Sistema de Salut de Catalunya
Institut Català de la Salut
[Psychogios MN] Department of Neuroradiology, Clinic for Radiology & Nuclear Medicine, University Hospital Basel, Basel, Switzerland. [Sporns PB] Department of Neuroradiology, Clinic for Radiology & Nuclear Medicine, University Hospital Basel, Basel, Switzerland. Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. [Ospel J] Department of Neuroradiology, Clinic for Radiology & Nuclear Medicine, University Hospital Basel, Basel, Switzerland. Department of Clinical Neurosciences, Radiology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada. [Katsanos AH] Department of Medicine (Neurology), McMaster University/Population Health Research Institute, Hamilton, Canada. Second Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece. [Kabiri R, Flottmann FA] Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. [Ribo M, Ruiz MR] Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2022-07-18T10:26:16Z
2022-07-18T10:26:16Z
2021-06
Acute ischemic stroke; Automated evaluation; Perfusion imaging
Accidente cerebrovascular isquémico agudo; Evaluación automatizada; Imágenes de perfusión
Accident cerebrovascular isquèmic agut; Avaluació automatitzada; Imatge de perfusió
Purpose Use of automated perfusion software has gained importance for imaging of stroke patients for mechanical thrombectomy (MT). We aim to compare four perfusion software packages: 1) with respect to their association with 3‑month functional outcome after successful reperfusion with MT in comparison to visual Cerebral Blood Volume - Alberta Stroke Program Early CT Score (CBV-ASPECTS) and collateral scoring and 2) with respect to their agreement in estimation of core and penumbra volume. Methods This retrospective, multicenter cohort study (2015–2019) analyzed data from 8 centers. We included patients who were functionally independent before and underwent successful MT of the middle cerebral artery. Primary outcome measurements were the relationship of core and penumbra volume calculated by each software, qualitative assessment of collaterals and CBV-APECTS with 3‑month functional outcome and disability (modified Rankin scale >2). Quantitative differences between perfusion software measurements were also assessed. Results A total of 215 patients (57% women, median age 77 years) from 8 centers fulfilled the inclusion criteria. Multivariable analyses showed a significant association of RAPID core (common odds ratio, cOR 1.02; p = 0.015), CBV-ASPECTS (cOR 0.78; p = 0.007) and collaterals (cOR 0.78; p = 0.001) with 3‑month functional outcome (shift analysis), while RAPID core (OR 1.02; p = 0.018), CBV-ASPECTS (OR 0.77; p = 0.024), collaterals (OR 0.78; p = 0.007) and OLEA core (OR 1.02; p = 0.029) were significantly associated with 3‑month functional disability. Mean differences on core estimates between VEOcore and RAPID were 13.4 ml, between syngo.via and RAPID 30.0 ml and between OLEA and RAPID −3.2 ml. Conclusion Collateral scoring, CBV-ASPECTS and RAPID were independently associated with functional outcome at 90 days. Core and Penumbra estimates using automated software packages varied significantly and should therefore be used with caution.
Open access funding provided by University of Basel
Article
Published version
English
Isquèmia cerebral - Imatgeria; Vasos sanguinis - Cirurgia; Avaluació de resultats (Assistència sanitària); DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia; Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging; ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral; Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen
Springer
Clinical Neuroradiology;31
https://doi.org/10.1007/s00062-020-00974-3
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
