Related Experiment Video
Updated: May 22, 2026
Integrated Photoacoustic, Ultrasound, and Angiographic Tomography (PAUSAT) for NonInvasive Whole-Brain Imaging of Ischemic Stroke
Published on: June 2, 2023
Differences in CT perfusion summary maps for patients with acute ischemic stroke generated by 2 software packages
F Fahmi1, H A Marquering, G J Streekstra
1Departments of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, the Netherlands. f.fahmi@amc.uva.nl
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.
