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CT perfusion extended window ischemic core estimation: Bayesian algorithm versus oscillation index singular value

Nicola Morelli1,2, Paolo Immovilli1, Elena Giacopazzi3

  • 1Neurology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|February 13, 2023
PubMed

Insights

The Bayesian algorithm shows higher accuracy than oSVD in estimating the ischemic core using CT perfusion in stroke patients, improving reperfusion therapy selection.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Accurate ischemic core estimation via CT perfusion (CTp) is crucial for reperfusion therapies but challenged by data noise.
  • Two CTp postprocessing algorithms, Bayesian Method and oscillation index singular value decomposition (oSVD), were evaluated for diagnostic accuracy.

Purpose of the Study:

  • To assess the diagnostic accuracy of Bayesian Method and oSVD algorithms for ischemic core estimation.
  • To compare the agreement of these algorithms with diffusion-weighted imaging (DWI) in stroke patients.

Main Methods:

  • Retrospective analysis of stroke patients undergoing CTp and DWI in an extended time window (>4.5 hours).
  • Agreement assessment using Bland-Altman plots, Wilcoxon signed-rank test, Spearman's correlation, and intraclass correlation coefficient (ICC).

Main Results:

  • Twenty-four patients were included (average age 72 ± 15 years).
  • Excellent correlation was found between DWI and both algorithms (Bayesian: ρ=0.94; oSVD: ρ=0.87).
  • The Bayesian algorithm demonstrated a significantly stronger ICC with DWI (0.97) compared to oSVD (0.59).

Conclusions:

  • The Bayesian algorithm shows superior agreement with DWI for ischemic core estimation in the extended time window.
  • This enhanced accuracy may improve patient selection for reperfusion therapies.
Abstract

Keywords:
Bayesian algorithmCT perfusionextended windowischemic coresingular value decompositionstroke

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