Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasets
Abstract To assess ischaemic penumbra through the post-processing of the spectral multiphasic CT Angiography (mCTA) data in acute ischaemic stroke (AIS) patients. Thirty one consecutive patients strongly suspected of severe Middle Cerebral Artery AIS presenting less than 6 h after onset of symptoms...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-07-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-38370-9 |
| _version_ | 1797778941486825472 |
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| author | T. Duprez A. Vlassenbroek A. Peeters P. A. Poncelet E. Levecque F. Austein G. Pahn Y. Nae S. Abdallah E. Coche |
| author_facet | T. Duprez A. Vlassenbroek A. Peeters P. A. Poncelet E. Levecque F. Austein G. Pahn Y. Nae S. Abdallah E. Coche |
| author_sort | T. Duprez |
| collection | DOAJ |
| description | Abstract To assess ischaemic penumbra through the post-processing of the spectral multiphasic CT Angiography (mCTA) data in acute ischaemic stroke (AIS) patients. Thirty one consecutive patients strongly suspected of severe Middle Cerebral Artery AIS presenting less than 6 h after onset of symptoms or with unknown time of onset of symptoms underwent a standardized CT protocol in spectral mode including Non Contrast CT, mCTA, and Perfusion CT (CTP) on a dual-layer MDCT system. Areas disclosing delayed enhancement on iodine density (ID) maps were highlighted by subtraction of the serial mCTA datasets. Two neuroradiologists independently rated the correspondence between delayed enhancing areas at mCTA and the penumbral/infarcted areas delineated by two validated CTP applications using a 5-levels scoring scale. Interobserver agreement between observers was evaluated by kappa statistics. Dose delivery was recorded for each acquisition. Averaged correspondence score between penumbra delineation using subtracted mCTA-derived ID maps and CTP ones was 2.76 for one application and 2.9 for the other with best interobserver agreement kappa value at 0.59. All 6 stroke mimics out of the 31 patients’ cohort were correctly identified. Average dose delivery was 7.55 mSv for the whole procedure of which CTP accounted for 39.7%. Post-processing of spectral mCTA data could allow clinically relevant assessment of the presence or absence of ischaemic penumbra in AIS-suspected patients if results of this proof-of-concept study should be confirmed in larger patients’series. |
| first_indexed | 2024-03-12T23:24:47Z |
| format | Article |
| id | doaj.art-ff6d8f3451104080b7b7b5552255e20c |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-12T23:24:47Z |
| publishDate | 2023-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-ff6d8f3451104080b7b7b5552255e20c2023-07-16T11:16:15ZengNature PortfolioScientific Reports2045-23222023-07-0113111010.1038/s41598-023-38370-9Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasetsT. Duprez0A. Vlassenbroek1A. Peeters2P. A. Poncelet3E. Levecque4F. Austein5G. Pahn6Y. Nae7S. Abdallah8E. Coche9Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain)CT/AMI Clinical Science, Philips Health SystemsDepartment of Neurology, Stroke Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain)Department of Medical Imaging, Grand Hôpital de Charleroi (GHdC)Department of Neurology, Stroke Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain)Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-EppendorfPD CT/AMI Clinical Science, Philips GmbH Market DACHCT/AMI Clinical Science, Advanced Technologies Center, Philips Medical Systems Technologies Ltd.CT/AMI Clinical Science, Advanced Technologies Center, Philips Medical Systems Technologies Ltd.Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain)Abstract To assess ischaemic penumbra through the post-processing of the spectral multiphasic CT Angiography (mCTA) data in acute ischaemic stroke (AIS) patients. Thirty one consecutive patients strongly suspected of severe Middle Cerebral Artery AIS presenting less than 6 h after onset of symptoms or with unknown time of onset of symptoms underwent a standardized CT protocol in spectral mode including Non Contrast CT, mCTA, and Perfusion CT (CTP) on a dual-layer MDCT system. Areas disclosing delayed enhancement on iodine density (ID) maps were highlighted by subtraction of the serial mCTA datasets. Two neuroradiologists independently rated the correspondence between delayed enhancing areas at mCTA and the penumbral/infarcted areas delineated by two validated CTP applications using a 5-levels scoring scale. Interobserver agreement between observers was evaluated by kappa statistics. Dose delivery was recorded for each acquisition. Averaged correspondence score between penumbra delineation using subtracted mCTA-derived ID maps and CTP ones was 2.76 for one application and 2.9 for the other with best interobserver agreement kappa value at 0.59. All 6 stroke mimics out of the 31 patients’ cohort were correctly identified. Average dose delivery was 7.55 mSv for the whole procedure of which CTP accounted for 39.7%. Post-processing of spectral mCTA data could allow clinically relevant assessment of the presence or absence of ischaemic penumbra in AIS-suspected patients if results of this proof-of-concept study should be confirmed in larger patients’series.https://doi.org/10.1038/s41598-023-38370-9 |
| spellingShingle | T. Duprez A. Vlassenbroek A. Peeters P. A. Poncelet E. Levecque F. Austein G. Pahn Y. Nae S. Abdallah E. Coche Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasets Scientific Reports |
| title | Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasets |
| title_full | Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasets |
| title_fullStr | Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasets |
| title_full_unstemmed | Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasets |
| title_short | Preliminary experience of CT imaging of the ischaemic brain penumbra through spectral processing of multiphasic CTA datasets |
| title_sort | preliminary experience of ct imaging of the ischaemic brain penumbra through spectral processing of multiphasic cta datasets |
| url | https://doi.org/10.1038/s41598-023-38370-9 |
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