The Relative Effect of Vendor Variability in CT Perfusion Results: A Method Comparison Study

Abstract

Different vendor software applications do not generate quantitative perfusion results equivalently. Intervendor difference is, by far, the largest cause of variability in perfusion results relative to interoperator and intraoperator difference. Caution should be exercised when interpreting quantitative CT perfusion results because these values may vary considerably depending on the postprocessing software.

CTA Collateral Status and Response to Recanalization in Patients with Acute Ischemic Stroke

“…27 CT perfusion needs algorithms for postprocessing images that are vendor-specific, not standardized, and therefore variable across centers. [28][29][30][31] Trained personnel are sometimes needed to process these images. In addition, image quality is affected to some extent by patient motion.…”

Differences in CT Perfusion Summary Maps for Patients with Acute Ischemic Stroke Generated by 2 Software Packages

“…21 Recently, it was shown that intravendor differences are the primary cause of the variability in CTP analysis. 13 In this study, we have assessed the reproducibility of the CTP analysis summary maps between both methods, rather than the accuracy of either method. We, therefore, abstain from any judgment on which package is more accurate.…”

“…12 A more recent study showed that intervendor differences constituted the primary cause of the variability in CTP analysis results in a population of 11 patients. 13 In this study, we assessed quantitative differences in CTP summary maps between 2 software packages analyzing identical CTP source images. These 2 software packages represent the 2 mainstream algorithms: delay-sensitive and delay-insensitive.…”

Perfusion computed tomography: 4 cm versus 8 cm coverage size in subjects with chronic carotid artery stenosis

“…Actually, software differences constitute the primary cause of variability in perfusion results relative to interoperator and intraoperator differences. [20][21][22] The strength of our study is that we used equipment from the same manufacturer and used the same post-processing procedure for all subjects. Furthermore, both experienced neuroradiologists independently drew two standardized elliptical mirrored ROIs (an area of approximately 5 cm each) on the section level of the reference CT image (Figure 1a) over the cortical grey matter of the middle cerebral artery territory.…”