Radiology Department, St. Vincent Hospital, Worcester, MA.
Marcus Stroke and Neuroscience Center, Grady Memorial Hospital and Department of Neurology, Emory University School of Medicine, Atlanta, GA.
Ann Neurol. 2023 Nov;94(5):848-855. doi: 10.1002/ana.26748. Epub 2023 Aug 16.
Computed tomography perfusion (CTP) has played an important role in patient selection for mechanical thrombectomy (MT) in acute ischemic stroke. We aimed to investigate the agreement between perfusion parametric maps of 3 software packages - RAPID (RapidAI-IschemaView), Viz CTP(Viz.ai), and e-CTP(Brainomix) - in estimating baseline ischemic core volumes of near completely/completely reperfused patients.
We retrospectively reviewed a prospectively maintained MT database to identify patients with anterior circulation large vessel occlusion strokes (LVOS) involving the internal carotid artery or middle cerebral artery M1-segment and interpretable CTP maps treated during September 2018 to November 2019. A subset of patients with near-complete/complete reperfusion (expanded thrombolysis in cerebral infarction [eTICI] 2c-3) was used to compare the pre-procedural prediction of final infarct volumes.
In this analysis of 242 patients with LVOS, RAPID and Viz CTP relative cerebral blood flow (rCBF) < 30% values had substantial agreement (ρ = 0.767 [95% confidence interval [CI] = 0.71-0.81]) as well as for RAPID and e-CTP (ρ = 0.668 [95% CI = 0.61-0.71]). Excellent agreement was seen for time to maximum of the residue function (T ) > 6 seconds between RAPID and Viz CTP (ρ = 0.811 [95% CI = 0.76-0.84]) and substantial for RAPID and e-CTP (ρ = 0.749 [95% CI = 0.69-0.79]). Final infarct volume (FIV) prediction (n = 136) was substantial in all 3 packages (RAPID ρ = 0.744; Viz CTP ρ = 0.711; and e-CTP ρ = 0.600).
Perfusion parametric maps of the RAPID, Viz CTP, and e-CTP software have substantial agreement in predicting final infarct volume in near-completely/completely reperfused patients. ANN NEUROL 2023;94:848-855.
计算机断层灌注（CTP）在急性缺血性脑卒中患者的机械血栓切除术（MT）的患者选择中发挥了重要作用。我们旨在研究 3 种软件包的灌注参数图- RAPID（RapidAI-IschemaView）、Viz CTP（Viz.ai）和 e-CTP（Brainomix）-在估计近乎完全/完全再灌注患者的基线缺血核心体积方面的一致性。
我们回顾性地审查了一个前瞻性维护的 MT 数据库，以确定 2018 年 9 月至 2019 年 11 月期间接受治疗的涉及颈内动脉或大脑中动脉 M1 段的前循环大血管闭塞性中风（LVOS）且可解释 CTP 图的患者。使用接近完全/完全再灌注（扩展的脑梗死溶栓[eTICI]2c-3）的患者子集来比较最终梗死体积的术前预测。
在这项对 242 例 LVOS 患者的分析中，RAPID 和 Viz CTP 的相对脑血流量（rCBF）<30%值具有高度一致性（ρ=0.767 [95%置信区间[CI] = 0.71-0.81]），RAPID 和 e-CTP 也具有高度一致性（ρ=0.668 [95% CI = 0.61-0.71]）。RAPID 和 Viz CTP 之间 T 最大值（T）>6 秒的时间具有极好的一致性（ρ=0.811 [95% CI = 0.76-0.84]），RAPID 和 e-CTP 之间具有高度一致性（ρ=0.749 [95% CI = 0.69-0.79]）。在所有 3 种方案中（RAPID ρ=0.744；Viz CTP ρ=0.711；e-CTP ρ=0.600），最终梗死体积（FIV）预测（n=136）均具有高度一致性。
RAPID、Viz CTP 和 e-CTP 软件的灌注参数图在预测近乎完全/完全再灌注患者的最终梗死体积方面具有高度一致性。
