Observational studyLa Radiologia medica2022
Predictive value of Tmax perfusion maps on final core in acute ischemic stroke: an observational single-center study.
Observational study in La Radiologia medica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Quantitative MRI in Neuroimaging: A Review of Techniques, Biomarkers, and Emerging Clinical Applications.Brain sciences · 2025Review
- Predictor value of pCASL maps on final core in acute ischemic stroke: an observational single‑center study.Neuroradiology · 2025Observational
- Association of critical hypoperfusion biomarkers on CT with futile recanalization and poor outcome after mechanical thrombectomy in acute ischemic stroke.BMC neurology · 2024Article
- Effects of intracranial artery stenosis of anterior circulation on cognition-A CT perfusion-based study.Brain and behavior · 2024Article
- Artificial intelligence and radiation effects on brain tissue in glioblastoma patient: preliminary data using a quantitative tool.La Radiologia medica · 2023Article
- Predictors of ghost infarct core on baseline computed tomography perfusion in stroke patients with successful recanalization after mechanical thrombectomy.European radiology · 2023Article
- Comparing the predictive value of quantitative magnetic resonance imaging parametric response mapping and conventional perfusion magnetic resonance imaging for clinical outcomes in patients with chronic ischemic stroke.Frontiers in neuroscience · 2023Article
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19 authors.
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Abstract
purposeTo assess utility of computed tomography perfusion (CTP) protocols for selection of patients with acute ischemic stroke (AIS) for reperfusive treatments and compare the diagnostic accuracy (ACC) in predicting follow-up infarction, using time-to-maximum (Tmax) maps.
methodsWe retrospectively reviewed consecutive AIS patients evaluated for reperfusive treatments at comprehensive stroke center, employing a multimodal computed tomography. To assess prognostic accuracy of CTP summary maps in predicting final infarct area (FIA) in AIS patients, we assumed the best correlation between non-viable tissue (NVT) and FIA in early and fully recanalized patients and/or in patients with favorable clinical response (FCR). On the other hand, the tissue at risk (TAR) should better correlate with FIA in untreated patients and in treatment failure.
resultsWe enrolled 158 patients, for which CTP maps with Tmax thresholds of 9.5 s and 16 s, presented sensitivity of 82.5%, specificity of 74.6%, and ACC of 75.9%. In patients selected for perfusion deficit in anterior circulation territory, CTP-Tmax > 16 s has proven relatively reliable to identify NVT in FCR patients, with a tendency to overestimate NVT. Similarly, CTP-Tmax > 9.5 s was reliable for TAR, but it was overestimated comparing to FIA, in patients with unfavorable outcomes.
conclusionsIn our experience, Tmax thresholds have proven sufficiently reliable to identify global hypoperfusion, with tendency to overestimate both NVT and TAR, not yielding satisfactory differentiation between true penumbra and benign oligoemia. In particular, the overestimation of NVT could have serious consequences in not selecting potential candidates for a reperfusion treatment.
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