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Diffusion-Weighted-Imaging infarct volume measurement tools show discrepancies leading to diverging thrombectomy decisions
- Source :
- Journal of Neuroradiology. 48:305-310
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background and purpose Recent clinical trials demonstrated the benefit of thrombectomy beyond 6 h based on the automated measurement of infarct volume exclusively with the RAPID software. We aimed to compare eight tools commonly used for the measurement of infarct volume and see whether they would lead to similar thrombectomy decisions based on the Diffusion-weighted-imaging or computerized-tomography-perfusion Assessment with clinical mismatch in the triage of Wake-up and late-presenting strokes undergoing Neurointervention with Trevo (DAWN) trial imaging inclusion criteria. Materials and Methods The diffusion-weighted-imaging (DWI) infarct volume of 36 patients was measured with 3 automated tools (including RAPID) and 5 non-automated tools. The agreement for the measurements of DWI infarct volume and the resulting thrombectomy decisions were assessed with intraclass correlation coefficient (ICC) and Fleiss’ Kappa (K) statistics. Results The correlation for the measurement of DWI infarct volume between all 9 tools was excellent (ICC > 0.8). After dichotomization, agreement was substantial for any of the cut-points used in DAWN trial. Discrepancies involving at least one of the tools for thrombectomy decisions based on DAWN criteria occurred in one third of cases. Compared with RAPID, the use of any other tool for treatment decision based on DAWN criteria would have led to contradictory decisions in 6% to 19% of cases. Conclusion There are several currently available tools for the measurement of DWI infarct volume with excellent correlation. Despite the high agreement demonstrated in our study, frequent discrepancies between measurements in some dichotomized configurations led to frequent diverging thrombectomy decisions when applying DAWN criteria.
- Subjects :
- medicine.medical_specialty
Intraclass correlation
Brain Ischemia
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Stroke
Thrombectomy
Radiological and Ultrasound Technology
business.industry
medicine.disease
Triage
Clinical trial
Diffusion Magnetic Resonance Imaging
Infarction
Infarct volume
Neurology (clinical)
Treatment decision making
Radiology
business
030217 neurology & neurosurgery
Kappa
Diffusion MRI
Subjects
Details
- ISSN :
- 01509861
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- Journal of Neuroradiology
- Accession number :
- edsair.doi.dedup.....3628d4ab2936afc6a439565beafaaaaa