Automated Infarct Core Volumetry Within the Hypoperfused Tissue: Technical Implementation and Evaluation.

Area of Science:

• Neuroimaging
• Stroke Research
• Medical Image Analysis

Background:

• Acute ischemic stroke requires accurate assessment of infarct core and tissue at risk.
• Current volumetry methods can be time-consuming and lack patient-specific normalization.

Purpose of the Study:

• To develop a rapid, fully automatic method for infarct core and tissue at risk volumetry in acute ischemic stroke.
• To compare the proposed method against existing global thresholding techniques.

Main Methods:

• A novel algorithm,
• Tmax inside
• , was developed, restricting segmentation to one hemisphere.
• Lesion characterization used the Tmax perfusion parameter with region-wise histogram comparison to a mirrored counterpart.
• The method was validated on 30 cases from a public dataset with ground-truth segmentations.

Main Results:

• The
• Tmax inside
• method demonstrated robust lesion identification.
• Dice coefficients for apparent diffusion coefficient (0.83 ± 0.22) and Tmax (0.80 ± 0.05) were significantly higher than global thresholding (0.53 ± 0.27 and 0.56 ± 0.18).

Conclusions:

• The
• Tmax inside
• method is superior to global thresholding for acute ischemic stroke volumetry.
• This approach enables evaluation of cerebral blood volume and flow changes using the contralateral hemisphere as a reference.