Abstract W MP20: PerfAngio: A Software Solution for Quantitative Perfusion Angiography
Background: Visualization and quantification of blood flow are essential for the diagnosis and treatment evaluation of cerebrovascular diseases. For rapid imaging of the cerebrovasculature, digital subtraction angiography (DSA) remains the gold standard as it offers high spatial resolution. The video densitometric theory has established in the early 1980’s the relationship between the intensity of DSA images and blood flow. This theoretical foundation enables the computation of parametric maps summarizing blood volume, flow, and delay by tracking the injected contrast agent across the vasculature. Although perfusion imaging is widely used with MR and CT, it has yet to be translated into accessible software for DSA.
Methods: We introduce Perfusion Angiography (PerfAngio) software to calculate multi-parametric perfusion maps, including: CBV, CBF, MTT, TTP, and Tmax. These are produced by deconvolution of the time-density curve with the arterial input function and displayed as high-definition color-coded images; an innovative way to visualize perfusion. The application, PerfAngio, will be freely available for the iPad tablet. A user-friendly web interface (http://www.perfangio.com) will allow clinicians to upload their own datasets and visualize/download the quantitative results.
Results: In addition to providing visualization of unique features, never seen before on DSA, PerfAngio has been successfully used to retrospectively analyze multi-center datasets. The software demonstrated feasibility and performance to evaluate angiographic outcome in TREVO2. It was also a useful tool to compare the hemodynamic impact of devices during thrombectomy in TREVO2 and stenting in SAMMPRIS. Yet, numerous questions remain to be studied with PerfAngio, including identification of futile recanalizaton, hemorrhagic transformation, correlation with MRI and CT and automatic quantification of collateral flow.
Conclusions: This revolutionary imaging software can provide insights into Stroke from standard DSA. It is particularly promising for retrospective studies and during clot-retrieval interventions as it offers an objective, continuous measure to characterize angiographic observations.
Author Disclosures: F. Scalzo: None. A.S. Ahluwalia: None. Z. Huang: None. G. Ren: None. D.S. Liebeskind: None.
- © 2014 by American Heart Association, Inc.