ArticleAJNR. American journal of neuroradiology2015
Performance and Predictive Value of a User-Independent Platform for CT Perfusion Analysis: Threshold-Derived Automated Systems Outperform Examiner-Driven Approaches in Outcome Prediction of Acute Ischemic Stroke.
Article in AJNR. American journal of neuroradiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Software with artificial intelligence-derived algorithms for analysing CT brain scans in people with a suspected acute stroke: a systematic review and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2024Pooled it
- An experimental system for detection and localization of hemorrhage using ultra-wideband microwaves with deep learning.Communications engineering · 2024Article
- CT perfusion stroke lesion threshold calibration between deconvolution algorithms.Scientific reports · 2023Article
- Automated advanced imaging in acute ischemic stroke. Certainties and uncertainties.European journal of radiology open · 2023Article
- Automated Detection of Ischemic Stroke and Subsequent Patient Triage in Routinely Acquired Head CT.Clinical neuroradiology · 2022Article
- Diagnostic Performance of Computed Tomography Angiography and Computed Tomography Perfusion Tissue Time-to-Maximum in Vasospasm Following Aneurysmal Subarachnoid Hemorrhage.Journal of the American Heart Association · 2022Article
- Do Prior Iodine Contrast Injections Affect Cerebral Blood Flow Measurement on CT Perfusion Studies of Patients with Large-Vessel Occlusions?AJNR. American journal of neuroradiology · 2021Article
- Normative distribution of posterior circulation tissue time-to-maximum: Effects of anatomic variation, tracer kinetics, and implications for patient selection in posterior circulation ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021Article
- Reply.AJNR. American journal of neuroradiology · 2021Article
- Perfusion imaging averting intravenous thrombolysis in stroke mimics.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Article
- Qualitative versus automatic evaluation of CT perfusion parameters in acute posterior circulation ischaemic stroke.Neuroradiology · 2021Article
- Effect of different thresholds for CT perfusion volumetric analysis on estimated ischemic core and penumbral volumes.PloS one · 2021Article
- Assessment of Ischemic Volumes by Using Relative Filling Time Delay on CTP Source Image in Patients with Acute Stroke with Anterior Circulation Large Vessel Occlusions.AJNR. American journal of neuroradiology · 2020Article
- Penumbra volume predicts unfavorable outcome in patients with acute minor stroke or transient ischemic attack.Journal of the Chinese Medical Association : JCMA · 2020Article
- Automated CT Perfusion Imaging to Aid in the Selection of Patients With Acute Ischemic Stroke for Mechanical Thrombectomy: A Health Technology Assessment.Ontario health technology assessment series · 2020Review
- Mild fever as a catalyst for consumption of the ischaemic penumbra despite endovascular reperfusion.Brain communications · 2020Article
- Microstructural Integrity of Salvaged Penumbra after Mechanical Thrombectomy.AJNR. American journal of neuroradiology · 2020Article
- Computer-aided imaging analysis in acute ischemic stroke - background and clinical applications.Neurological research and practice · 2019Review
- Endovascular Therapy and Ethnic Disparities in Stroke Outcomes.Interventional neurology · 2018Article
- Automated CT Perfusion Prediction of Large Vessel Acute Stroke from Intracranial Atherosclerotic Disease.Interventional neurology · 2018Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeTreatment strategies in acute ischemic stroke aim to curtail ischemic progression. Emerging paradigms propose patient subselection using imaging biomarkers derived from CT, CTA, and CT perfusion. We evaluated the performance of a fully-automated computational tool, hypothesizing enhancements compared with qualitative approaches. The correlation between imaging variables and clinical outcomes in a cohort of patients with acute ischemic stroke is reported. MATERIALS AND
methodsSixty-two patients with acute ischemic stroke and MCA or ICA occlusion undergoing multidetector CT, CTA, and CTP were retrospectively evaluated. CTP was processed on a fully operator-independent platform (RApid processing of PerfusIon and Diffusion [RAPID]) computing automated core estimates based on relative cerebral blood flow and relative cerebral blood volume and hypoperfused tissue volumes at varying thresholds of time-to-maximum. Qualitative analysis was assigned by 2 independent reviewers for each variable, including CT-ASPECTS, CBV-ASPECTS, CBF-ASPECTS, CTA collateral score, and CTA clot burden score. Performance as predictors of favorable clinical outcome and final infarct volume was established for each variable.
resultsBoth RAPID core estimates, CT-ASPECTS, CBV-ASPECTS, and clot burden score correlated with favorable clinical outcome (P < .05); CBF-ASPECTS and collateral score were not significantly associated with favorable outcome, while hypoperfusion estimates were variably associated, depending on the selected time-to-maximum thresholds. Receiver operating characteristic analysis demonstrated disparities among tested variables, with RAPID core and hypoperfusion estimates outperforming all qualitative approaches (area under the curve, relative CBV = 0.86, relative CBF = 0.81; P < .001).
conclusionsQualitative approaches to acute ischemic stroke imaging are subject to limitations due to their subjective nature and lack of physiologic information. These findings support the benefits of high-speed automated analysis, outperforming conventional methodologies while limiting delays in clinical management.
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