ArticlePloS one2015
Characteristics of Misclassified CT Perfusion Ischemic Core in Patients with Acute Ischemic Stroke.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Neurological Functional Independence After Endovascular Thrombectomy and Different Imaging Modalities for Large Infarct Core Assessment : A Systematic Review and Meta-analysis.Clinical neuroradiology · 2023Pooled it
- High relative cerebral blood volume is associated with good long term clinical outcomes in acute ischemic stroke: a retrospective cohort study.BMC neurology · 2024Article
- Current and Emerging Endovascular and Neurocritical Care Management Strategies in Large-Core Ischemic Stroke.Journal of clinical medicine · 2023Review
- Detecting CTP truncation artifacts in acute stroke imaging from the arterial input and the vascular output functions.PloS one · 2023Article
- Review of Current Large Core Volume Stroke Thrombectomy Clinical Trials: Controversies and Progress.Stroke (Hoboken, N.J.) · 2022Review
- Diagnosis of Ischemic Stroke: As Simple as Possible.Diagnostics (Basel, Switzerland) · 2022Review
- Artificial Intelligence in "Code Stroke"-A Paradigm Shift: Do Radiologists Need to Change Their Practice?Radiology. Artificial intelligence · 2022Article
- The Society of Vascular and Interventional Neurology (SVIN) Mechanical Thrombectomy Registry: Methods and Primary Results.Stroke (Hoboken, N.J.) · 2022Article
- Preprocedural Imaging : A Review of Different Radiological Factors Affecting the Outcome of Thrombectomy.Clinical neuroradiology · 2022Review
- Selection criteria for large core trials: rationale for the ANGEL-ASPECT study design.Journal of neurointerventional surgery · 2022Article
- Article
- Outcomes of Mechanical Thrombectomy for Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score in the Early and Extended Window.JAMA network open · 2021Article
- Accuracy and reliability of PBV ASPECTS, CBV ASPECTS and NCCT ASPECTS in acute ischaemic stroke: a matched-pair analysis.The neuroradiology journal · 2021Article
- Automated prediction of final infarct volume in patients with large-vessel occlusion acute ischemic stroke.Neurosurgical focus · 2021Article
- Recanalization Therapy for Acute Ischemic Stroke with Large Vessel Occlusion: Where We Are and What Comes Next?Translational stroke research · 2021Review
- Is limited-coverage CT perfusion helpful in treatment decision-making in patients with acute ischemic stroke?Quantitative imaging in medicine and surgery · 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
- Defining Ischemic Core in Acute Ischemic Stroke Using CT Perfusion: A Multiparametric Bayesian-Based Model.AJNR. American journal of neuroradiology · 2019Article
- A Simple Imaging Guide for Endovascular Thrombectomy in Acute Ischemic Stroke: From Time Window to Perfusion Mismatch and Beyond.Frontiers in neurology · 2019Article
- Neuroimaging Paradigms to Identify Patients for Reperfusion Therapy in Stroke of Unknown Onset.Frontiers in neurology · 2018Review
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCT perfusion (CTP) is used to estimate the extent of ischemic core and penumbra in patients with acute ischemic stroke. CTP reliability, however, is limited. This study aims to identify regions misclassified as ischemic core on CTP, using infarct on follow-up noncontrast CT. We aim to assess differences in volumetric and perfusion characteristics in these regions compared to areas that ended up as infarct on follow-up. MATERIALS AND
methodsThis study included 35 patients with >100 mm brain coverage CTP. CTP processing was performed using Philips software (IntelliSpace 7.0). Final infarct was automatically segmented on follow-up noncontrast CT and used as reference. CTP and follow-up noncontrast CT image data were registered. This allowed classification of ischemic lesion agreement (core on CTP: rMTT≥145%, aCBV<2.0 ml/100g and infarct on follow-up noncontrast CT) and misclassified ischemic core (core on CTP, not identified on follow-up noncontrast CT) regions. False discovery ratio (FDR), defined as misclassified ischemic core volume divided by total CTP ischemic core volume, was calculated. Absolute and relative CTP parameters (CBV, CBF, and MTT) were calculated for both misclassified CTP ischemic core and ischemic lesion agreement regions and compared using paired rank-sum tests.
resultsMedian total CTP ischemic core volume was 49.7ml (IQR:29.9ml-132ml); median misclassified ischemic core volume was 30.4ml (IQR:20.9ml-77.0ml). Median FDR between patients was 62% (IQR:49%-80%). Median relative mean transit time was 243% (IQR:198%-289%) and 342% (IQR:249%-432%) for misclassified and ischemic lesion agreement regions, respectively. Median absolute cerebral blood volume was 1.59 (IQR:1.43-1.79) ml/100g (P<0.01) and 1.38 (IQR:1.15-1.49) ml/100g (P<0.01) for misclassified ischemic core and ischemic lesion agreement, respectively. All CTP parameter values differed significantly.
conclusionFor all patients a considerable region of the CTP ischemic core is misclassified. CTP parameters significantly differed between ischemic lesion agreement and misclassified CTP ischemic core, suggesting that CTP analysis may benefit from revisions.
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