A benchmarking tool to evaluate computer tomography perfusion infarct core predictions against a DWI standard

J Cereb Blood Flow Metab. 2016 Oct;36(10):1780-1789. doi: 10.1177/0271678X15610586. Epub 2015 Oct 19.


Differences in research methodology have hampered the optimization of Computer Tomography Perfusion (CTP) for identification of the ischemic core. We aim to optimize CTP core identification using a novel benchmarking tool. The benchmarking tool consists of an imaging library and a statistical analysis algorithm to evaluate the performance of CTP. The tool was used to optimize and evaluate an in-house developed CTP-software algorithm. Imaging data of 103 acute stroke patients were included in the benchmarking tool. Median time from stroke onset to CT was 185 min (IQR 180-238), and the median time between completion of CT and start of MRI was 36 min (IQR 25-79). Volumetric accuracy of the CTP-ROIs was optimal at an rCBF threshold of <38%; at this threshold, the mean difference was 0.3 ml (SD 19.8 ml), the mean absolute difference was 14.3 (SD 13.7) ml, and CTP was 67% sensitive and 87% specific for identification of DWI positive tissue voxels. The benchmarking tool can play an important role in optimizing CTP software as it provides investigators with a novel method to directly compare the performance of alternative CTP software packages.

Keywords: Cerebrovascular disease; brain imaging; brain ischemia; cerebral blood flow measurement; diffusion weighted MRI.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Benchmarking
  • Brain / blood supply
  • Brain / diagnostic imaging
  • Cerebral Infarction / diagnostic imaging*
  • Cerebral Infarction / etiology
  • Cerebrovascular Circulation
  • Computed Tomography Angiography / methods*
  • Diffusion Magnetic Resonance Imaging / methods*
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Predictive Value of Tests
  • Software
  • Stroke / complications
  • Stroke / diagnostic imaging*
  • Time Factors