Department of Neurosciences, Eastern Health, Box Hill Hospital, Level 2, 5 Arnold St., Box Hill, Victoria 3128, Australia; Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.
Department of Neurosciences, Eastern Health, Box Hill Hospital, Level 2, 5 Arnold St., Box Hill, Victoria 3128, Australia.
J Stroke Cerebrovasc Dis. 2022 Jun;31(6):106482. doi: 10.1016/j.jstrokecerebrovasdis.2022.106482. Epub 2022 Apr 13.
Computed tomography perfusion (CTP) data are important for hyperacute stroke decision making. Available comparisons between outputs of different CTP software packages show variable outcomes. Evaluation for factors associated with agreement between the volume estimates is limited. We assessed for differences in core and penumbra volume estimates of three CTP software packages - AutoMIStar, RAPID, and Vitrea - and analyzed factors associated with agreement between the volume estimates.
Differences between software estimates of penumbra and core volumes were calculated for each patient with suspected acute ischemic stroke who underwent CTP. Exploratory hierarchical clustering and principal component analysis were performed to identify factors of decreased volume estimate agreement. Two-sample t-tests were performed, stratified by large vessel occlusion (LVO) location.
579 CTP studies were performed; 267 were normal, 139 artifacts, with 172 included in the final analysis. 79/172 had LVO of internal carotid artery (ICA, n = 20), M1 (n = 38) and proximal M2 (n = 21). LVO was the only factor associated with decreased software package agreement, and proximal LVO location was associated with general trend of increasing mean differences and standard deviations between software packages (range of mean differences [SD]: non-LVO, -17-6 [4-33] ml; M2, -40-13 [5-39] ml; M1, -43-26 [16-58] ml; ICA, -76-39 [22-97] ml).
Core and penumbra volume estimates can be affected by LVO location significantly between CTP software packages.
计算机断层灌注（CTP）数据对超急性脑卒中决策至关重要。不同 CTP 软件包输出结果的比较显示存在可变的结果。评估与体积估计值之间一致性相关的因素的研究有限。我们评估了三种 CTP 软件包（AutoMIStar、RAPID 和 Vitrea）的核心和半影区体积估计值之间的差异，并分析了与体积估计值之间一致性相关的因素。
对每位疑似急性缺血性脑卒中且接受 CTP 检查的患者的半影区和核心体积的软件估计值之间的差异进行计算。进行探索性层次聚类和主成分分析，以确定降低体积估计值一致性的因素。对大血管闭塞（LVO）位置进行分层，进行两样本 t 检验。
共进行了 579 次 CTP 研究；267 次正常，139 次为伪影，172 次纳入最终分析。79/172 例患者存在颈内动脉（ICA，n=20）、M1（n=38）和近端 M2（n=21）的 LVO。LVO 是唯一与降低软件包一致性相关的因素，近端 LVO 位置与软件包之间平均差异和标准差增加的总体趋势相关（平均差异范围[SD]：非-LVO，-17-6[4-33]ml；M2，-40-13[5-39]ml；M1，-43-26[16-58]ml；ICA，-76-39[22-97]ml）。
在 CTP 软件包之间，核心和半影区体积估计值会受到 LVO 位置的显著影响。
