Different Ways of Estimating Postreperfusion Infarct Volume Have Comparable Results

By Reuters Staff

January 22, 2021

NEW YORK (Reuters Health) - In assessing post-reperfusion final infarct volume (FIV) and functional outcomes in certain stroke patients, noncontrast computed tomography (NCCT) e-Stroke Suite software performs similarly to RAPID computed tomography perfusion (CTP), according to a cross-sectional observational study.

The e-Stroke Suite software uses a machine-learning algorithm to provide a fully automated means of quantifying The Alberta Stroke Program Early CT Score (ASPECTS) and ischemic-core volumes on NCCT, researchers write in Stroke.

The approach has demonstrated sensitivity and specificity comparable to that achieved by experienced neuroradiologists in a various circumstances, Dr. Raul G. Nogueira of Emory University School of Medicine, in Atlanta, and colleagues add. However, they write, "the ability and accuracy of the e-Stroke Suite software to determine baseline ischemic core volumes has not been explored."

The RAPID software, they say, is used as part of their center's clinical stroke protocol. To compare it with the e-Stroke Suite, the researchers reviewed data on 479 patients with anterior-circulation large-vessel-occlusion strokes who underwent mechanical thrombectomy and achieved full reperfusion. Their mean age was 64 years and all had undergone an institutional imaging protocol including NCCT and CTP.

Median e-Stroke software NCCT core volume was 38.4 mL and median CTP core volume was 5 mL. Median FIV was 22.2 mL. The correlation between e-Stroke and CTP ischemic-core volumes was moderate (R=0.44; P<0.001).

This was also the case for e-Stroke software ischemic core and FIV (R=0.52; P<0.001) and CTP core and FIV (R=0.43; P<0.001).

Subgroup analysis showed that the two approached performed similarly in both early and late treatment windows. And "importantly," the authors write, multivariate analysis demonstrated that both e-Stroke software NCCT baseline ischemic core volume and RAPID CTP ischemic core volume were independently and comparably associated with good outcome at 90 days.

"NCCT e-Stroke volumes seem to represent a viable alternative in centers where access to advanced imaging is limited," the team concludes, adding that "the future development of fusion maps of NCCT and CTP ischemic core estimates may improve upon the current performance of these tools as applied in isolation."

Dr. Nogueira did not respond to requests for comments.

SOURCE: https://bit.ly/3p6D9TY Stroke, online January 12, 2021.

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