Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis–A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials

Vaníček, Jiří; Cimflová, Petra; Bulik, Martin; Jarkovský, Jiří; Prelecova, Veronika; Szeder, Viktor; Volný, Ondřej

doi:10.1016/j.jstrokecerebrovasdis.2018.12.041

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Recently, increasing large comprehensive stroke centers have applied the automated perfusion analysis software to process the perfusion data. It may dramatically shorten the time usage of CTP reconstruction and subsequent analysis [ 12 , 15 , 16 ]. While in primary stroke center, the automated reconstruction software was still not popularized.…”

Section: Discussionmentioning

confidence: 99%

Comparison of time consumption and success rate between CT angiography- and CT perfusion- based imaging assessment strategy for the patients with acute ischemic stroke

Chu

et al. 2022

BMC Med Imaging

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Background Our study aimed to compare the time consumption and success rate between CTA- and CTP- based assessment strategy, and to clarify the risk factors associated with the CTP scan failure. Methods Clinical and radiological data of 437 consecutive AIS patients who underwent multiphase CTA or CTP for pre-treatment evaluation were retrospectively enrolled (CTA group, n = 302; CTP group, n = 135). Time consumption and success rate of CTA- and CTP- based assessment strategy were compared using Mann–Whitney U test and Chi-Squared Test. Univariate analysis and receiver operating curve analysis were used to clarify the risk factors, and their performance in predicting the CTP scan failure. Results Time consumption of CTP scan and reconstruction was significantly longer than that of CTA [775 s vs 263.5 s, P < 0.001]. CTP scan showed significantly higher failure rate than CTA (11% vs 1%, P < 0.001). Severe motion was the most common cause of CTP failure (n = 12, 80%). Baseline National Institute of Health Stroke Scale (NIHSS) score in CTP failure group was significantly higher than that in CTP success group [17 vs 13, P = 0.007]. Baseline NIHSS score of 11 was the optimal threshold value to predict CTP failure with an area under the curve of 0.715, a sensitivity of 86.7%, and a specificity of 45.0%. Conclusions CTP- based strategy showed longer time consumption and higher failure rate than CTA- based strategy. High baseline NIHSS score was significantly associated with CTP scan failure in AIS patients.

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Section: Discussionmentioning

confidence: 99%

Comparison of time consumption and success rate between CT angiography- and CT perfusion- based imaging assessment strategy for the patients with acute ischemic stroke

Chu

et al. 2022

BMC Med Imaging

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“…Currently, automated perfusion analysis software has been widely used in large comprehensive stroke centers. It may dramatically shorten the time usage of CTP reconstruction and subsequent analysis [11][12][13]. While in primary stroke center, the automated reconstruction software was still not popularized.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Time Usage and Success Rate Between CT Angiography- and CT Perfusion- Based Imaging Assessment Strategy for the Patients with Acute Ischemic Stroke

Chu¹,

Ma²,

Xu³

et al. 2021

Preprint

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Background: Our study aimed to compare the time usage and success rate between CTA- and CTP- based assessment strategy, and to clarify the risk factors associated with CTP scan failure. Methods: Clinical and radiological data of 437 consecutive AIS patients who underwent multiphase CTA or CTP for pre-treatment evaluation were retrospectively enrolled (CTA group, n=302; CTP group, n=135). Time usage and success rate of CTA and CTP were compared using Mann-Whitney U test and Chi-Squared Test. Univariate analysis and receiver operating curve analysis were used to clarify the risk factors and their values for predicting CTP scan failure.Results: Time usage of CTP scan and reconstruction was significantly longer than that of CTA [775sec vs 263.5sec, P<0.001]. CTP scan showed significantly higher failure rate than CTA (11% vs 1%, P<0.001). Severe motion was the most common cause of CTP failure (n=12, 80%). Baseline National Institute of Health Stroke Scale (NIHSS) score in CTP failure group was significantly higher than that in CTP success group [17 vs 13, P=0.007]. Baseline NIHSS score of 11 was the optimal threshold to predict CTP failure with an area under the curve of 0.771, sensitivity of 86.7% and specificity of 45.0%.Conclusions: CTP-based strategy showed longer time consumption and higher failure rate than CTA-based strategy. High baseline NIHSS score was significantly associated with CTP scan failure in AIS patients.

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“…This is not a new finding [ 18 ], although it has not yet been directly addressed. Recently, very convincing studies have been published claiming that ASPECTS overestimates tissue injury and that early CT lesions, if promptly treated, may resolve [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Real-World Comparison of Human and Software Image Assessment in Acute Ischemic Stroke Patients’ Qualification for Reperfusion Treatment

Łasocha¹,

Pułyk

Brzegowy

et al. 2020

JCM

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Our aim was to compare human and computer accuracy in reading medical images of acute stroke patients. We analyzed data of patients who underwent assessment of Alberta Stroke Program Early CT Score (ASPECTS) and CT Perfusion (CTP) via Rapid Processing of Perfusion and Diffusion (RAPID) software RAPID ASPECTS, and RAPID CTP), compared to radiologist reports and manual measurements. We compared volumes calculated by RAPID CTP software with those selected by scanner-equipped software (GE). For reference, follow-up images were manually assessed in accordance with the Alberta Stroke Program Early CT Score (ASPECTS) territories retrospectively. Although exact ASPECTS score agreement between the automatic and manual methods, and between each method and follow-up, was poor, crossing of the threshold for reperfusion therapy was characterized by an 80% match. CT perfusion analyses yielded only slight agreement (kappa = 0.193) in the qualification of patients for therapy. Either automatic or manual scoring methods of non-contrast images imply similar clinical decisions in real-world circumstances. However, volume measurements performed by fully automatic and manually assisted systems are not comparable. Thresholds devised and validated for computer algorithms are not compatible with measurements performed manually using other software and should not be applied to setups other than those with which they were developed.

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Single-Centre Experience with Patients Selection for Mechanical Thrombectomy Based on Automated Computed Tomography Perfusion Analysis–A Comparison with Computed TomographyCT Perfusion Thrombectomy Trials

Cited by 5 publications

References 14 publications

Comparison of time consumption and success rate between CT angiography- and CT perfusion- based imaging assessment strategy for the patients with acute ischemic stroke

Comparison of time consumption and success rate between CT angiography- and CT perfusion- based imaging assessment strategy for the patients with acute ischemic stroke

Comparison of Time Usage and Success Rate Between CT Angiography- and CT Perfusion- Based Imaging Assessment Strategy for the Patients with Acute Ischemic Stroke

Real-World Comparison of Human and Software Image Assessment in Acute Ischemic Stroke Patients’ Qualification for Reperfusion Treatment

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