Correlation between pretreatment and follow-up infarct volume using CT perfusion imaging: the Bayesian versus
Hiroyuki Kawano1, Takuya Adachi2, Mikito Saito3
1Department of Stroke and Cerebrovascular Medicine, Kyorin University, 6-20-2, Shinkawa, Tokyo, Mitaka, 181-8611, Japan. hkawanoo@gmail.com.
The Bayesian method may better estimate final infarct volume in acute ischemic stroke patients than the singular value decomposition (SVD) method, especially for larger lesions. However, neither method is perfect for predicting infarct growth.
Area of Science:
- Neuroscience
- Radiology
- Medical Imaging
Background:
- Accurate estimation of pretreatment ischemic core volume is crucial for predicting follow-up infarct volume (FIV) in acute ischemic stroke (AIS) patients with successful recanalization.
- Discrepancies between pretreatment core volume and FIV, termed absolute difference (AD), can occur, impacting treatment efficacy assessment.
- Comparing different imaging analysis methods is essential for refining prognostic accuracy in AIS.
Purpose of the Study:
- To compare the absolute volume difference (AD) between pretreatment ischemic core volume and follow-up infarct volume (FIV) using Bayesian and singular value decomposition (SVD) methods.
- To investigate the influence of time from onset-to-imaging on the AD values calculated by both methods in AIS patients undergoing mechanical thrombectomy.
- To assess the correlation between pretreatment core volume and AD values for each method.
Main Methods:
- Retrospective analysis of 47 AIS patients with anterior large vessel occlusion treated within 24 hours.
- Patients underwent pretreatment CT perfusion (CTP) and 24-hour diffusion-weighted imaging (DWI) following successful mechanical thrombectomy (mTICI ≥ 2b).
- Absolute volume difference (AD) between FIV (measured on 24-h DWI) and pretreatment core volume was calculated using Bayesian and SVD methods; Spearman's rank correlation was used.
Main Results:
- Shorter onset-to-imaging times showed a trend towards larger AD values, more pronounced with the SVD method (rho = -0.28, p = 0.05) than the Bayesian method (rho = -0.08).
- Larger pretreatment core volumes were significantly correlated with larger AD values for both methods.
- This correlation was stronger for the SVD method (rho = 0.63, p < 0.01) compared to the Bayesian method (rho = 0.32, p = 0.03).
Conclusions:
- The Bayesian method demonstrated a potentially stronger correlation with FIV than the SVD method, particularly in cases with large ischemic lesions.
- Both methods showed limitations in perfectly predicting follow-up infarct volume, indicating room for methodological improvement.
- Further research is needed to optimize imaging analysis techniques for more accurate infarct volume prediction in AIS.
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