Publication details

Detection of ischemic changes on baseline multimodal computed tomography: expert reading vs. Brainomix and RAPID software

Authors

CIMFLOVÁ Petra VOLNÝ Ondřej MIKULÍK Robert TYSHCHENKO Bohdan BELASKOVA Silvie VINKLAREK Jan ČERVEŇÁK Vladimír KŘIVKA Tomáš VANÍČEK Jiří KRAJINA Antonin

Year of publication 2020
Type Article in Periodical
Magazine / Source JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
MU Faculty or unit

Faculty of Medicine

Citation
Web https://linkinghub.elsevier.com/retrieve/pii/S1052305720303967
Doi http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104978
Keywords Stroke imaging; Early ischemic changes; ASPECTS; e-ASPECTS; CT perfusion; RAPID
Description 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. (c) 2020 Elsevier Inc. All rights reserved.

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