PT  - JOURNAL ARTICLE
AU  - F. Fahmi
AU  - H.A. Marquering
AU  - G.J. Streekstra
AU  - L.F.M. Beenen
AU  - B.K. Velthuis
AU  - E. VanBavel
AU  - C.B. Majoie
TI  - Differences in CT Perfusion Summary Maps for Patients with Acute Ischemic Stroke Generated by 2 Software Packages
AID  - 10.3174/ajnr.A3110
DP  - 2012 May 03
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2012/05/03/ajnr.A3110.short
4100  - http://www.ajnr.org/content/early/2012/05/03/ajnr.A3110.full
AB  - BACKGROUND AND PURPOSE: Although CT perfusion is a promising tool to support treatment decisions for patients with acute ischemic stroke, it still lacks a standardized method for CTP analysis. The purpose of this study was to assess the variability of the area of infarct core and penumbra as presented in summary maps produced by 2 different software packages. MATERIALS AND METHODS: Forty-one CTP image datasets of 26 consecutive patients who presented with acute ischemic stroke were retrospectively evaluated. Identical image datasets were analyzed by using 2 different commercially available CTP analysis software packages, each representing a mainstream of widely used algorithms: delay-sensitive and delay-insensitive. Bland-Altman analyses were performed to evaluate the level of agreement between the 2 methods in determining the area of infarct core and penumbra area in the summary maps. RESULTS: There was a statistically significant difference in infarct core area (−23.6 ± 25.6 cm2) and penumbra area (15.8 ± 25.3 cm2) between the 2 software packages. For all the areas presented in the summary maps, the Bland-Altman interval limit of agreement was larger than 100 cm2. CONCLUSIONS: The infarct core and penumbra area of CTP summary maps generated by 2 commonly used software packages were significantly different, emphasizing the need for standardization and validation of CTP analysis before it can be applied to patient management in clinical practice. Abbreviations AIFarterial input functionNVTnonviable tissueTARtissue at riskVOFvenous output function