Lu Qingqing, Fu Junyan, Lv Kun, Han Yan, Pan Yuning, Xu Yiren, Zhang Jun, Geng Daoying
Department of Radiology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200040, China; Department of Radiology, Ningbo First Hospital, Ningbo 315000, China.
Department of Radiology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200040, China.
Eur J Radiol. 2022 Nov;156:110500. doi: 10.1016/j.ejrad.2022.110500. Epub 2022 Aug 27.
To compare ischemic core volume (ICV) and penumbra volume (PV) measured by MIStar, F-STROKE, and Syngo.via with that measured by RAPID in acute ischemic stroke (AIS), and their concordance in selecting patients for endovascular thrombectomy (EVT).
Computed tomography perfusion (CTP) data were processed with four software packages. Bland-Altman analysis and intraclass correlation coefficient (ICC) were performed to evaluate their agreement in quantifying ICV and PV. Kappa test was conducted to assess consistency in the selection of EVT candidates. The correlation between predicted ICV and segmented final infarct volume (FIV) on follow-up images was investigated.
A total of 91 patients were retrospectively included. F-STROKE had the best consistency with RAPID (ICV: ICC = 0.97; PV: ICC = 0.84) and Syngo.via had the worst consistency (ICV: ICC = 0.77; PV: ICC = 0.66). F-STROKE had the narrowest limits of agreements both in ICV (-27.02, 24.40 mL) and PV (-85.59, 101.80 mL). When selecting EVT candidates, MIStar (kappa = 0.71-0.88) and F-STROKE (kappa = 0.84-0.90) had good to excellent consistency with RAPID, while Syngo.via had poor consistency (kappa = 0.20-0.41). ICV predicted by MIStar was correlated strongest with FIV (r = 0.77).
F-STROKE is most consistent with RAPID in quantitative ICV and PV. F-STROKE and MIStar exhibit similar EVT candidate selection to RAPID. Syngo.via, for its part, seems to have overestimated ICV and underestimated PV, leading to an overly restrictive selection of EVT candidates.
比较在急性缺血性卒中（AIS）中，通过MIStar、F-STROKE和Syngo.via测量的缺血核心体积（ICV）和半暗带体积（PV）与通过RAPID测量的结果，以及它们在选择血管内血栓切除术（EVT）患者时的一致性。
用四个软件包处理计算机断层扫描灌注（CTP）数据。进行Bland-Altman分析和组内相关系数（ICC）以评估它们在量化ICV和PV方面的一致性。进行Kappa检验以评估在选择EVT候选者方面的一致性。研究了预测的ICV与随访图像上分割的最终梗死体积（FIV）之间的相关性。
共回顾性纳入91例患者。F-STROKE与RAPID的一致性最佳（ICV：ICC = 0.97；PV：ICC = 0.84），而Syngo.via的一致性最差（ICV：ICC = 0.77；PV：ICC = 0.66）。F-STROKE在ICV（-27.02，24.40 mL）和PV（-85.59，101.80 mL）方面的一致性界限最窄。在选择EVT候选者时，MIStar（kappa = 0.71 - 0.88）和F-STROKE（kappa = 0.84 - 0.90）与RAPID的一致性良好至优秀，而Syngo.via的一致性较差（kappa = 0.20 - 0.41）。MIStar预测的ICV与FIV的相关性最强（r = 0.77）。
F-STROKE在定量ICV和PV方面与RAPID最一致。F-STROKE和MIStar在选择EVT候选者方面与RAPID表现出相似性。就Syngo.via而言，它似乎高估了ICV并低估了PV，导致对EVT候选者的选择过于严格。
