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JOURNAL ARTICLE
Zhixin Cao, David Wang, Xueyan Feng, Pengfei Yang, Hao Wang, Ziqi Xu, Yahui Hao, Wanxing Ye, Fengwei Chen, Liyuan Wang, Manjun Hao, Na Wu, Kai-Xuan Yang, Yunyun Xiong, Yongjun Wang
INTRODUCTION: To compare the perfusion volumes assessed by a new automated CT perfusion (CTP) software iStroke with the circular singular value decomposition software RAPID and determine its predictive value for functional outcome in patients with acute ischaemic stroke (AIS) who underwent endovascular treatment (EVT). METHODS: Data on patients with AIS were collected from four hospitals in China. All patients received CTP followed by EVT with complete recanalisation within 24 hours of symptom onset...
March 28, 2024: Stroke and Vascular Neurology
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JOURNAL ARTICLE
Dhairya A Lakhani, Aneri B Balar, Manisha Koneru, Sijin Wen, Burak Berksu Ozkara, Hanzhang Lu, Richard Wang, Meisam Hoseinyazdi, Janet Mei, Risheng Xu, Mehreen Nabi, Ishan Mazumdar, Andrew Cho, Kevin Chen, Sadra Sepehri, Nathan Hyson, Victor Urrutia, Licia Luna, Argye E Hillis, Jeremy J Heit, Greg W Albers, Ansaar T Rai, Adam A Dmytriw, Tobias Faizy, Max Wintermark, Kambiz Nael, Vivek S Yedavalli
Background: The pretreatment CT perfusion (CTP) marker the relative cerebral blood volume (rCBV) < 42% lesion volume has recently been shown to predict 90-day functional outcomes; however, studies assessing correlations of the rCBV < 42% lesion volume with other outcomes remain sparse. Here, we aim to assess the relationship between the rCBV < 42% lesion volume and the reference standard digital subtraction angiography (DSA)-derived American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN) collateral score, hereby referred as the DSA CS...
March 10, 2024: Journal of Clinical Medicine
#43
JOURNAL ARTICLE
Hulin Kuang, Xianzhen Tan, Jie Wang, Zhe Qu, Yuxin Cai, Qiong Chen, Beom Joon Kim, Wu Qiu
Differentiating between a salvageable Ischemic Penumbra (IP) and an irreversibly damaged Infarct Core (IC) is important for therapy decision making for acute ischemic stroke (AIS) patients. Existing methods rely on Computed Tomography Perfusion (CTP) or Diffusion-Weighted Imaging-Fluid Attenuated Inversion Recovery (DWI-FLAIR). We designed a novel Convolutional Neural Network named I2PC-Net, which relies solely on Non-Contrast Computed Tomography (NCCT) for the automatic and simultaneous segmentation of the IP and IC...
March 5, 2024: Biomedicines
#44
JOURNAL ARTICLE
Alejandro Gutierrez, Kimberly Amador, Anthony Winder, Matthias Wilms, Jens Fiehler, Nils D Forkert
Acute ischemic stroke is a critical health condition that requires timely intervention. Following admission, clinicians typically use perfusion imaging to facilitate treatment decision-making. While deep learning models leveraging perfusion data have demonstrated the ability to predict post-treatment tissue infarction for individual patients, predictions are often represented as binary or probabilistic masks that are not straightforward to interpret or easy to obtain. Moreover, these models typically rely on large amounts of subjectively segmented data and non-standard perfusion analysis techniques...
March 23, 2024: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
#45
JOURNAL ARTICLE
Jan W Hoving, Praneeta R Konduri, Manon L Tolhuisen, Miou S Koopman, Henk van Voorst, Laura M Van Poppel, Jasper D Daems, Adriaan C G M van Es, Marianne A A van Walderveen, Hester F Lingsma, Diederik W J Dippel, Wim H Van Zwam, Henk A Marquering, Charles B L M Majoie, Bart J Emmer
BACKGROUND: Computed tomography perfusion (CTP)-estimated core volume is associated with functional outcomes in acute ischemic stroke. This relationship might differ among patients, depending on brain volume. MATERIALS AND METHODS: We retrospectively included patients from the MR CLEAN Registry. Cerebrospinal fluid (CSF) and intracranial volume (ICV) were automatically segmented on NCCT. We defined the proportion of the ICV and total brain volume (TBV) affected by the ischemic core as ICVcore and TBVcore ...
February 28, 2024: Journal of Cardiovascular Development and Disease
#46
JOURNAL ARTICLE
Dhairya A Lakhani, Aneri B Balar, Manisha Koneru, Sijin Wen, Burak Berksu Ozkara, Richard Wang, Meisam Hoseinyazdi, Mehreen Nabi, Ishan Mazumdar, Andrew Cho, Kevin Chen, Sadra Sepehri, Nathan Hyson, Risheng Xu, Victor Urrutia, Licia Luna, Argye E Hillis, Jeremy J Heit, Greg W Albers, Ansaar T Rai, Vivek S Yedavalli
BACKGROUND: Collateral status (CS) is an important biomarker of functional outcomes in patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO). Pretreatment CT perfusion (CTP) parameters serve as reliable surrogates of collateral status (CS). In this study, we aim to assess the relationship between the relative cerebral blood flow less than 38% (rCBF <38%), with the reference standard American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score (CS) on DSA...
March 25, 2024: Neuroradiology Journal
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JOURNAL ARTICLE
Bettina L Serrallach, Adnan Mujanovic, Nikolaos Ntoulias, Michael Manhart, Mattia Branca, Alex Brehm, Marios-Nikos Psychogios, Christoph C Kurmann, Eike I Piechowiak, Sara Pilgram-Pastor, Thomas Meinel, David Seiffge, Pasquale Mordasini, Jan Gralla, Tomas Dobrocky, Johannes Kaesmacher
PURPOSE: Flat-panel detector computed tomography (FDCT) is increasingly used in (neuro)interventional angiography suites. This study aimed to compare FDCT perfusion (FDCTP) with conventional multidetector computed tomography perfusion (MDCTP) in patients with acute ischemic stroke. METHODS: In this study, 19 patients with large vessel occlusion in the anterior circulation who had undergone mechanical thrombectomy, baseline MDCTP and pre-interventional FDCTP were included...
March 25, 2024: Clinical Neuroradiology
#48
JOURNAL ARTICLE
Arkadiusz Siennicki-Lantz, Lena André-Petersson, Sölve Elmståhl
AIMS: Cognitive and perfusion changes have been previously observed in older men with Mini Mental State Examination scores>24 points. We aimed to investigate time change in cognitive domains in a cohort of non-demented men between age 68 and 82, and how they are expressed in regional defects estimated by Cerebral Blood Flow (rCBF). METHODS: 103 men at age 81 with MMSE scores >24 (mean 28.4 ± 1.7), no dementia or stroke, were examined with the same cognitive test battery at age 68 and age 81: Synonyms (SRB-1), Block design (SRB-3), Paired Associates, Digit Symbol Substitution and Benton Visual Retention test...
2024: Cerebral circulation—cognition and behavior
#49
JOURNAL ARTICLE
Huazheng Zhai, Yao Li, Ruiqi Jia, Jun Cao, Qiang Wei, Weimin Yang, Jingye Wang
OBJECTIVES: Blood-brain barrier (BBB) disruption is an important pathological change after cerebral infarction that exacerbates brain injury. We aimed to investigate and compare the predictive utility of pre-treatment BBB permeability (BBBP) and BBBP within 1 h after endovascular treatment (EVT) for hemorrhagic transformation (HT) and 90-day prognosis. METHODS: Patients underwent preoperative computed tomography perfusion (CTP) and non-contrast CT (NCCT) within 1 h after EVT...
March 25, 2024: Neurological Sciences
#50
REVIEW
Anthony Pereira, Vafa Alakbarzade, Deborah Lowe, David Hargroves
BACKGROUND: Traditionally, non-contrast computed tomography (CT) alone was used in the initial assessment of acute ischaemic stroke patients mainly to exclude haemorrhage or alternative pathology. SUMMARY: Late-window (beyond 6 hours) and recent large-volume endovascular mechanical thrombectomy (MT) trials integrated CT Perfusion (CTP) imaging to guide MT and/or intravenous thrombolysis (IVT) decision-making in stroke patients. KEY MESSAGES: In current clinical practice, many patients are being excluded from reperfusion therapy due to a lack of data from urgent investigations to assess cerebral vasculature and perfusion...
March 20, 2024: Cerebrovascular Diseases
#51
JOURNAL ARTICLE
Hamza Salim, Dhairya A Lakhani, Aneri Balar, Basel Musmar, Nimer Adeeb, Meisam Hoseinyazdi, Licia Luna, Francis Deng, Nathan Z Hyson, Janet Mei, Adam A Dmytriw, Adrien Guenego, Tobias D Faizy, Jeremy J Heit, Gregory W Albers, Victor C Urrutia, Raf Llinas, Elisabeth B Marsh, Argye E Hillis, Kambiz Nael, Vivek Yedavalli
BACKGROUND: Distal medium vessel occlusions (DMVOs) contribute substantially to the incidence of acute ischemic strokes (AIS) and pose distinct challenges in clinical management and prognosis. Neuroimaging techniques, such as Fluid Attenuation Inversion Recovery (FLAIR) imaging and cerebral blood volume (CBV) index derived from perfusion imaging, have significantly improved our ability to assess the impact of strokes and predict their outcomes. The primary objective of this study was to investigate relationship between follow-up infarct volume (FIV) as assessed by FLAIR imaging in patients with DMVOs...
March 20, 2024: Journal of Neurology
#52
JOURNAL ARTICLE
Hannah R Rowling, Dominic Italiano, Leonid Churilov, Logesh Palanikumar, Jackson Harvey, Timothy Kleinig, Mark Parsons, Peter Mitchell, Stephen M Davis, Nyika Kruyt, Bruce Campbell, Henry Zhao
BACKGROUND: Patients with large vessel occlusion (LVO) stroke presenting with milder baseline clinical severity are common and require endovascular thrombectomy. However, such patients are difficult to recognize using pre-hospital severity-based triage tools and therefore are likely to require a secondary inter-hospital transfer if transported to a non-thrombectomy center. Given the potential for milder severity to represent better underlying cerebrovascular collateral circulation, it is unknown whether transfer delays are still associated with poorer post-stroke outcomes in this patient group...
March 20, 2024: International Journal of Stroke: Official Journal of the International Stroke Society
#53
COMPARATIVE STUDY
Vignan Yogendrakumar, James Beharry, Leonid Churilov, Lauren Pesavento, Khairuinnisa Alidin, Melissa Ugalde, Louise Weir, Peter J Mitchell, Timothy J Kleinig, Nawaf Yassi, Vincent N Thijs, Teddy Y Wu, Helen Brown, Helen M Dewey, Tissa Wijeratne, Bernard Yan, Gagan J Sharma, Patricia Desmond, Mark W Parsons, Geoffrey A Donnan, Stephen M Davis, Bruce C V Campbell
BACKGROUND AND OBJECTIVES: Early treatment with intravenous alteplase increases the probability of lytic-induced reperfusion in large vessel occlusion (LVO) patients. The relationship of tenecteplase-induced reperfusion and the timing of thrombolytic administration has not been explored. In this study, we performed a comparative analysis of tenecteplase and alteplase reperfusion rates and assessed their relationship to the time of thrombolytic administration. METHODS: Patients who were initially treated with a thrombolytic within 4...
April 9, 2024: Neurology
#54
JOURNAL ARTICLE
Alexander Rau, Marco Reisert, Thomas Stein, Katharina Mueller-Peltzer, Stephan Rau, Fabian Bamberg, Christian A Taschner, Horst Urbach, Elias Kellner
PURPOSE: CT perfusion of the brain is a powerful tool in stroke imaging, though the radiation dose is rather high. Several strategies for dose reduction have been proposed, including increasing the intervals between the dynamic scans. We determined the impact of temporal resolution on perfusion metrics, therapy decision, and radiation dose reduction in brain CT perfusion from a large dataset of patients with suspected stroke. METHODS: We retrospectively included 3555 perfusion scans from our clinical routine dataset...
March 18, 2024: Neuroradiology
#55
JOURNAL ARTICLE
Yi Sui, Wenhuo Chen, Chushuang Chen, Yanting Chang, Andrew Bivard, Peng Wang, Yu Geng, Mark Parsons, Longting Lin
BACKGROUND: Recent trials confirmed the effectiveness of endovascular therapy in patients with large ischemic cores. Yet the optimal neuroimaging modalities to define large core remains unclear. We tried to address this question by comparing the functional outcomes in patients receiving thrombectomy selected by either noncontrast computed tomography Alberta Stroke Program Early Computed Tomography Score (ASPECTS) or Computed Tomography perfusion (CTP). METHODS: This study retrospectively selected patients enrolled in the International Stroke Perfusion Registry between August 2011 and April 2022...
March 15, 2024: Stroke; a Journal of Cerebral Circulation
#56
JOURNAL ARTICLE
Vivek S Yedavalli, Manisha Koneru, Meisam Hoseinyazdi, Cynthia Greene, Dhairya A Lakhani, Risheng Xu, Licia P Luna, Justin M Caplan, Adam A Dmytriw, Adrien Guenego, Jeremy J Heit, Gregory W Albers, Max Wintermark, L Fernando Gonzalez, Victor C Urrutia, Judy Huang, Kambiz Nael, Richard Leigh, Elisabeth B Marsh, Argye E Hillis, Rafael H Llinas
BACKGROUND: Poor venous outflow (VO) profiles are associated with unfavorable outcomes in patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO), despite achieving successful reperfusion. The objective of this study is to assess the association between mortality and prolonged venous transit (PVT), a novel visual qualitative VO marker on CT perfusion (CTP) time to maximum (Tmax) maps. METHODS: We performed a retrospective analysis of prospectively collected data from consecutive adult patients with AIS-LVO with successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b/2c/3)...
March 12, 2024: Journal of Neurointerventional Surgery
#57
JOURNAL ARTICLE
Yiying Pan, Pengjun Chen, Shunyang Chen, Yanjun Li, Junhe Wang, Shuiwei Xia, Jie Rao, Ruijie Gao, Chenying Lu, Jiansong Ji
OBJECTIVES: To investigate the relationship between baseline computed tomography perfusion deficit volumes and functional outcomes in patients with basilar artery occlusion (BAO) undergoing endovascular therapy. METHODS: This was a single-center study in which the data of 64 patients with BAO who underwent endovascular therapy were retrospectively analyzed. All the patients underwent multi-model computed tomography on admission. The posterior-circulation Acute Stroke Prognosis Early Computed Tomography Score was applied to assess the ischemic changes...
March 7, 2024: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
#58
JOURNAL ARTICLE
Jose Danilo Bengzon Diestro, Robert Fahed, Abdelsimar Tan Omar, Christine Hawkes, Eef J Hendriks, Clare Enriquez, Muneer Eesa, Grant Stotts, Hubert Lee, Shashank Nagendra, Alexandre Poppe, Célina Ducroux, Timothy Lim, Karl Narvacan, Michael Rizzuto, Afra Alfalahi, Hidehisa Nishi, Pragyan Sarma, Ze'ev Itsekson Hayosh, Katrina Ignacio, William Boisseau, Eduardo Pimenta Ribeiro Pontes Almeida, Anass Benomar, Mohammed A Almekhlafi, Genvieve Milot, Aviraj Deshmukh, Kislay Kishore, Donatella Tampieri, Jeffrey Wang, Abhilekh Srivastava, Daniel Roy, Federico Carpani, Nima Kashani, Claudia Candale-Radu, Nishita Singh, Maria Bres Bullrich, Robert Sarmiento, Ryan T Muir, Carmen Parra-Fariñas, Stephanie Reiter, Yan Deschaintre, Ravinder-Jeet Singh, Vivek Bodani, Aristeidis Katsanos, Ronit Agid, Atif Zafar, Vitor M Pereira, Julian Spears, Thomas R Marotta, Pascal Djiadeu, Sunjay Sharma, Forough Farrokhyar
BACKGROUND: Limited research exists regarding the impact of neuroimaging on endovascular thrombectomy (EVT) decisions for late-window cases of large vessel occlusion (LVO) stroke. OBJECTIVE: T0 assess whether perfusion CT imaging: (1) alters the proportion of recommendations for EVT, and (2) enhances the reliability of EVT decision-making compared with non-contrast CT and CT angiography. METHODS: We conducted a survey using 30 patients drawn from an institutional database of 3144 acute stroke cases...
March 7, 2024: Journal of Neurointerventional Surgery
#59
JOURNAL ARTICLE
Diane Philippe, Angélique Bernard, Frédéric Ricolfi, Yannick Béjot, Gauthier Duloquin, Pierre-Olivier Comby, Charles Guenancia
PURPOSE: The purpose of this study was to assess the type and prevalence of stroke and non-stroke-related findings diagnosed on early cardiac computed tomography (CT) in patients with suspected stroke. The secondary objective was to assess the clinical consequences on the management of patients with non-stroke-related conditions identified by early cardiac CT. MATERIALS AND METHODS: This single-center, retrospective, observational study included 1111 consecutive patients with suspected ischemic stroke between November 2018 and March 2020 who underwent cardiac CT examination in addition to the usual brain CT protocol (i...
March 1, 2024: Diagnostic and Interventional Imaging
#60
JOURNAL ARTICLE
Burak B Ozkara, Mert Karabacak, Meisam Hoseinyazdi, Samir A Dagher, Richard Wang, Sadik Y Karadon, F Eymen Ucisik, Konstantinos Margetis, Max Wintermark, Vivek S Yedavalli
BACKGROUND AND PURPOSE: We aimed to predict the functional outcome of acute ischemic stroke patients with anterior circulation large vessel occlusions (LVOs), irrespective of how they were treated or the severity of the stroke at admission, by only using imaging parameters in machine learning models. METHODS: Consecutive adult patients with anterior circulation LVOs who were scanned with CT angiography (CTA) and CT perfusion were queried in this single-center, retrospective study...
March 2, 2024: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
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