Differences in CT Perfusion Summary Maps for Patients with Acute Ischemic Stroke Generated by 2 Software Packages
Differences in CT Perfusion Summary Maps for Patients with Acute Ischemic Stroke Generated by 2 Software Packages
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DOI：
10.3174/ajnr.a3110
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发表时间：
2012-12-01
影响因子：
3.5
通讯作者：
Majoie, C. B.
中科院分区：
文献类型：
--
作者：
Fahmi, F.;Marquering, H. A.;Majoie, C. B.
背景和目的：虽然CT灌注是一种很有前途的工具，以支持急性缺血性卒中患者的治疗决策，它仍然缺乏一个标准化的方法CTP分析。本研究的目的是评估梗死核心和半暗带的面积的变异性，在由2个不同的软件package.MATERIALS和METHODS产生的摘要地图：41 CTP图像数据集的26个连续的急性缺血性卒中患者进行了回顾性评价。通过使用2种不同的市售CTP分析软件包分析相同的图像数据集，每种软件包代表广泛使用的主流算法：延迟敏感和延迟不敏感。Bland-Altman分析用于评价两种方法在确定总结图中梗死核心区和半暗带区面积方面的一致性水平。结果：两种软件包在梗死核心区面积（-23.6 +/- 25.6 cm（2））和半暗带区面积（15.8 +/- 25.3 cm（2））方面存在统计学显著差异。对于总结图中显示的所有区域，Bland-Altman间期一致性限值大于100 cm（2）。结论：由2种常用软件包生成的CTP总结图的梗死核心和半影区有显著差异，强调在将CTP分析应用于临床实践中的患者管理之前，需要对其进行标准化和验证。
BACKGROUND AND PURPOSE: Although CT perfusion is a promising tool to support treatment decisions for patients with acute ischemic stroke, it still lacks a standardized method for CTP analysis. The purpose of this study was to assess the variability of the area of infarct core and penumbra as presented in summary maps produced by 2 different software packages.MATERIALS AND METHODS: Forty-one CTP image datasets of 26 consecutive patients who presented with acute ischemic stroke were retrospectively evaluated. Identical image datasets were analyzed by using 2 different commercially available CTP analysis software packages, each representing a mainstream of widely used algorithms: delay-sensitive and delay-insensitive. Bland-Altman analyses were performed to evaluate the level of agreement between the 2 methods in determining the area of infarct core and penumbra area in the summary maps.RESULTS: There was a statistically significant difference in infarct core area (-23.6 +/- 25.6 cm(2)) and penumbra area (15.8 +/- 25.3 cm(2)) between the 2 software packages. For all the areas presented in the summary maps, the Bland-Altman interval limit of agreement was larger than 100 cm(2).CONCLUSIONS: The infarct core and penumbra area of CTP summary maps generated by 2 commonly used software packages were significantly different, emphasizing the need for standardization and validation of CTP analysis before it can be applied to patient management in clinical practice.