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research article

Integrating regional perfusion CT information to improve prediction of infarction after stroke

Klug, Julian
•
Dirren, Elisabeth
•
Preti, Maria G.  
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June 5, 2020
Journal Of Cerebral Blood Flow And Metabolism

Physiological evidence suggests that neighboring brain regions have similar perfusion characteristics (vascular supply, collateral blood flow). It is largely unknown whether integrating perfusion CT (pCT) information from the area surrounding a given voxel (i.e. the receptive field (RF)) improves the prediction of infarction of this voxel. Based on general linear regression models (GLMs) and using acute pCT-derived maps, we compared the added value of cuboid RF to predict the final infarct. To this aim, we included 144 stroke patients with acute pCT and follow-up MRI, used to delineate the final infarct. Overall, the performance of GLMs to predict the final infarct improved when using RF for all pCT maps (cerebral blood flow, cerebral blood volume, mean transit time and time-to-maximum of the tissue residual function (Tmax)). The highest performance was obtained with Tmax (glm(Tmax); AUC = 0.89 +/- 0.03 with RF vs. 0.78 +/- 0.02 without RF; p < 0.001) and with a model combining all perfusion parameters (glm(multi); AUC 0.89 +/- 0.02 with RF vs. 0.79 +/- 0.02 without RF; p < 0.001). These results suggest that prediction of infarction improves by integrating perfusion information from adjacent tissue. This approach may be applied in future studies to better identify ischemic core and penumbra thresholds and improve patient selection for acute stroke treatment.

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Type
research article
DOI
10.1177/0271678X20924549
Web of Science ID

WOS:000538270700001

Author(s)
Klug, Julian
Dirren, Elisabeth
Preti, Maria G.  
Machi, Paolo
Kleinschmidt, Andreas
Vargas, Maria I
Van de Ville, Dimitri  
Carrera, Emmanuel
Date Issued

2020-06-05

Publisher

SAGE PUBLICATIONS INC

Published in
Journal Of Cerebral Blood Flow And Metabolism
Article Number

0271678X20924549

Subjects

Endocrinology & Metabolism

•

Hematology

•

Neurosciences

•

Endocrinology & Metabolism

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Hematology

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Neurosciences & Neurology

•

machine learning

•

prediction

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perfusion imaging

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receptive field

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stroke

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cerebral-blood-flow

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tissue fate

•

time

•

model

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
MIPLAB  
Available on Infoscience
June 19, 2020
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/169452
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