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J Cereb Blood Flow Metab. 2016 Oct;36(10):1780-1789. Epub 2015 Oct 19.

A benchmarking tool to evaluate computer tomography perfusion infarct core predictions against a DWI standard.

Author information

1
Stanford Stroke Center, Stanford University Medical Center, Stanford, CA, USA Stroke Center, Neurocenter (EOC) of Southern Switzerland, Lugano, Switzerland.
2
Stanford Stroke Center, Stanford University Medical Center, Stanford, CA, USA.
3
Departments of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.
4
Department of Neurology, John Hunter Hospital, University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia.
5
Stanford Stroke Center, Stanford University Medical Center, Stanford, CA, USA lansberg@stanford.edu.

Abstract

Differences in research methodology have hampered the optimization of Computer Tomography Perfusion (CTP) for identification of the ischemic core. We aim to optimize CTP core identification using a novel benchmarking tool. The benchmarking tool consists of an imaging library and a statistical analysis algorithm to evaluate the performance of CTP. The tool was used to optimize and evaluate an in-house developed CTP-software algorithm. Imaging data of 103 acute stroke patients were included in the benchmarking tool. Median time from stroke onset to CT was 185 min (IQR 180-238), and the median time between completion of CT and start of MRI was 36 min (IQR 25-79). Volumetric accuracy of the CTP-ROIs was optimal at an rCBF threshold of <38%; at this threshold, the mean difference was 0.3 ml (SD 19.8 ml), the mean absolute difference was 14.3 (SD 13.7) ml, and CTP was 67% sensitive and 87% specific for identification of DWI positive tissue voxels. The benchmarking tool can play an important role in optimizing CTP software as it provides investigators with a novel method to directly compare the performance of alternative CTP software packages.

KEYWORDS:

Cerebrovascular disease; brain imaging; brain ischemia; cerebral blood flow measurement; diffusion weighted MRI

PMID:
26661203
PMCID:
PMC5076783
DOI:
10.1177/0271678X15610586
[Indexed for MEDLINE]
Free PMC Article

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