Assessment of Perfusion Volumes by a New Automated Software for Computed Tomography Perfusion

作者：Zhixin Cao, David Wang, Xueyan Feng, Pengfei Yang, Hao Wang, Ziqi Xu, Yahui Hao, Wanxing Ye, Fengwei Chen, Liyuan Wang, Manjun Hao, Na Wu, Kaixuan Yang, Yunyun Xiong, Yongjun Wang · 发表于：Stroke and Vascular Neurology · 年份：2024 · DOI：10.1136/svn-2023-002964 · 被引用次数：18 · 研究领域：Acute Ischemic Stroke Management、MRI in cancer diagnosis、Cardiac Imaging and Diagnostics

INTRODUCTION: To compare the perfusion volumes assessed by a new automated CT perfusion (CTP) software iStroke with the circular singular value decomposition software RAPID and determine its predictive value for functional outcome in patients with acute ischaemic stroke (AIS) who underwent endovascular treatment (EVT). METHODS: Data on patients with AIS were collected from four hospitals in China. All patients received CTP followed by EVT with complete recanalisation within 24 hours of symptom onset. We evaluated the agreement of CTP measures between the two softwares by Spearman's rank correlation tests and kappa tests. Bland-Altman plots were used to evaluate the agreement of infarct core volume (ICV) on CTP and ground truth on diffusion-weighted imaging (DWI). Logistic regression models were used to test the association between ICV on these two softwares and functional outcomes. RESULTS: Among 326 patients, 228 had DWI examinations and 40 of them had infarct volume >70 mL. In all patients, the infarct core and hypoperfusion volumes on iStroke had a strong correlation with those on RAPID (ρ=0.68 and 0.66, respectively). The agreement of large infarct core (volume >70 mL) was substantial (kappa=0.73, p<0.001) between these two softwares. The ICV measured by iStroke and RAPID was significantly correlated with independent functional outcome at 90 days (p=0.009 and p<0.001, respectively). In patients with DWI examinations and those with an ICV >70 mL, the ICV of iStroke and RAP...