Detection of ischemic changes on baseline multimodal computed tomography: expert reading vs. Brainomix and RAPID software
Language English Country United States Media print-electronic
Document type Comparative Study, Journal Article, Observational Study
PubMed
32807415
DOI
10.1016/j.jstrokecerebrovasdis.2020.104978
PII: S1052-3057(20)30396-7
Knihovny.cz E-resources
- Keywords
- ASPECTS, CT perfusion, Early ischemic changes, RAPID, Stroke imaging, e-ASPECTS,
- MeSH
- Early Diagnosis MeSH
- Time Factors MeSH
- Stroke diagnostic imaging physiopathology therapy MeSH
- Adult MeSH
- Brain Ischemia diagnostic imaging physiopathology therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Cerebrovascular Circulation * MeSH
- Perfusion Imaging methods MeSH
- Tomography, X-Ray Computed * MeSH
- Predictive Value of Tests MeSH
- Prognosis MeSH
- Radiographic Image Interpretation, Computer-Assisted * MeSH
- Reproducibility of Results MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Software * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Comparative Study MeSH
PURPOSE: The aim of the study was to compare the assessment of ischemic changes by expert reading and available automated software for non-contrast CT (NCCT) and CT perfusion on baseline multimodal imaging and demonstrate the accuracy for the final infarct prediction. METHODS: Early ischemic changes were measured by ASPECTS on the baseline neuroimaging of consecutive patients with anterior circulation ischemic stroke. The presence of early ischemic changes was assessed a) on NCCT by two experienced raters, b) on NCCT by e-ASPECTS, and c) visually on derived CT perfusion maps (CBF<30%, Tmax>10s). Accuracy was calculated by comparing presence of final ischemic changes on 24-hour follow-up for each ASPECTS region and expressed as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The subanalysis for patients with successful recanalization was conducted. RESULTS: Of 263 patients, 81 fulfilled inclusion criteria. Median baseline ASPECTS was 9 for all tested modalities. Accuracy was 0.76 for e-ASPECTS, 0.79 for consensus, 0.82 for CBF<30%, 0.80 for Tmax>10s. e-ASPECTS, consensus, CBF<30%, and Tmax>10s had sensitivity 0.41, 0.46, 0.49, 0.57, respectively; specificity 0.91, 0.93, 0.95, 0.91, respectively; PPV 0.66, 0.75, 0.82, 0.73, respectively; NPV 0.78, 0.80, 0.82, 0.83, respectively. Results did not differ in patients with and without successful recanalization. CONCLUSION: This study demonstrated high accuracy for the assessment of ischemic changes by different CT modalities with the best accuracy for CBF<30% and Tmax>10s. The use of automated software has a potential to improve the detection of ischemic changes.
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