Evaluating CT Perfusion and Angiography as Ancillary Tests for Brain Death Diagnosis: Insights from a Multicenter Canadian Study

Highlight

• Qualitative brainstem CT perfusion demonstrated high sensitivity (98.5%) but moderate specificity (74.4%) for diagnosing death by neurologic criteria (DNC).
• Whole-brain CT perfusion showed balanced sensitivity (93.6%) and specificity (92.3%), outperforming CT angiography in specificity.
• CT angiography showed variable sensitivity (75.5%–87.3%) and high specificity (approximately 90%), with excellent interrater reliability across imaging modalities.
• No serious adverse events were reported; minor, transient events occurred in 5% of patients.

Study Background