scholarly journals Automated Measurement of Computed Tomography Acute Ischemic Core in Stroke

Stroke ◽  
2021 ◽  
Vol 52 (2) ◽  
pp. 642-644
Author(s):  
Mark W. Parsons
Keyword(s):  
Computed Tomography ◽  
Automated Measurement ◽  
Ischemic Core

scholarly journals Machine Learning–Enabled Automated Determination of Acute Ischemic Core From Computed Tomography Angiography

Stroke ◽  
2019 ◽  
Vol 50 (11) ◽  
pp. 3093-3100 ◽  
Author(s):  
Sunil A. Sheth ◽  
Victor Lopez-Rivera ◽  
Arko Barman ◽  
James C. Grotta ◽  
Albert J. Yoo ◽  
...  
Keyword(s):  
Machine Learning ◽  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Ischemic Core ◽  
Automated Determination

scholarly journals e-ASPECTS derived acute ischemic volumes on non-contrast-enhanced computed tomography images

2019 ◽  
Vol 15 (9) ◽  
pp. 995-1001
Author(s):  
Simon Nagel ◽  
Olivier Joly ◽  
Johannes Pfaff ◽  
Panagiotis Papanagiotou ◽  
Klaus Fassbender ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Outcome ◽  
Diffusion Weighted Imaging ◽  
Clinical Severity ◽  
Stroke Severity ◽  
Lesion Volume ◽  
Computed Tomography Perfusion ◽  
Computed Tomography Images ◽  
Diffusion Weighted ◽  
Ischemic Core

Background and purpose Validation of automatically derived acute ischemic volumes (AAIV) from e-ASPECTS on non-contrast computed tomography (NCCT). Materials and methods Data from three studies were reanalyzed with e-ASPECTS Version 7. AAIV was calculated in milliliters (ml) in all scored ASPECTS regions of the hemisphere detected by e-ASPECTS. The National Institute of Health Stroke Scale (NIHSS) determined stroke severity at baseline and clinical outcome was measured with the modified Rankin Scale (mRS) between 45 and 120 days. Spearman ranked correlation coefficients (R) of AAIV and e-ASPECTS scores with NIHSS and mRS as well as Pearson correlation of AAIV with diffusion-weighted imaging and CT perfusion-estimated ischemic “core” volumes were calculated. Multivariate regression analysis (odds ratio, OR with 95% confidence intervals, CI) and Bland–Altman plots were performed. Results We included 388 patients. Mean AAIV was 11.6 ± 18.9 ml and e-ASPECTS was 9 (8–10: median and interquartile range). AAIV, respectively e-ASPECTS correlated with NIHSS at baseline (R = 0.35, p < 0.001; R = −0.36, p < 0.001) and follow-up mRS (R = 0.29, p < 0.001; R = −0.3, p < 0.001). In subsets of patients, AAIV correlated strongly with diffusion-weighted imaging ( n = 37, R = 0.68, p < 0.001) and computed tomography perfusion-derived ischemic “core” ( n = 41, R = 0.76, p < 0.001) lesion volume and Bland–Altman plots showed a bias close to zero (−2.65 ml for diffusion-weighted imaging and 0.45 ml forcomputed tomography perfusion “core”). Within the whole cohort, the AAIV (OR 0.98 per ml, 95% CI 0.96–0.99) and e-ASPECTS scores (OR 1.3, 95%CI 1.07–1.57) were independent predictors of good outcome Conclusion AAIV on NCCT correlated moderately with clinical severity but strongly with diffusion-weighted imaging lesion and computed tomography perfusion ischemic “core” volumes and predicted clinical outcome.

Automated measurement of medial temporal lobe atrophy by computed tomography

2007 ◽  
Vol 1 (6) ◽  
pp. 321-330
Author(s):  
Masumi Hattori ◽  
Shuji Koyama ◽  
Yoshie Kodera ◽  
Yosuke Kogure ◽  
Yasushi Ido ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Automated Measurement ◽  
Medial Temporal Lobe Atrophy ◽  
Lobe Atrophy

scholarly journals Noncontrast Computed Tomography e-Stroke Infarct Volume Is Similar to RAPID Computed Tomography Perfusion in Estimating Postreperfusion Infarct Volumes

Stroke ◽  
2021 ◽  
Vol 52 (2) ◽  
pp. 634-641 ◽  
Author(s):  
Mehdi Bouslama ◽  
Krishnan Ravindran ◽  
George Harston ◽  
Gabriel M. Rodrigues ◽  
Leonardo Pisani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Odds Ratio ◽  
Functional Outcomes ◽  
Adjusted Odds Ratio ◽  
Infarct Volume ◽  
Tertiary Care ◽  
Computed Tomography Perfusion ◽  
Ischemic Core ◽  
Noncontrast Computed Tomography ◽  
Core Volume

Background and Purpose: The e-Stroke Suite software (Brainomix, Oxford, United Kingdom) is a tool designed for the automated quantification of The Alberta Stroke Program Early CT Score and ischemic core volumes on noncontrast computed tomography (NCCT). We sought to compare the prediction of postreperfusion infarct volumes and the clinical outcomes across NCCT e-Stroke software versus RAPID (IschemaView, Menlo Park, CA) computed tomography perfusion measurements. Methods: All consecutive patients with anterior circulation large vessel occlusion stroke presenting at a tertiary care center between September 2010 and November 2018 who had available baseline infarct volumes on both NCCT e-Stroke Suite software and RAPID CTP as well as final infarct volume (FIV) measurements and achieved complete reperfusion (modified Thrombolysis in Cerebral Infarction scale 2c-3) post-thrombectomy were included. The associations between estimated baseline ischemic core volumes and FIV as well as 90-day functional outcomes were assessed. Results: Four hundred seventy-nine patients met inclusion criteria. Median age was 64 years (55–75), median e-Stroke and computed tomography perfusion ischemic core volumes were 38.4 (21.8–58) and 5 (0–17.7) mL, respectively, whereas median FIV was 22.2 (9.1–56.2) mL. The correlation between e-Stroke and CTP ischemic core volumes was moderate (R=0.44; P <0.001). Similarly, moderate correlations were observed between e-Stroke software ischemic core and FIV (R=0.52; P <0.001) and CTP core and FIV (R=0.43; P <0.001). Subgroup analysis showed that e-Stroke software and CTP performance was similar in the early and late (>6 hours) treatment windows. Multivariate analysis showed that both e-Stroke software NCCT baseline ischemic core volume (adjusted odds ratio, 0.98 [95% CI, 0.97–0.99]) and RAPID CTP ischemic core volume (adjusted odds ratio, 0.98 [95% CI, 0.97–0.99]) were independently and comparably associated with good outcome (modified Rankin Scale score of 0–2) at 90 days. Conclusions: NCCT e-Stroke Suite software performed similarly to RAPID CTP in assessing postreperfusion FIV and functional outcomes for both early- and late-presenting patients. NCCT e-Stroke volumes seems to represent a viable alternative in centers where access to advanced imaging is limited. Moreover, the future development of fusion maps of NCCT and CTP ischemic core estimates may improve upon the current performance of these tools as applied in isolation.

Computed tomography-based triage of extensive baseline infarction: ASPECTS and collaterals versus perfusion imaging for outcome prediction

2020 ◽  
pp. neurintsurg-2020-016848
Author(s):  
Rosalie McDonough ◽  
Sarah Elsayed ◽  
Tobias Djamsched Faizy ◽  
Friederike Austein ◽  
Peter B Sporns ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Functional Outcome ◽  
Operating Characteristic ◽  
Primary Outcome ◽  
Area Under The Curve ◽  
Inclusion Criteria ◽  
Radiological Score ◽  
Ischemic Core ◽  
Core Volume ◽  
Selection Of

BackgroundPatients presenting with large baseline infarctions are often excluded from mechanical thrombectomy (MT) due to uncertainty surrounding its effect on outcome. We hypothesized that computed tomography perfusion (CTP)-based selection may be predictive of functional outcome in low Alberta Stroke Program Early CT Score (ASPECTS) patients.MethodsThis was a double-center, retrospective analysis of patients presenting with ASPECTS≤5 who received multimodal admission CT imaging between May 2015 and June 2020. The predicted ischemic core (pCore) was defined as a reduction in cerebral blood flow (rCBF), while mismatch volume was defined using time to maximum (Tmax). The pCore perfusion mismatch ratio (CPMR) was also calculated. These parameters (pCore, mismatch volume, and CPMR), as well as a combined radiological score consisting of ASPECTS and collateral status (ASCO score), were tested in logistic regression and receiver operating characteristic (ROC) analyses. The primary outcome was favorable modified Rankin Scale (mRS) at discharge (≤3).ResultsA total of 113 patients met the inclusion criteria. The median ischemic core volume was 74.1 mL (IQR 43.8–121.8). The ASCO score was associated with favorable outcome at discharge (aOR 3.7, 95% CI 1.8 to 10.7, P=0.002), while no association was observed for the CTP parameters. A model including the ASCO score also had significantly higher area under the curve (AUC) values compared with the CTP-based model (0.88 vs 0.64, P=0.018).ConclusionsThe ASCO score was superior to the CTP-based model for the prediction of good functional outcome and could represent a quick, practical, and easily implemented method for the selection of low ASPECTS patients most likely benefit from MT.

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