42.9% versus Protocol 1, respectively. For perfusion parameters: Tmax SD differed significantly across protocols [F(1.92, 222.42)=11.17, P<0.001, partial η2=0.09]; post hoc tests showed significant mean differences between Protocol 1 vs 2 (P<0.016 7) and Protocol 1 vs 3 (P<0.016 7), but not Protocol 2 vs 3. MTT means showed no significant difference [F(1.88, 218.11)=0.47, partial η2=0.004], though SD differed significantly between Protocol 1 vs 2 and 1 vs 3 (P<0.016 7). CBV SD differed significantly [F(1.98, 229.25)=22.97, P<0.001, partial η2=0.17] with no mean difference (Friedman test). CBF means showed no significant difference (Bonferroni-adjusted) but SD differed significantly between Protocol 1 vs 2 and 1 vs 3 (P<0.016 7). Ischemic penumbra volumes differed significantly across all protocols (P<0.016 7).ConclusionTemporal resolution optimization significantly reduces CTP radiation dose while minimally impacting core perfusion parameters (MTT, CBV, CBF means). CBF remained stable across reduced-dose protocols and may serve as a reliable diagnostic criterion for infarct core delineation.}
}