Abstract
Abstract 55: Comparison of Sequential Multi-Detector CT and Cone-Beam CT Perfusion Maps in 54 Subjects With an Acute Ischemic Stroke
Stroke (1970), Vol.51(Suppl_1)
02/2020
DOI: 10.1161/str.51.suppl_1.55
Abstract
Introduction:
Time from diagnostic imaging to groin puncture highly correlates with outcome and often accounts for delays between hospital arrival and EVT. Our study comparing image quality and information content of MDCTP and CBCTP provides feasibility data for selected AIS patients to go straight to the angio-suite for comprehensive imaging and treatment.
Methods:
AIS patients eligible for EVT underwent MDCTP, then a CBCTP study on arrival in angio-suite. Of 939 admitted June 2017-April 2019, 226 (24%) received EVT. Of these 54 (35%) were enrolled to receive additional CBCTP imaging. Inability to obtain consent and co-morbidities were major causes for non-enrollment. Times from the start of MDCTP to angio-suite and from angio-suite arrival to first arterial image were recorded. Acquired CBCTP data were reconstructed and processed with an in-house toolbox. MDCTP and CBCTP data were matched for slice thickness and angulation and were processed using RAPID CTP (iSchemaView, Inc.). The rCBF, rCBV, MTT, tMAX maps were randomized to generate 3 unique evaluation sets. 3 neuroradiologists scored diagnostic image quality, artifacts, mismatch pattern detection and EVT indication using 5-point Likert scales. Stroke laterality was compared with the clinical standard for diagnostic accuracy.
Results:
Accuracies for stroke diagnosis are 97% [95%, 97%] with MDCTP and 92% [90%, 95%] with CBCTP. Cohen’s Kappa between observers is 0.90 for MDCTP-based diagnosis and 0.89 for CBCTP-based diagnosis. Scores of CBCTP to make the stroke diagnosis, detect mismatch pattern, and make treatment decision were non-inferior to corresponding scores for MDCTP (alpha=0.05) within 10% of the whole score range. Subjective scores of MDCTP for image quality and artifacts were slightly superior to those of CBCTP (1.8 vs. 2.3, p<0.01).
Conclusions:
In this study, a direct to angio-suite workflow provided non-inferior perfusion imaging for AIS patient triage while saving nearly one hour per patient.
Details
- Title: Subtitle
- Abstract 55: Comparison of Sequential Multi-Detector CT and Cone-Beam CT Perfusion Maps in 54 Subjects With an Acute Ischemic Stroke
- Creators
- Laura Eisenmenger - University of Wisconsin–MadisonKelly Capel - University of Wisconsin–MadisonJohn Garrett - University of Wisconsin–MadisonKe Li - University of Wisconsin–MadisonYinsheng Li - University of Wisconsin–MadisonAzam Ahmed - University of Wisconsin–MadisonDavid Niemann - University of Wisconsin–MadisonDalton Griner - University of Wisconsin–MadisonEdgar Samaniego - University of IowaSantiago Ortega-Gutierrez - University of IowaColin Derdeyn - University of IowaSebastian Schafer - Siemens HealthcareCharles Strother - University of Wisconsin–MadisonGuang-Hong Chen - University of Wisconsin–MadisonBeverly Aagaard Kienitz - University of Wisconsin–Madison
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.51(Suppl_1)
- DOI
- 10.1161/str.51.suppl_1.55
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Neurosurgery; Radiology; Neurology; Iowa Neuroscience Institute
- Record Identifier
- 9984303436102771
Metrics
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