Metabolic brain

perfusion software

Cercare Medical Neurosuite for MRI & CT

Revolutionizing post-processing imaging with cutting-edge technology.

Perfusion Post-Processing Software
All Made Simple

Cercare Medical’s advanced microvascular modeling technology leverages these unique metrics to provide a comprehensive and detailed assessment of brain health. By going beyond traditional perfusion imaging, we empower clinicians with the tools needed to make more informed decisions, improve patient care, and ultimately enhance clinical outcomes.
MTT
CTH
Combining MTT and CTH maps provides a comprehensive view of cerebral perfusion, showing both average transit time and variability for enhanced diagnostic precision.

Advanced Automation

Automate the entire imaging process from detection to reporting for rapid, consistent results and reduced radiologist workload.

Precision
Imaging

Deliver highly accurate biomarkers, including advanced perfusion and microvascular metrics, using cutting-edge technology

Seamless
Integration

Integrate effortlessly with PACS and other systems, ensuring secure and accessible image sharing across departments.

Customizable Workflows

Tailor workflow settings to meet the specific needs of individual clinics, optimizing imaging processes and patient care.

Unveiling 25 Years of Pioneering Research in Perfusion Imaging with Cercare Medical

Cercare Medical stands on more than 25 years of research in perfusion imaging and post-processing. The DSC and CT perfusion analysis module offers standard perfusion markers such as relative blood flow (rCBF). Via proprietary methods encompassing microvascular modeling, Cercare Medical uniquely offers vascular heterogeneity and model-based oxygen extraction and consumption markers from standard DSC MRI or CT perfusion data.

Explanation of Perfusion Imaging and Its Importance 

Perfusion imaging is a crucial technique in medical imaging that measures the flow of blood through the brain’s vascular network. It provides vital information about the delivery of oxygen and nutrients to brain tissue, which is essential for maintaining healthy brain function. By visualizing and quantifying blood flow, perfusion imaging helps in diagnosing and treating various neurological conditions, including stroke, brain tumors, and traumatic brain injuries. 

Perfusion imaging is particularly important in acute settings, such as during a stroke, where timely and accurate information about blood flow can significantly impact treatment decisions and outcomes. It helps clinicians identify areas of the brain that are at risk due to reduced blood flow (ischemia) and differentiate between regions that are permanently damaged and those that can potentially be saved with appropriate intervention.

Relative Cerebral Blood Flow (rCBF) 

  • Explanation: rCBF measures the volume of blood passing through a given amount of brain tissue per unit of time. It is a critical marker for assessing the adequacy of blood supply to different regions of the brain. 
  • Importance: Low rCBF values can indicate areas of ischemia, which is essential for diagnosing conditions like acute ischemic stroke. rCBF is also useful in evaluating brain tumors, as malignant tissues often exhibit abnormal blood flow patterns. 

Relative Cerebral Blood Volume (rCBV) 

  • Explanation: rCBV represents the total volume of blood within a given amount of brain tissue.

  • Importance: rCBV helps in assessing the density of the vascular network within brain tissues. Higher rCBV values are often associated with hypervascular tumors, while lower values can indicate areas of reduced perfusion due to stroke or other pathologies. 

Mean Transit Time (MTT) 

  • Explanation: MTT is the average time it takes for blood to pass through a given region of the brain. 
  • Importance: MTT provides insights into the efficiency of blood flow through the brain's vascular system. Prolonged MTT can indicate impaired perfusion, which is commonly seen in ischemic stroke and other conditions affecting cerebral blood flow. 

Time to Maximum (Tmax) 

  • Explanation: Tmax is a measure of the time difference (delay) between the time a contrast agent enters the brain (measured though the arterial input function) until it reaches the brain tissue in question.  
  • Importance: Tmax is a sensitive indicator of delays in blood flow, which can help in identifying regions of the brain that are experiencing reduced perfusion. It is particularly useful in stroke imaging, where elevated Tmax can highlight areas at risk of infarction. 

Capillary Transit-Time Heterogeneity (CTH) 

  • Explanation: Capillary Transit-Time Heterogeneity (CTH) measures the variability in the time it takes for blood to pass through the capillaries in the brain. It is an indicator of the efficiency and health of the microvascular network. 
  • Importance: CTH provides insights into the distribution of blood flow at the capillary level. A lower CTH value suggests a more uniform and efficient blood flow, which is typical of healthy brain tissue. Conversely, higher CTH values indicate heterogeneity in capillary transit times, which can signal microvascular dysfunction, often seen in conditions like stroke and neurodegenerative diseases. 

Oxygen Extraction Fraction (OEF) 

  • Explanation: Oxygen Extraction Fraction (OEF) quantifies the proportion of oxygen removed from the blood by the brain tissue as it passes through the cerebral microvasculature. It is a critical marker of the brain's metabolic demand and its ability to extract oxygen. Cercare uniquely offers model-based OEF derived from standard DSC or CT perfusion data. 
  • Importance: OEF is vital for understanding the brain’s metabolic state. Elevated OEF values can indicate increased metabolic demand or reduced blood flow, which is often observed in ischemic conditions. By assessing OEF, clinicians can determine areas of the brain that are experiencing hypoxia, aiding in the diagnosis of conditions like stroke and brain tumors. 

Cerebral Metabolic Rate of Oxygen (CMRO2) 

  • Explanation: The Cerebral Metabolic Rate of Oxygen (CMRO2) measures the rate at which oxygen is consumed by the brain tissue. It combines information from CBF and OEF to provide a comprehensive assessment of the brain’s oxygen metabolism. Cercare uniquely offers model-based CMRO2 derived from standard DSC or CT perfusion data. 
  • Importance: CMRO2 is a direct measure of brain metabolism and energy consumption. Abnormal CMRO2 values can indicate metabolic dysfunction, which is crucial for diagnosing and monitoring neurological diseases. For instance, reduced CMRO2 may suggest areas of brain tissue that are at risk due to insufficient oxygen supply, while increased CMRO2 might be seen in regions with high metabolic activity, such as tumors. 

Benefits of Microvascular Modeling in Diagnosis and Treatment Planning 

Microvascular modeling offers significant advantages in the diagnosis and treatment planning of various neurological conditions. Here are some key benefits: 

Enhanced Diagnostic Accuracy 

  • Microvascular modeling provides a detailed picture of the brain’s vascular and metabolic state. By incorporating unique metrics like CTH, OEF, and CMRO2, clinicians might achieve a more accurate diagnosis. This is particularly important in conditions where traditional perfusion markers may not provide enough information, such as in chronic ischemic diseases or subtle microvascular changes in neurodegenerative disorders. 

Early Detection of Disease 

  • Metrics such as CTH and OEF can detect microvascular abnormalities before significant structural damage occurs. This early detection capability allows for timely intervention, which can significantly improve patient outcomes. For example, identifying early microvascular changes in stroke patients can facilitate the rapid initiation of therapies to restore blood flow and prevent further brain damage. 

Personalized Treatment Planning 

  • Microvascular modeling enables personalized treatment plans based on the specific vascular and metabolic characteristics of an individual’s brain. By understanding the precise areas of ischemia or hypermetabolism, clinicians can tailor interventions to target affected regions more effectively. This approach is especially beneficial in managing complex conditions like brain tumors, where the metabolic activity of the tumor can guide surgical planning and radiation therapy. 

Monitoring Treatment Efficacy 

  • The ability to track changes in microvascular and metabolic parameters over time allows for the continuous monitoring of treatment efficacy. For instance, after revascularization procedures in stroke patients, metrics like CTH and CMRO2 can be used to assess the improvement in blood flow and oxygen metabolism, helping to adjust treatments as needed to optimize recovery. 

Improved Prognostication 

  • Microvascular modeling provides prognostic information that can assist in assessing patient outcomes. Through images of the metabolic and vascular health of brain tissue, clinicians can potentially identify patients at higher risk of complications and implement more aggressive monitoring and management strategies. 

Cercare Medical’s advanced microvascular modeling technology leverages these unique metrics to provide a comprehensive and detailed assessment of brain health. By going beyond traditional perfusion imaging, we empower clinicians with the tools needed to make more informed decisions, improve patient care, and ultimately enhance clinical outcomes 

What Our Users Say...

"Using Cercare Medical Neurosuite gives us greater confidence in predicting the infarct core and detecting tumor recurrence earlier than with CBV alone. The key benefits in our clinical routine are increased confidence, superior robustness, and earlier tumor detection—leading to better treatment and outcomes. To get the most out of Cercare’s software for stroke and oncology, go beyond traditional perfusion maps like CBV and CBF—explore the deeper insights provided by its advanced biomarkers and maps."
Assoc. Prof. Dr. Maximilian Thormann, Neuroradiology, University Hospital Magdeburg – Germany
“Cercare Medical Neurosuite enhances our stroke imaging with greater clarity, reliability, and versatility. It provides clearer insights, ensures robust and consistent results, and adapts seamlessly to clinical needs. By moving beyond blood flow measurement to assessing blood oxygenation, its advanced biomarkers and maps offer deeper diagnostic value.”
Dr. Alexandre Bani-Sadr, MD, PhD, Hospices Civils De Lyon – France
“We are impressed with Cercare’s perfusion software, due to its ease of use, reliability and speed, thanks to its fully automated post processing”
Assoc. Prof. Dr. Tobias Granberg, Karolinska Institutet – Sweden

Stroke

KEY CONSIDERATIONS IN STROKE IMAGING
AND DIAGNOSIS
Acute ischemic stroke is a leading cause of morbidity in aging populations worldwide, making timely prevention and treatment critical. Seeking emergency medical care at the first signs of stroke is essential for improving outcomes.

To diagnose stroke, computed tomography (CT) or magnetic resonance imaging (MRI) are typically employed. Ideally, advanced imaging techniques like CT perfusion or MR perfusion and diffusion sequences are included in the diagnostic protocol.

Perfusion maps, such as Tmax, are often used as pseudo-markers of the ischemic ‘penumbra’—the area of potentially salvageable tissue. In contrast, markers such as cerebral blood flow (CBF) and the apparent diffusion coefficient ((ADC) are commonly associated with irreversible tissue damage.
Stroke modules

Cercare CT Stroke

Fully automated computation of CT perfusion maps and automated segmentation of infarct core and hypoperfused volumes for a complete decision support Stroke solution using the thresholds method.

Cercare CT Stroke Advanced

Complete decision support Stroke solution with fully automated computation of CT perfusion maps and automated delineation of infarct core and hypoperfused volumes by using either thresholds method or Cercare Medical’s unique AI algorithm.

Cercare MR Stroke

Fully automated computation of MR perfusion maps and automated segmentation of infarct core and hypoperfused volumes for a complete decision support Stroke solution using the thresholds method.

Cercare MR Stroke Advanced

Complete decision support Stroke solution with fully automated computation of MR perfusion maps and automated delineations of infarct core and hypoperfused
volumes by using either thresholds method or Cercare Medical’s unique AI algorithm.

ONCOLOGY and
Neurodegenerative
Diseases

THE CHALLENGE OF ACCURATE ASSESSMENT
In oncology, accurate tumor characterization and understanding of metabolic activity are essential for guiding treatment decisions, especially in early interventions that can improve survival rates. In neurodegenerative diseases like Alzheimer’s and Parkinson’s, as well as neurovascular conditions such as Moyamoya, timely assessment of perfusion and metabolism is crucial for tracking progression and optimizing treatment.

Oncological and neurovascular conditions pose unique diagnostic challenges, as abnormal vascular structures and disease progression impact blood flow and metabolic function. Early detection and precise characterization of these changes are critical in tailoring treatments, improving prognostic accuracy, and tracking response. Advanced imaging offers vital insights to guide appropriate therapeutic interventions and improve patient outcomes.
ONCOLOGY modules

Cercare MR Neuro Advanced

Fully automated and vendor neutral perfusion processing application calculating high quality perfusion maps based on MR DSC Perfusion including the standard SVD markers (CBV, CBF, MTT, TTP, Tmax) + Vascular Model perfusion markers including advanced markers (Delay, CTH, OEF, CMRO2, COV, Leakage).
The Cercare Medical’s Proprietary
Deliver advanced, detailed maps that provide critical insights into tumor
behavior, brain perfusion characteristics, and the distinction between
true progression and pseudoprogression.

The Disease Wheel

Cercare Medical's Focus Areas

Cercare Medical's proprietary

Biomarkers

Deliver advanced, detailed maps that provide critical insights into tumor behavior, brain perfusion characteristics, and the distinction between true progression and pseudoprogression. *

OEF

Model based Oxygen Extraction Fraction.
Reflects the efficiency of oxygen utilization by the tissue.

CTH

Capillary Transit time Heterogeneity.
Shows microvascular flow heterogeneity.

cov

Coefficient Of Variance (COV = CTH/MTT).
Shows the variability of flow heterogeneity in the brain tissue.

CMRO2

Cerebral Metabolic Rate of Oxygen (CMRO2 = OEF x CBF).
Represents the rate at which oxygen is consumed by the brain tissue.

Leakage

Specific to DSC-Perfusion. Shows the extravasation of contrast
agent in a particular voxel (i.e. in case of disrupted Blood Brain Barrier).

LOI

Lack Of Information. Quality check map. Shows the lack of information for each voxel. Areas with no vascularization are expected to have high LOI, such as CSF and necrotic tissue.

*Park et al., 2023 , ASAN Center, Seoul, South Korea
Prediction of pseudoprogression in post-treatment glioblastoma using dynamic susceptibility
contrast-derived oxygenation and microvascular transit time heterogeneity
measures - doi.org/10.1007/s00330-023-10324-9

CERCARE MEDICAL NEUROSUITE

New Release! Cercare Medical Neurosuite v16
Download: CMN v16 Brochure

STROKE

STROKE

CT

CT

CERCARE CT STROKE

Fully automated computation of CT perfusion maps and automated segmentation of infarct core and hypoperfused volumes for a complete decision support Stroke solutionusing the thresholds method.
CE
FDA
CLEARED
SVD BASED PERFUSION MAPS
CBF, CBV, MTT, Tmax, MaxIP, TTP
THRESHOLD BASED LESION QUANTIFICATION
Tmax and CBF thresholds and mismatch

CERCARE CT STROKE
ADVANCED

Complete decision support Stroke solution
with fully automated computation of CT
perfusion maps and automated delineation
of infarct core and hypoperfused volumes
by using either thresholds method or
Cercare Medical’s unique AI algorithm.
CE
FDA
CLEARED
SVD BASED PERFUSION MAPS
CBF, CBV, MTT, Tmax, MaxIP, TTP
VASCULAR MODEL BASED PERFUSION MAPS
CBF, CBV, MTT, Delay, CTH, COV, OEF, CMRO2, Leakage, LOI
THRESHOLD BASED LESION QUANTIFICATION
Tmax and CBF thresholds and mismatch
AI BASED LESION QUANTIFICATION
Core and Hypoperfusion lesion and mismatch
ADD-ONS:
ASPECTS
NCCT for ASPECTS, ASPECTS Regions
- includes montage and overlay series for ASPECTS
LVO
LVO Detection (coronal and axial), MaxIPs in 3 planes, vertical and horizontal MaxIPs. - Includes montage and overlay series for LVO detection
ICH
AI based hemorrhage detection
- Includes montage and overlay series for ICH lesion
THRESHOLD BASED LESION QUANTIFICATION
Tmax and CBF thresholds and mismatch
RESEARCH - NO CE/FDA Clearance
AI-based LVO detection (CT angiography)

MR

MR

CERCARE MR STROKE

Fully automated computation of MR perfusion
maps and automated segmentation of
infarct core and hypoperfused volumes for
a complete decision support Stroke solution
using the thresholds method.
CE
FDA
CLEARED
DIFFUSION
Mean DWI, B0, ADC
SVD BASED DSC PERFUSION MAPS
CBF, CBV, MTT, Tmax, MinIP, TTP
THRESHOLD BASED LESION QUANTIFICATION
Tmax and CBF thresholds and mismatch

CERCARE MR STROKE
ADVANCED

Complete decision support Stroke solution
with fully automated computation of MR
perfusion maps and automated deline-
ations of infarct core and hypoperfused
volumes by using either thresholds method
or Cercare Medical’s unique AI algorithm.
CE
FDA
CLEARED
DIFFUSION
Mean DWI, B0, ADC
SVD BASED DSC PERFUSION MAPS
CBF, CBV, MTT, Tmax, MinIP, TTP
VASCULAR MODEL BASED PERFUSION MAPS
CBF, CBV, MTT, Delay, CTH, COV, OEF, CMRO2, Leakage, LOI
THRESHOLD BASED LESION QUANTIFICATION
Tmax and CBF thresholds and mismatch
AI BASED LESION QUANTIFICATION
Core and Hypoperfusion lesion and mismatch

NEURO

NEURO

MR

MR

CERCARE MR NEURO
ADVANCED

Fully automated and vendor neutral perfusion processing application calculating high quality perfusion maps based on MR DSC Perfusion including the standard SVD markers (CBV, CBF, MTT, TTP, Tmax) + Vascular Model perfusion markers including advanced markers (Delay, CTH, OEF, CMRO2, COV, Leakage).
CE
FDA
CLEARED
DIFFUSION
Mean DWI, B0, ADC
SVD BASED DSC PERFUSION MAPS
CBF, CBV, MTT, Tmax, MinIP, TTP
VASCULAR MODEL BASED PERFUSION MAPS
CBF, CBV, MTT, Delay, CTH, COV, OEF, CMRO2, Leakage, LOI
DCE PERFUSION MAPS
Ktrans, Ve, Vp, Kep, Delay, CBF, MaxIP, TTP
RESEARCH - NO CE/FDA Clearance.
AI based brain tumor segmentation

Output Series

rCBF

The relative cerebral blood flow. SVD* & PARAMETRIC

MR DSC, MR
DCE*, CTP

rCBV

The relative cerebral blood volume. SVD & PARAMETRIC

MR DSC, CTP

MTT

Mean transit time of the passage
of blood through a voxel. SVD &
Parametric.

MR DSC, CTP

CTH

Capillary Transit-time heterogeneity. A measure of the dispersion in intra-voxel capillary transit times.

MR DSC, CTP

OEF

Model-based oxygen extraction fraction

MR DSC, CTP

CMRO2

The relative model-based
cerebral metabolic rate of oxygen

MR DSC, CTP

Delay

Delay from site of measurement
of the arterial input function
concentration time-curve and site of measurement of the tissue
concentration-time curve.

MR DSC, MR DCE, CTP

Tmax

The timepoint at which the
residue function attains its
maximum value.

MR DSC, CTP

LOI

Measure of the lack of information. I.e. a value larger than 0.05 means that there is very little information in the particular voxel.

MR DSC, CTP

COV

Coefficient of Variance also referred to as relative transit time heterogeneity ‘RTH’ in scientific and clinical literature.

MR DSC, CTP

rLeakage

Extravasation of contrast agent in a particular voxel, i.e. leakage from the vascular compartment to the extravascular compartment.

TTP

Time to peak of the concentration-time curve.
Note that the TTP map is not related to the SVD or parametric deconvolution methods.

MR DSC, MR DCE, CTP

TTD

Time from peak until wash out of contrast agent - MR DSC
.

MR DSC

Request our complete
datasheet

Download
Output Series Brochure

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    Imaging

    MTT

    SVD model

    MTT

    Vascular Model

    T2 FLAIR

    follow-up image
    Perfusion maps of a stroke patient show a large difference in lesion appearance compared to the SVD technique, where the VM appears in better correspondence with the T2 FLAIR follow-up.

    MTT

    SVD model

    MTT

    Vascular Model

    T2 FLAIR

    follow-up image
    The modest degree of tissue involvement is consistent with the
    moderate neurologic deficits, National Institutes of Health Stroke
    Scale (NIHSS) = 4.

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      Seamless Upload & Analysis

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      Discover how Cercare Medical Neurosuite can enhance your perfusion imaging post-processing.




        Stroke Imaging

        MTT

        SVD model

        MTT

        Vascular Model

        T2 FLAIR

        follow-up image
        Perfusion maps of a stroke patient show a large difference in lesion appearance compared to the SVD technique, where the VM appears in better correspondence with the T2 FLAIR follow-up.

        MTT

        SVD model

        MTT

        Vascular Model

        T2 FLAIR

        follow-up image
        The modest degree of tissue involvement is consistent with the
        moderate neurologic deficits, National Institutes of Health Stroke
        Scale (NIHSS) = 4.
        Stroke

        CLINICAL EVIDENCE

        The works2,3 by Pr Mouridsen (CEO of Cercare) and Dr.Hansen (co-founder of Cercare) document a technique for identifying proposed malperfused tissue in acute stroke patients and appears to highlight information not detected by the standard SVD technique.

        The work also suggested that the maps created with the VM model developed by Cercare matched better with the patients’ neurological symptoms compared to the traditional method (SVD).

        Oncology Imaging

        MRI of patient with a GBM detected in 2001. New increased contrast area in 2022

        MRI

        MRI of patient with a GBM detected in 2001. New increased contrast area in 2022

        SVD METHOD

        rCBV vendor standard map based on the single value decomposition model (SVD)

        VASCULAR MODEL

        rCBV Cercare standard map based on the vascular model (VM)
        Oncology

        CLINICAL EVIDENCE

        The works of Cercare Medical founders in 2006, 2014, and 2017 show that the cerebral maps based on the vascular model (Bayesian estimation) developed by Cercare has less bias to estimate the functional maps. It enhances the quality of maps to better understand the cerebral perfusion dynamics, which is crucial for diagnosing and treating various neurological conditions.

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        A Cercare Meical Representative will reach out to you directly to assist with your inquiry.