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PLoS One. 2017 Oct 3;12(10):e0185552. doi: 10.1371/journal.pone.0185552. eCollection 2017.

Temporal similarity perfusion mapping: A standardized and model-free method for detecting perfusion deficits in stroke.

Author information

1
NIH/NINDS, Human Cortical Physiology and Neurorehabilitation Section, Bethesda, Maryland, United States of America.
2
Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
3
NIH/NINDS, Stroke Branch, Bethesda, Maryland, United States of America.
4
NIH/NIMH, Scientific and Statistical Computing Core, Bethesda, Maryland, United States of America.

Abstract

INTRODUCTION:

Interpretation of the extent of perfusion deficits in stroke MRI is highly dependent on the method used for analyzing the perfusion-weighted signal intensity time-series after gadolinium injection. In this study, we introduce a new model-free standardized method of temporal similarity perfusion (TSP) mapping for perfusion deficit detection and test its ability and reliability in acute ischemia.

MATERIALS AND METHODS:

Forty patients with an ischemic stroke or transient ischemic attack were included. Two blinded readers compared real-time generated interactive maps and automatically generated TSP maps to traditional TTP/MTT maps for presence of perfusion deficits. Lesion volumes were compared for volumetric inter-rater reliability, spatial concordance between perfusion deficits and healthy tissue and contrast-to-noise ratio (CNR).

RESULTS:

Perfusion deficits were correctly detected in all patients with acute ischemia. Inter-rater reliability was higher for TSP when compared to TTP/MTT maps and there was a high similarity between the lesion volumes depicted on TSP and TTP/MTT (r(18) = 0.73). The Pearson's correlation between lesions calculated on TSP and traditional maps was high (r(18) = 0.73, p<0.0003), however the effective CNR was greater for TSP compared to TTP (352.3 vs 283.5, t(19) = 2.6, p<0.03.) and MTT (228.3, t(19) = 2.8, p<0.03).

DISCUSSION:

TSP maps provide a reliable and robust model-free method for accurate perfusion deficit detection and improve lesion delineation compared to traditional methods. This simple method is also computationally faster and more easily automated than model-based methods. This method can potentially improve the speed and accuracy in perfusion deficit detection for acute stroke treatment and clinical trial inclusion decision-making.

PMID:
28973000
PMCID:
PMC5626465
DOI:
10.1371/journal.pone.0185552
[Indexed for MEDLINE]
Free PMC Article

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