ArticleNeuroradiology2022
Multiphase CTA-derived tissue maps aid in detection of medium vessel occlusions.
Article in Neuroradiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 14 citations in OpenAlex.
- CT perfusion enhances accuracy of intracranial occlusion detection in acute stroke: effect of specialty and experience level.Neuroradiology · 2025Article
- Back to the Future: How Much or Little Imaging Is Really Necessary After Endovascular Thrombectomy Large-Core Trials.Stroke (Hoboken, N.J.) · 2024Article
- Multiphase CT angiography perfusion maps for predicting target mismatch and ischemic lesion volumes.Scientific reports · 2023Article
- Automated advanced imaging in acute ischemic stroke. Certainties and uncertainties.European journal of radiology open · 2023Article
- Contemporary Methods for Detection and Intervention of Distal Medium and Small Vessel Occlusions.Journal of clinical medicine · 2023Review
- Pivotal role of multiphase computed tomography angiography for collateral assessment in patients with acute ischemic stroke.La Radiologia medica · 2023Review
- Spatial CT perfusion data helpful in automatically locating vessel occlusions for acute ischemic stroke patients.Frontiers in neurology · 2023Article
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6 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMedium vessel occlusions (MeVOs) can be challenging to detect on imaging. Multiphase computed tomography angiography (mCTA) has been shown to improve large vessel occlusion (LVO) detection and endovascular treatment (EVT) selection. The aims of this study were to determine if mCTA-derived tissue maps can (1) accurately detect MeVOs and (2) predict infarction on 24-h follow-up imaging with comparable accuracy to CT perfusion (CTP).
methodsTwo readers assessed mCTA tissue maps of 116 ischemic stroke patients (58 MeVOs, 58 non-MeVOs) and determined by consensus: (1) MeVO (yes/no) and (2) occlusion site, blinded to clinical or imaging data. Sensitivity, specificity, and area under the curve (AUC) for MeVO detection were estimated in comparison to reference standards of (1) expert readings of baseline mCTA and (2) CTP maps. Volumetric and spatial agreement between mCTA- and CTP-predicted infarcts was assessed using concordance/intraclass correlation and Dice coefficients. Interrater agreement for MeVO detection on mCTA tissue maps was estimated with Cohen's kappa.
resultsMeVO detection from mCTA-derived tissue maps had a sensitivity of 91% (95% CI: 80-97), specificity of 82% (95% CI: 70-90), and AUC of 0.87 (95% CI: 0.80-0.93) compared to expert reads of baseline mCTA. Interrater reliability was good (0.72, 95% CI: 0.60-0.85). Compared to CTP maps, sensitivity was 87% (95% CI: 75-95), specificity was 78% (95%CI: 65-88), and AUC was 0.83 (95% CI: 0.76-0.90). The mean difference between mCTA- and CTP-predicted final infarct volume was 4.8 mL (limits of agreement: - 58.5 to 68.1) with a Dice coefficient of 33.5%.
conclusionmCTA tissue maps can be used to reliably detect MeVO stroke and predict tissue fate.
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