RT Journal Article
SR Electronic
T1 What is the impact of head movement on automated CT perfusion mismatch evaluation in acute ischemic stroke?
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP neurintsurg-2021-017510
DO 10.1136/neurintsurg-2021-017510
A1 Arne Potreck
A1 Fatih Seker
A1 Matthias Anthony Mutke
A1 Charlotte Sabine Weyland
A1 Christian Herweh
A1 Sabine Heiland
A1 Martin Bendszus
A1 Markus Möhlenbruch
YR 2021
UL http://jnis.bmj.com/content/early/2021/07/21/neurintsurg-2021-017510.abstract
AB Objectives Automated CT perfusion mismatch assessment is an established treatment decision tool in acute ischemic stroke. However, the reliability of this method in patients with head motion is unclear. We therefore sought to evaluate the influence of head movement on automated CT perfusion mismatch evaluation.Methods Using a realistic CT brain-perfusion-phantom, 7 perfusion mismatch scenarios were simulated within the left middle cerebral artery territory. Real CT noise and artificial head movement were added. Thereafter, ischemic core, penumbra volumes and mismatch ratios were evaluated using an automated mismatch analysis software (RAPID, iSchemaView) and compared with ground truth simulated values.Results While CT scanner noise alone had only a minor impact on mismatch evaluation, a tendency towards smaller infarct core estimates (mean difference of −5.3 (−14 to 3.5) mL for subtle head movement and −7.0 (−14.7 to 0.7) mL for strong head movement), larger penumbral estimates (+9.9 (−25 to 44) mL and +35 (−14 to 85) mL, respectively) and consequently larger mismatch ratios (+0.8 (−1.5 to 3.0) for subtle head movement and +1.9 (−1.3 to 5.1) for strong head movement) were noted in dependence of patient head movement.Conclusions Motion during CT perfusion acquisition influences automated mismatch evaluation. Potentially treatment-relevant changes in mismatch classifications in dependence of head movement were observed and occurred in favor of mechanical thrombectomy.The datasets generated and/or analyzed during this research are available from the corresponding author upon reasonable request.