A Quantitative Method Using Head Noncontrast CT Scans to Detect Hyperacute Nonvisible Ischemic Changes in Patients With Stroke

Gomolka, Ryszard; Chrzan, Robert; Urbanik, Andrzej; Nowinski, Wiesław L.

doi:10.1111/jon.12363

Cited by 18 publications

(14 citation statements)

References 31 publications

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“…One patient did not meet the reperfusion inclusion criteria and was excluded. The 5 patients included had a mean age of 59 (standard deviation (SD) = ±8.8) years, a median National Institute of Health Stroke Scale of 13 (interquartile range, [10][11][12][13][14], and a mean time from symptom onset until CT scan of 4.95 (SD, ±3.5; range, 1.05-10.45) hours. Three patients had Internal Carotid Artery occlusions and two had Middle Cerebral Artery occlusions.…”

Section: Resultsmentioning

confidence: 99%

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A Relative Noncontrast CT Map to Detect Early Ischemic Changes in Acute Stroke

Srivatsan

Christensen

Lansberg

2019

Journal of Neuroimaging

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BACKGROUND AND PURPOSE Early ischemic changes on noncontrast computed tomography (NCCT) are often subtle. We developed a novel postprocessing technique that aids in detecting such changes. METHODS NCCT maps were generated that display the relative density difference between corresponding voxels in contralateral hemispheres (ratio maps of the NCCT [rNCCT]). Voxels with a relative density difference below .95 were designated as infarct. We pilot tested the rNCCT for infarct segmentation on 6 consecutive subjects enrolled in the CT Perfusion to predict Response in Ischemic Stroke Project (CRISP) study and applied the inclusion criteria of an adequate quality NCCT and successful endovascular reperfusion. rNCCT infarct segmentation was compared to baseline NCCT, baseline CTP, and day‐5 follow‐up fluid‐attenuated inversion recovery (FLAIR). RESULTS Five of the six selected cases met the inclusion criteria. Their median time from symptom onset to CT was 4.95 hours (standard deviation [SD], ±3.5; range, 1.05‐10.45), and median NIHSS was 13. Early ischemic changes were identified on the rNCCT in all five cases and on the standard NCCT in three of the five cases. Lesions outlined by the rNCCT maps trended toward a better estimation of the day‐5 FLAIR volume (median difference = 6.2 mL) than the ischemic core volumes assessed on baseline CTP (median difference = 51.7 mL) in the four cases with a day‐5 FLAIR (P = .1). CONCLUSION In this proof‐of‐concept study, the rNCCT appears promising for detecting and quantifying early ischemic changes. These findings should be confirmed in a larger cohort.

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Section: Resultsmentioning

confidence: 99%

“…Other previous studies that have exploited asymmetry did not use a voxel‐based reference. Instead, they used as a reference either the entire contralesional hemisphere or large regions defined by the ASPECT scale, a 10‐point scale that describes the extent of early ischemic changes in 10 brain regions …”

Section: Discussionmentioning

confidence: 99%

A Relative Noncontrast CT Map to Detect Early Ischemic Changes in Acute Stroke

Srivatsan

Christensen

Lansberg

2019

Journal of Neuroimaging

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“…The promising results obtained for early ischemic stroke detection encouraged us to further study the SIM to improve its performance for hyperacute ischemic stroke. Two quantities were studied in the SIM formula: (1) parameter selection and their value setting as well as (2) its components (Gomolka et al, 2016).…”

Section: Modified Sim-based Methodsmentioning

confidence: 99%

“…As previously reported in Gomolka et al (2016) the modified SIM method was evaluated on 70 early (for the detection) and 70 follow-up (to set of the gold standard) ischemic stroke scans from two centers. The best performance was obtained for the P-ratio including seven percentile subranges within the range of 35th-75th percentile achieving a 76% ischemic hemisphere detection rate and 54% sensitivity in spatial localization of hyperacute ischemia.…”

Section: Modified Sim-based Methodsmentioning

confidence: 99%

Ischemic infarct detection, localization, and segmentation in noncontrast CT human brain scans: review of automated methods

Nowinski

Walecki

Półtorak-Szymczak

et al. 2020

PeerJ

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Noncontrast Computed Tomography (NCCT) of the brain has been the first-line diagnosis for emergency evaluation of acute stroke, so a rapid and automated detection, localization, and/or segmentation of ischemic lesions is of great importance. We provide the state-of-the-art review of methods for automated detection, localization, and/or segmentation of ischemic lesions on NCCT in human brain scans along with their comparison, evaluation, and classification. Twenty-two methods are (1) reviewed and evaluated; (2) grouped into image processing and analysis-based methods (11 methods), brain atlas-based methods (two methods), intensity template-based methods (1 method), Stroke Imaging Marker-based methods (two methods), and Artificial Intelligence-based methods (six methods); and (3) properties of these groups of methods are characterized. A new method classification scheme is proposed as a 2 × 2 matrix with local versus global processing and analysis, and density versus spatial sampling. Future studies are necessary to develop more efficient methods directed toward deep learning methods as well as combining the global methods with a high sampling both in space and density for the merged radiologic and neurologic data.

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“…Newer technologies delivered us a multidetector CT scanners with full brain coverage in a single rotation (36). This can be essential in evaluation of acute conditions such as ischemic stroke and that is why improvements in this area should be made, especially regarding the reduction of radiation doses by use of low dose imaging (37,38).…”

Section: The Role Of Computed Tomography In Imaging Of Acute Ischemicmentioning

confidence: 99%

The role of computed tomography in evaluation of the acute ischemic stroke

Vojinović¹,

Opančina²

2016

Medicinski casopis

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A Quantitative Method Using Head Noncontrast CT Scans to Detect Hyperacute Nonvisible Ischemic Changes in Patients With Stroke

Abstract: The improved SIM is a dedicated and potentially useful tool for hyperacute nonvisible brain infarct detection from CT scans and may contribute to reduction of image-to-needle time in patients eligible for revascularization therapy.

Cited by 18 publications

References 31 publications

A Relative Noncontrast CT Map to Detect Early Ischemic Changes in Acute Stroke

A Relative Noncontrast CT Map to Detect Early Ischemic Changes in Acute Stroke

Ischemic infarct detection, localization, and segmentation in noncontrast CT human brain scans: review of automated methods

The role of computed tomography in evaluation of the acute ischemic stroke

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