Analysis of Dynamic Computed Tomography Scan Brain Images

Abstract

Dynamic computed tomography (DCT) of the brain can be used to study the transit time of first passage of a bolus injection of intravenous contrast medium. Comparison of cerebral perfusion with corresponding sites in the left and right cerebral hemispheres is of diagnostic interest because a real difference may be indicative of differential damage. A method for estimating the mean transit time and approximating its standard error, by assuming a gamma function for the response curve and an appropriate error structure, is presented. Expressed as log-linear regression, estimation is achieved by maximum likelihood using a statistical package such as GLIM or SPSSX. Statistical comparison of the mean transit time to or between corresponding sites can be made; issues of model fit and biologic interpretation need to be considered as an integral part of statistical inference. These methods enable users of CT equipment (without specific software for estimation of mean transit time) to use any log-linear routine for diagnostic purposes. An example of the fit procedure and interpretation in the light of clinical evidence is given.