The predictive value of a targeted posterior fossa multimodal stroke protocol for the diagnosis of acute posterior ischemic stroke

Sharon, Michal; Boyle, Karl; Yeung, Robert; zhang, Liying; Symons, Sean; Boulos, Mark I.; Aviv, Richard I.

doi:10.1186/s40809-016-0013-6

Cited by 11 publications

(11 citation statements)

References 27 publications

(44 reference statements)

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“…Few other studies have tested the performance of CTP in this stroke territory [6][7][8][9][10]14]. A subgroup analysis from the Dutch Acute Stroke Trial (DUST) showed that the addition of CTP increases the detection rate of early ischaemic changes in the posterior circulation compared to combinatory NCCT and CTA [7].…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomography with CT perfusion (CTP) approximately doubles the detection rate of acute ischaemia compared to plain CT . Whilst there has been extensive research concerning the diagnostic and prognostic value of CTP in the anterior circulation, there is only little evidence regarding the posterior circulation . The clinical and imaging parameters associated with focal hypoperfusion on acute CTP were explored in patients with posterior circulation stroke and it was hypothesized that CTP hypoperfusion is an independent predictor of clinical outcome in such patients.…”

Section: Introductionmentioning

confidence: 99%

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Perfusion computed tomography in posterior circulation stroke: predictors and prognostic implications of focal hypoperfusion

Pallesen

Lambrou

Eskandari

et al. 2018

Euro J of Neurology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perfusion computed tomography in posterior circulation stroke: predictors and prognostic implications of focal hypoperfusion

Pallesen

Lambrou

Eskandari

et al. 2018

Euro J of Neurology

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“…The diagnostic value of CTP in the posterior circulation has been little investigated with few evidences of its reliability and accuracy; moreover, the diagnostic effects of RAPID introduction in the evaluation of infratentorial ischaemic changes have not yet been clarified [ 3 , 4 , 38 – 40 ]. To the best of our knowledge, these are the first reported instances of PC stroke patient selection using RAPID from European countries.…”

Section: Introductionmentioning

confidence: 99%

Qualitative versus automatic evaluation of CT perfusion parameters in acute posterior circulation ischaemic stroke

et al. 2020

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Purpose To compare the diagnostic accuracy (ACC) in the detection of acute posterior circulation strokes between qualitative evaluation of software-generated colour maps and automatic assessment of CT perfusion (CTP) parameters. Methods Were retrospectively collected 50 patients suspected of acute posterior circulation stroke who underwent to CTP (GE "Lightspeed", 64 slices) within 24 h after symptom onset between January 2016 and December 2018. The Posterior circulation-Acute Stroke Prognosis Early CT Score (pc-ASPECTS) was used for quantifying the extent of ischaemic areas on non-contrast (NC)CT and colour-coded maps generated by CTP4 (GE) and RAPID (iSchemia View) software. Final pc-ASPECTS was calculated on follow-up NCCT and/or MRI (Philips Intera 3.0 T or Philips Achieva Ingenia 1.5 T). RAPID software also elaborated automatic quantitative mismatch maps. Results By qualitative evaluation of colour-coded maps, MTT-CTP4D and Tmax-RAPID showed the highest sensitivity (SE) (88.6% and 90.9%, respectively) and ACC (84% and 88%, respectively) compared with the other perfusion parameters (CBV, CBF). Baseline NCCT and CBF provided by RAPID quantitative perfusion mismatch maps had the lowest SE (29.6% and 6.8%, respectively) and ACC (38% and 18%, respectively). CBF and Tmax assessment provided by quantitative RAPID perfusion mismatch maps showed significant lower SE and ACC than qualitative evaluation. No significant differences were found between the pc-ASPECTSs assessed on colour-coded MTT and Tmax maps neither between the scores assessed on colourcoded CBV-CTP4D and CBF-RAPID maps. Conclusion Qualitative analysis of colour-coded maps resulted more sensitive and accurate in the detection of ischaemic changes than automatic quantitative analysis.

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“…To date, Computed Tomography (CT) is the most applicable tool for rapid screening of ischemic in medical emergency [3] [6] [7]. Despite that, the diagnosis of ischemic in CT slices of Posterior Fossa (PF) remains as the most challenging area, which demands the expertise of radiologist [8]- [10]. The diagnosis process can be monotonous and time-consuming.…”

Section: Introductionmentioning

confidence: 99%

Deep Transfer Learning Application for Automated Ischemic Classification in Posterior Fossa CT Images

Suberi¹,

Nurshazwani²,

Tomari³

et al. 2019

IJACSA

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Computed Tomography (CT) imaging is one of the conventional tools used to diagnose ischemic in Posterior Fossa (PF). Radiologist commonly diagnoses ischemic in PF through CT imaging manually. However, such a procedure could be strenuous and time consuming for large scale images, depending on the expertise and ischemic visibility. With the rapid development of computer technology, automatic image classification based on Machine Learning (ML) is widely been developed as a second opinion to the ischemic diagnosis. The practical performance of ML is challenged by the emergence of deep learning applications in healthcare. In this study, we evaluate the performance of deep transfer learning models of Convolutional Neural Network (CNN); VGG-16, GoogleNet and ResNet-50 to classify the normal and abnormal (ischemic) brain CT images of PF. This is the first study that intensively studies the application of deep transfer learning for automated ischemic classification in the posterior part of brain CT images. The experimental results show that ResNet-50 is capable to achieve the highest accuracy performance in comparison to other proposed models. Overall, this automatic classification provides a convenient and time-saving tool for improving medical diagnosis.

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The predictive value of a targeted posterior fossa multimodal stroke protocol for the diagnosis of acute posterior ischemic stroke

Cited by 11 publications

References 27 publications

Perfusion computed tomography in posterior circulation stroke: predictors and prognostic implications of focal hypoperfusion

Perfusion computed tomography in posterior circulation stroke: predictors and prognostic implications of focal hypoperfusion

Qualitative versus automatic evaluation of CT perfusion parameters in acute posterior circulation ischaemic stroke

Deep Transfer Learning Application for Automated Ischemic Classification in Posterior Fossa CT Images

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