Evidence map›Paper›PMID 38225983›Full record

ArticleFrontiers in neurology2023

Computed tomography hypoperfusion-hypodensity mismatch vs. automated perfusion mismatch to identify stroke patients eligible for thrombolysis.

Peter B Sporns, André Kemmling, Lennart Meyer, Christos Krogias, Volker Puetz, Kolja M Thierfelder, Marco Duering, Carsten Lukas, Daniel Kaiser, Sönke Langner and 11 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04277728 (Mismatch Between Hypoperfusion and Hypodensity on CT for the Identification of Patients With Stroke Onset Within 4.5 Hours), which is not on this map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

NCT04277728 completednot on this map

Mismatch Between Hypoperfusion and Hypodensity on CT for the Identification of Patients With Stroke Onset Within 4.5 Hours

TypeobservationalSponsorUniversity Hospital MuensterRan2018 to 2019Enrolled689ConditionsAcute Ischemic StrokeArmshypoperfusion-hypodensity mismatch
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Peter B Sporns *Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
André Kemmling *Department of Radiology, Westfaelische Wilhelms-University of Münster and University Hospital of Münster, Münster, Germany.
Lennart Meyer *Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Christos KrogiasDepartment of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
Volker PuetzDepartment of Neurology, University Hospital Carl Gustav Carus, Dresden, Germany.
Kolja M ThierfelderDepartment of Radiology and Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany.
Marco DueringMedical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
Carsten LukasDepartment of Neuroradiology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
Daniel KaiserDepartment of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany.
Sönke LangnerDepartment of Radiology and Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany.
Alex BrehmDepartment of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Lukas T RotkopfDepartment of Radiology, German Cancer Research Center, Heidelberg, Germany.
Wolfgang G KunzDepartment of Radiology, University Hospital, LMU Munich, Germany.
Carolin BeukerDepartment of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Walter HeindelDepartment of Radiology, Westfaelische Wilhelms-University of Münster and University Hospital of Münster, Münster, Germany.
Jens FiehlerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Peter SchrammDepartment of Neuroradiology, University Medical Center Schleswig-Holstein, Lübeck, Germany.
Heinz WiendlDepartment of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Heike MinnerupInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Marios Nikos Psychogios *Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Jens Minnerup *Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and purpose: Automated perfusion imaging can detect stroke patients with unknown time of symptom onset who are eligible for thrombolysis. However, the availability of this technique is limited. We, therefore, established the novel concept of computed tomography (CT) hypoperfusion-hypodensity mismatch, i.e., an ischemic core lesion visible on cerebral perfusion CT without visible hypodensity in the corresponding native cerebral CT. We compared both methods regarding their accuracy in identifying patients suitable for thrombolysis. Methods: In a retrospective analysis of the MissPerfeCT observational cohort study, patients were classified as suitable or not for thrombolysis based on established time window and imaging criteria. We calculated predictive values for hypoperfusion-hypodensity mismatch and automated perfusion imaging to compare accuracy in the identification of patients suitable for thrombolysis. Results: Of 247 patients, 219 (88.7%) were eligible for thrombolysis and 28 (11.3%) were not eligible for thrombolysis. Of 197 patients who were within 4.5 h of symptom onset, 190 (96.4%) were identified by hypoperfusion-hypodensity mismatch and 88 (44.7%) by automated perfusion mismatch ( Conclusion: The novel method of hypoperfusion-hypodensity mismatch can identify patients suitable for thrombolysis with higher sensitivity and lower specificity than established techniques. Using this simple method might therefore increase the proportion of patients treated with thrombolysis without the use of special automated software.The MissPerfeCT study is a retrospective observational multicenter cohort study and is registered with clinicaltrials.gov (NCT04277728).

Indexed as

computed tomographystrokethrombolysistime windowunknown onset stroke

Identifiers

PMID38225983
PMCPMC10788186

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