J 2022

Multiphase CTA-derived tissue maps aid in detection of medium vessel occlusions

MCDONOUGH, R. V., W. QIU, J. M. OSPEL, B. K. MENON, Petra CIMFLOVÁ et. al.

Basic information

Original name

Multiphase CTA-derived tissue maps aid in detection of medium vessel occlusions

Authors

MCDONOUGH, R. V., W. QIU, J. M. OSPEL, B. K. MENON, Petra CIMFLOVÁ (203 Czech Republic, belonging to the institution) and M. GOYAL (guarantor)

Edition

NEURORADIOLOGY, NEW YORK, SPRINGER, 2022, 0028-3940

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30224 Radiology, nuclear medicine and medical imaging

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.800

RIV identification code

RIV/00216224:14110/22:00125371

Organization unit

Faculty of Medicine

DOI

UT WoS

000708810800003

Keywords in English

Acute ischemic stroke; Endovascular treatment; Medium vessel occlusions; Multiphase computed tomography; Treatment selection

Tags

Tags

International impact, Reviewed
Změněno: 28/4/2022 11:05, Mgr. Tereza Miškechová

Abstract

V originále

Purpose Medium vessel occlusions (MeVOs) can be challenging to detect on imaging. Multiphase computed tomography angiography (mCTA) has been shown to improve large vessel occlusion (LVO) detection and endovascular treatment (EVT) selection. The aims of this study were to determine if mCTA-derived tissue maps can (1) accurately detect MeVOs and (2) predict infarction on 24-h follow-up imaging with comparable accuracy to CT perfusion (CTP). Methods Two readers assessed mCTA tissue maps of 116 ischemic stroke patients (58 MeVOs, 58 non-MeVOs) and determined by consensus: (1) MeVO (yes/no) and (2) occlusion site, blinded to clinical or imaging data. Sensitivity, specificity, and area under the curve (AUC) for MeVO detection were estimated in comparison to reference standards of (1) expert readings of baseline mCTA and (2) CTP maps. Volumetric and spatial agreement between mCTA- and CTP-predicted infarcts was assessed using concordance/intraclass correlation and Dice coefficients. Interrater agreement for MeVO detection on mCTA tissue maps was estimated with Cohen's kappa. Results MeVO detection from mCTA-derived tissue maps had a sensitivity of 91% (95% CI: 80-97), specificity of 82% (95% CI: 70-90), and AUC of 0.87 (95% CI: 0.80-0.93) compared to expert reads of baseline mCTA. Interrater reliability was good (0.72, 95% CI: 0.60-0.85). Compared to CTP maps, sensitivity was 87% (95% CI: 75-95), specificity was 78% (95%CI: 65-88), and AUC was 0.83 (95% CI: 0.76-0.90). The mean difference between mCTA- and CTP-predicted final infarct volume was 4.8 mL (limits of agreement: - 58.5 to 68.1) with a Dice coefficient of 33.5%. Conclusion mCTA tissue maps can be used to reliably detect MeVO stroke and predict tissue fate.