ArticleInsights into imaging2022
Agreement between estimated computed tomography perfusion ischemic core and follow-up infarct on diffusion-weighted imaging.
Article in Insights into imaging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Estimation of Acute Infarct Core and Hypoperfused Region from Baseline Noncontrast Computed Tomography and Computed Tomography Angiography Scans of Patients with Ischemic Stroke.Stroke (Hoboken, N.J.) · 2025Article
- Accuracy of computed tomography perfusion-defined ischemic core and follow-up infarction after basilar artery thrombectomy.Frontiers in neurology · 2025Article
- Assessment of Perfusion Volumes by a New Automated Software for Computed Tomography Perfusion.Stroke and vascular neurology · 2024Article
- Spectral imaging and analysis of monophasic CT angiography to assess infarct core and penumbra in acute stroke.Scientific reports · 2024Article
- Accuracy of Four Different CT Perfusion Thresholds for Ischemic Core Volume and Location Estimation Using IntelliSpace Portal.Journal of cardiovascular development and disease · 2023Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComputed tomography perfusion (CTP) is frequently performed during the diagnostic workup of acute ischemic stroke patients. Yet, ischemic core estimates vary widely between different commercially available software packages. We assessed the volumetric and spatial agreement of the ischemic core on CTP with the follow-up infarct on diffusion-weighted imaging (DWI) using an automated software.
methodsWe included successfully reperfused patients who underwent endovascular treatment (EVT) with CTP and follow-up DWI between November 2017 and September 2020. CTP data were processed with a fully automated software using relative cerebral blood flow (rCBF) < 30% to estimate the ischemic core. The follow-up infarct was segmented on DWI imaging data, which were acquired at approximately 24 h. Ischemic core on CTP was compared with the follow-up infarct lesion on DWI using intraclass correlation coefficient (ICC) and Dice similarity coefficient (Dice).
resultsIn 59 patients, the median estimated core volume on CTP was 16 (IQR 8-47) mL. The follow-up infarct volume on DWI was 11 (IQR 6-42) mL. ICC was 0.60 (95% CI 0.33-0.76), indicating moderate volumetric agreement. Median Dice was 0.20 (IQR 0.01-0.35). The median positive predictive value was 0.24 (IQR 0.05-0.57), and the median sensitivity was 0.3 (IQR 0.13-0.47). Severe core overestimation on computed tomography perfusion > 50 mL occurred in 4/59 (7%) of the cases.
conclusionsIn patients with successful reperfusion after EVT, CTP-estimated ischemic core showed moderate volumetric and spatial agreement with the follow-up infarct lesion on DWI, similar to the most used commercially available CTP software packages. Severe ischemic core overestimation was relatively uncommon.
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