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Journal of Healthcare Engineering
Volume 5, Issue 1, Pages 67-78
Research Article

Automatic Detection of CT Perfusion Datasets Unsuitable for Analysis due to Head Movement of Acute Ischemic Stroke Patients

Fahmi Fahmi,1,3 Henk Marquering,1,2 Geert Streekstra,1,2 Ludo Beenen,2 Natasja Janssen,1 Charles Majoie,2 and Ed vanBavel1

1Department of Biomedical Engineering and Physics, Academic Medical Centre, Amsterdam, The Netherlands
2Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands
3Department of Electrical Engineering, University of Sumatra Utara, Indonesia

Received 1 June 2013; Accepted 1 October 2013

Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Head movement during brain Computed Tomography Perfusion (CTP) can deteriorate perfusion analysis quality in acute ischemic stroke patients. We developed a method for automatic detection of CTP datasets with excessive head movement, based on 3D image-registration of CTP, with non-contrast CT providing transformation parameters. For parameter values exceeding predefined thresholds, the dataset was classified as ‘severely moved’. Threshold values were determined by digital CTP phantom experiments. The automated selection was compared to manual screening by 2 experienced radiologists for 114 brain CTP datasets. Based on receiver operator characteristics, optimal thresholds were found of respectively 1.0°, 2.8° and 6.9° for pitch, roll and yaw, and 2.8 mm for z-axis translation. The proposed method had a sensitivity of 91.4% and a specificity of 82.3%. This method allows accurate automated detection of brain CTP datasets that are unsuitable for perfusion analysis.