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Conference Paper: The Assessment of infarct core on non contrast computed tomography versus computed tomography perfusion imaging using RAPID software in patients with large vessel occlusion

TitleThe Assessment of infarct core on non contrast computed tomography versus computed tomography perfusion imaging using RAPID software in patients with large vessel occlusion
Authors
Issue Date2018
PublisherSage Publications Ltd. The Journal's web site is located at http://www.sagepub.in/journals/Journal202429
Citation
11th World Stroke Congress (WSC) 2018, Montreal, Canada, 17-20 October 2018. World Stroke Congress Abstracts, 2018 in International Journal of Stroke, 2018, v. 13 n. 2, Suppl., p. 54 How to Cite?
AbstractObjective: To evaluate whether infarct core on non-contrast computed tomography (NCCT) and CT perfusion (CTP) correspond and equally predict infarct extent after thrombectomy for ischemic stroke. Methods: From our prospective database, we selected consecutive patients with acute middle cerebral artery occlusion undergoing successful thrombectomy (TICI 2b/3) between May-‘16 and February-‘18. All patients had baseline NCCT, CTP with RAPID post-processing software, and 24h NCCT. Two raters independently assessed the infarct cores using the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on each modality in a blinded fashion: 1) baseline NCCT, 2) CTP (CBF <30% of normal tissue), and 3) 24h NCCT. We calculated the interrater agreement, correlation between baseline NCCT-ASPECTS, CTP-ASPECTS, and 24h NCCT-ASPECTS; and the positive predictive value (PPV) of NCCT- and CTP-ASPECTS. Results: We studied 86 patients: 63% (54/86) women, median age 74 (IQR62-82), median baseline NCCT-ASPECTS 9 (IQR 8–10), median CTP-ASPECTS 9 (IQR 8–10), and mean CTP-infarct volume 14 28cc. Interrater agreement was substantial for NCCT-ASPECTS (weighted kappa: 0.71) and almost perfect for CTP-ASPECTS (weighted kappa: 0.94). There was substantial correlation between baseline and 24h NCCT-ASPECTS (Spearman’s rho: 0.62; p < 0.001), but poor correlation between baseline NCCT-ASPECTS and CTP-ASPECTS (Spearman’s rho: 0.18; p ¼ 1.0). CTP-ASPECTS and CTP-core volume did poorly correlate with 24h NCCT-ASPECTS (Spearman’s rho: 0.21; p ¼ 0.06 and -0.16; p ¼ 0.15 respectively). PPV of baseline NCCT-ASPECTS was 81%, while that of CTPASPECTS was 53%. Conclusion: In this series, infarct core on RAPID-CTP did not correlate with the baseline-NCCTand tended to depict a larger core than the final infarct.
DescriptionWSC18-1085 Free Communications: Acute Imaging and Stroke Management - no. 210
Persistent Identifierhttp://hdl.handle.net/10722/275870
ISSN
2020 Impact Factor: 5.266
2020 SCImago Journal Rankings: 2.375

 

DC FieldValueLanguage
dc.contributor.authorTsang, COA-
dc.contributor.authorLenck, S-
dc.contributor.authorKrings, T-
dc.contributor.authorPereira, VM-
dc.contributor.authorSilver, FL-
dc.contributor.authorSchaafasma, J-
dc.date.accessioned2019-09-10T02:51:19Z-
dc.date.available2019-09-10T02:51:19Z-
dc.date.issued2018-
dc.identifier.citation11th World Stroke Congress (WSC) 2018, Montreal, Canada, 17-20 October 2018. World Stroke Congress Abstracts, 2018 in International Journal of Stroke, 2018, v. 13 n. 2, Suppl., p. 54-
dc.identifier.issn1747-4930-
dc.identifier.urihttp://hdl.handle.net/10722/275870-
dc.descriptionWSC18-1085 Free Communications: Acute Imaging and Stroke Management - no. 210-
dc.description.abstractObjective: To evaluate whether infarct core on non-contrast computed tomography (NCCT) and CT perfusion (CTP) correspond and equally predict infarct extent after thrombectomy for ischemic stroke. Methods: From our prospective database, we selected consecutive patients with acute middle cerebral artery occlusion undergoing successful thrombectomy (TICI 2b/3) between May-‘16 and February-‘18. All patients had baseline NCCT, CTP with RAPID post-processing software, and 24h NCCT. Two raters independently assessed the infarct cores using the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on each modality in a blinded fashion: 1) baseline NCCT, 2) CTP (CBF <30% of normal tissue), and 3) 24h NCCT. We calculated the interrater agreement, correlation between baseline NCCT-ASPECTS, CTP-ASPECTS, and 24h NCCT-ASPECTS; and the positive predictive value (PPV) of NCCT- and CTP-ASPECTS. Results: We studied 86 patients: 63% (54/86) women, median age 74 (IQR62-82), median baseline NCCT-ASPECTS 9 (IQR 8–10), median CTP-ASPECTS 9 (IQR 8–10), and mean CTP-infarct volume 14 28cc. Interrater agreement was substantial for NCCT-ASPECTS (weighted kappa: 0.71) and almost perfect for CTP-ASPECTS (weighted kappa: 0.94). There was substantial correlation between baseline and 24h NCCT-ASPECTS (Spearman’s rho: 0.62; p < 0.001), but poor correlation between baseline NCCT-ASPECTS and CTP-ASPECTS (Spearman’s rho: 0.18; p ¼ 1.0). CTP-ASPECTS and CTP-core volume did poorly correlate with 24h NCCT-ASPECTS (Spearman’s rho: 0.21; p ¼ 0.06 and -0.16; p ¼ 0.15 respectively). PPV of baseline NCCT-ASPECTS was 81%, while that of CTPASPECTS was 53%. Conclusion: In this series, infarct core on RAPID-CTP did not correlate with the baseline-NCCTand tended to depict a larger core than the final infarct.-
dc.languageeng-
dc.publisherSage Publications Ltd. The Journal's web site is located at http://www.sagepub.in/journals/Journal202429-
dc.relation.ispartofInternational Journal of Stroke-
dc.relation.ispartofWorld Stroke Congress-
dc.rightsInternational Journal of Stroke. Copyright © Sage Publications Ltd.-
dc.titleThe Assessment of infarct core on non contrast computed tomography versus computed tomography perfusion imaging using RAPID software in patients with large vessel occlusion-
dc.typeConference_Paper-
dc.identifier.emailTsang, COA: acotsang@hku.hk-
dc.identifier.authorityTsang, COA=rp01519-
dc.identifier.hkuros302718-
dc.identifier.volume13-
dc.identifier.issue2, Suppl.-
dc.identifier.spage54-
dc.identifier.epage54-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1747-4930-

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