One-stop-shop stroke imaging with functional CT

• Multimodal functional CT comprising of NCCT, PCT and CTA, provides a one-stop-shop for rapid stroke imaging.
• PCT can differentiate infarcted tissue from penumbra. PCT can also assess the collateral circulation and prediction hemorrhagic transformation or malignant edema.
• CTA evaluates the vasculature and can help identify candidates for endovascular treatment.
• Utilization of functional CT for therapy selection or extension of treatment time-window has not yet been confirmed in clinical trials. The EXTEND phase 3 trial is one of the ongoing studies.

Advanced imaging techniques have extended beyond traditional anatomic imaging and progressed to dynamic, physiologic and functional imaging. Neuroimaging is no longer a mere diagnostic tool. Multimodal functional CT, comprising of NCCT, PCT and CTA, provides a one-stop-shop for rapid stroke imaging. Integrating those imaging findings with pertinent clinical information can help guide subsequent treatment decisions, medical management and follow-up imaging selection. This review article will briefly discuss the indication and utility of each modality in acute stroke imaging.