1. Comparison of automated infarct core volume measures between non-contrast computed tomography and perfusion imaging in acute stroke code patients evaluated for potential endovascular treatment
- Author
-
Nicolas Martinez-Majander, Olli P. Suomalainen, Ahmed Abou Elseoud, Nina Forss, Marjaana Tiainen, Sami Curtze, University of Helsinki, Department of Neuroscience and Biomedical Engineering, Aalto-yliopisto, Aalto University, Neurologian yksikkö, Helsinki University Hospital Area, HUS Medical Imaging Center, Department of Diagnostics and Therapeutics, HUS Neurocenter, Department of Neurosciences, Clinicum, University of Helsinki, Neurologian yksikkö, University of Helsinki, HUS Medical Imaging Center, University of Helsinki, HUS Neurocenter, and University of Helsinki, Clinicum
- Subjects
SELECTION ,medicine.medical_specialty ,Perfusion Imaging ,Infarction ,Computed tomography ,Perfusion scanning ,THERAPY ,3124 Neurology and psychiatry ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,SCORE ,medicine ,Humans ,Computed Tomography Perfusion Imaging ,Infarct core ,030212 general & internal medicine ,ACUTE ISCHEMIC-STROKE ,Ischemic core ,Endovascular treatment ,Endovascular thrombectomy ,Stroke ,Outcome ,Early ischemic changes ,ASSESSING CT SCANS ,Ischemic stroke ,medicine.diagnostic_test ,business.industry ,Penumbra ,INTRAVENOUS ALTEPLASE ,3112 Neurosciences ,THROMBECTOMY ,medicine.disease ,3. Good health ,Neurology ,CT perfusion ,TRIAL ,Neurology (clinical) ,Radiology ,Tomography, X-Ray Computed ,business ,030217 neurology & neurosurgery - Abstract
Funding Information: None. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved. Introduction: Patients with small core infarction and salvageable penumbra are likely to benefit from endovascular treatment (EVT). As computed tomography perfusion imaging (CTP) is not always available 24/7 for patient selection, many patients are transferred to stroke centers for CTP. We compared automatically measured infarct core volume (NCCTcore) from the non-contrast computed tomography (NCCT) with ischemic core volume (CTPcore) from CTP and the outcome of EVT to clarify if NCCTcore measurement alone is sufficient to identify patients that benefit from transfer to stroke centers for EVT. Patients and methods: We included all consecutive stroke-code patients imaged with both NCCT and CTP at Helsinki University Hospital during 9/2016–01/2018. NCCTcore and CTPcore volumes were automatically calculated from the acute NCCT images. Follow-up infarct volume (FIV) was measured from 24 h follow-up NCCT to evaluate efficacy of EVT. To study whether NCCTcore could be used to identify patients eligible to EVT, we sub-grouped patients based on NCCTcore volumes (>50 mL and ≥ 70 mL). Results: Out of 1743 patients, baseline NCCTcore, CTPcore and follow-up NCCT was available for 288 patients. Median time from symptom onset to baseline imaging was 74 min (IQR 52–118), and time to follow-up imaging 24.15 h (22.25–26.33). Baseline NCCTcore was 20 mL (10–42), CTPcore 4 mL (0–16), and FIV 5 mL (1–49). Out of 288 patients, 23 had NCCTcore ≥ 70 mL and 26 had CTPcore ≥ 70 mL. NCCTcore and CTPcore performed similarly well in predicting large FIV (≥70 ml). Conclusion: NCCTcore is a promising tool to identify patients that are not eligible to EVT due to large ischemic cores at baseline imaging.
- Published
- 2021