TY - JOUR
T1 - Comparison of three commonly used CT perfusion software packages in patients with acute ischemic stroke
AU - Koopman, Miou S.
AU - Berkhemer, Olvert A.
AU - Geuskens, Ralph R. E. G.
AU - Emmer, Bart J.
AU - van Walderveen, Marianne A. A.
AU - Jenniskens, Sjoerd F. M.
AU - van Zwam, Wim H.
AU - van Oostenbrugge, Robert J.
AU - van der Lugt, Aad
AU - Dippel, Diederik W. J.
AU - Beenen, Ludo F.
AU - Roos, Yvo B. W. E. M.
AU - Marquering, Henk A.
AU - Majoie, Charles B. L. M.
AU - MR CLEAN Trial Investigators
PY - 2019/12
Y1 - 2019/12
N2 - Background and purpose CT perfusion (CTP) might support decision making in patients with acute ischemic stroke by providing perfusion maps of ischemic tissue. Currently, the reliability of CTP is hampered by varying results between different post-processing software packages. The purpose of this study is to compare ischemic core volumes estimated by IntelliSpace Portal (ISP) and syngo.via with core volumes as estimated by RAPID. Methods Thirty-five CTP datasets from patients in the MR CLEAN trial were post-processed. Core volumes were estimated with ISP using default settings and with syngo.via using three different settings: default settings (method A); additional smoothing filter (method B); and adjusted settings (method C). The results were compared with RAPID. Agreement between methods was assessed using Bland-Altman analysis and intraclass correlation coefficient (ICC). Accuracy for detecting volumes up to 25 mL, 50 mL, and 70 mL was assessed. Final infarct volumes were determined on follow-up non-contrast CT. Results Median core volume was 50 mL with ISP, 41 mL with syngo.via method A, 20 mL with method B, 36 mL with method C, and 11 mL with RAPID. Agreement ranged from poor (ISP: ICC 0.41; method A: ICC 0.23) to good (method B: ICC 0.83; method C: ICC 0.85). The bias (1.8 mL) and limits of agreement (-27, 31 mL) were the smallest with syngo.via with additional smoothing (method B). Agreement for detecting core volumes
AB - Background and purpose CT perfusion (CTP) might support decision making in patients with acute ischemic stroke by providing perfusion maps of ischemic tissue. Currently, the reliability of CTP is hampered by varying results between different post-processing software packages. The purpose of this study is to compare ischemic core volumes estimated by IntelliSpace Portal (ISP) and syngo.via with core volumes as estimated by RAPID. Methods Thirty-five CTP datasets from patients in the MR CLEAN trial were post-processed. Core volumes were estimated with ISP using default settings and with syngo.via using three different settings: default settings (method A); additional smoothing filter (method B); and adjusted settings (method C). The results were compared with RAPID. Agreement between methods was assessed using Bland-Altman analysis and intraclass correlation coefficient (ICC). Accuracy for detecting volumes up to 25 mL, 50 mL, and 70 mL was assessed. Final infarct volumes were determined on follow-up non-contrast CT. Results Median core volume was 50 mL with ISP, 41 mL with syngo.via method A, 20 mL with method B, 36 mL with method C, and 11 mL with RAPID. Agreement ranged from poor (ISP: ICC 0.41; method A: ICC 0.23) to good (method B: ICC 0.83; method C: ICC 0.85). The bias (1.8 mL) and limits of agreement (-27, 31 mL) were the smallest with syngo.via with additional smoothing (method B). Agreement for detecting core volumes
KW - stroke
KW - brain ischemia
KW - CT perfusion
KW - post-processing software
KW - ischemic core
KW - FINAL INFARCT VOLUME
KW - ENDOVASCULAR TREATMENT
KW - INTRAVENOUS ALTEPLASE
KW - THROMBECTOMY
KW - REPERFUSION
KW - SELECTION
KW - ACCURACY
KW - PREDICT
KW - CORE
KW - MAPS
U2 - 10.1136/neurintsurg-2019-014822
DO - 10.1136/neurintsurg-2019-014822
M3 - Article
C2 - 31203208
VL - 11
SP - 1249
EP - 1256
JO - Journal of Neurointerventional Surgery
JF - Journal of Neurointerventional Surgery
SN - 1759-8478
IS - 12
ER -