RT Journal Article
SR Electronic
T1 Assessment of a Bayesian Vitrea CT Perfusion Analysis to Predict Final Infarct and Penumbra Volumes in Patients with Acute Ischemic Stroke: A Comparison with RAPID
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A6395
A1 R.A. Rava
A1 K.V. Snyder
A1 M. Mokin
A1 M. Waqas
A1 A.B. Allman
A1 J.L. Senko
A1 A.R. Podgorsak
A1 M.M. Shiraz Bhurwani
A1 Y. Hoi
A1 A.H. Siddiqui
A1 J.M. Davies
A1 E.I. Levy
A1 C.N. Ionita
YR 2020
UL http://www.ajnr.org/content/early/2020/01/16/ajnr.A6395.abstract
AB BACKGROUND AND PURPOSE: Brain CTP is used to estimate infarct and penumbra volumes to determine endovascular treatment eligibility for patients with acute ischemic stroke. We aimed to assess the accuracy of a Bayesian CTP algorithm in determining penumbra and final infarct volumes.MATERIALS AND METHODS: Data were retrospectively collected for 105 patients with acute ischemic stroke (55 patients with successful recanalization [TICI 2b/2c/3] and large-vessel occlusions and 50 patients without interventions). Final infarct volumes were calculated using DWI and FLAIR 24 hours following CTP imaging. RAPID and the Vitrea Bayesian CTP algorithm (with 3 different settings) predicted infarct and penumbra volumes for comparison with final infarct volumes to assess software performance. Vitrea settings used different combinations of perfusion maps (MTT, TTP, CBV, CBF, delay time) for infarct and penumbra quantification. Patients with and without interventions were included for assessment of predicted infarct and penumbra volumes, respectively.RESULTS: RAPID and Vitrea default setting had the most accurate final infarct volume prediction in patients with interventions ([Spearman correlation coefficient, mean infarct difference] default versus FLAIR: [0.77, 4.1 mL], default versus DWI: [0.72, 4.7 mL], RAPID versus FLAIR: [0.75, 7.5 mL], RAPID versus DWI: [0.75, 6.9 mL]). Default Vitrea and RAPID were the most and least accurate in determining final infarct volume for patients without an intervention, respectively (default versus FLAIR: [0.76, –0.4 mL], default versus DWI: [0.71, –2.6 mL], RAPID versus FLAIR: [0.68, −49.3 mL], RAPID versus DWI: [0.65, –51.5 mL]).CONCLUSIONS: Compared with RAPID, the Vitrea default setting was noninferior for patients with interventions and superior in penumbra estimation for patients without interventions as indicated by mean infarct differences and correlations with final infarct volumes.AISacute ischemic strokeFIVfinal infarct volumeMAEmean absolute errorTmaxtime until the residue function reaches its peak