Computed Tomography Perfusion Data for Acute Ischemic Stroke Evaluation Using Rapid Software: Pitfalls of Automated Postprocessing

Frans Kauw; Jeremy J Heit; Blake W Martin; Fasco van Ommen; L Jaap Kappelle; Birgitta K Velthuis; Hugo W A M de Jong; Jan W Dankbaar; Max Wintermark

doi:10.1097/RCT.0000000000000946

Computed Tomography Perfusion Data for Acute Ischemic Stroke Evaluation Using Rapid Software: Pitfalls of Automated Postprocessing

J Comput Assist Tomogr. 2020 Jan/Feb;44(1):75-77. doi: 10.1097/RCT.0000000000000946.

Authors

Frans Kauw, Jeremy J Heit¹, Blake W Martin¹, Fasco van Ommen, L Jaap Kappelle², Birgitta K Velthuis³, Hugo W A M de Jong³, Jan W Dankbaar³, Max Wintermark¹

Affiliations

¹ From the Department of Neuroradiology, Stanford University, Palo Alto, CA.
² Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
³ Department of Radiology.

PMID: 31804241
DOI: 10.1097/RCT.0000000000000946

Abstract

Computed tomography perfusion (CTP) is increasingly used to determine treatment eligibility for acute ischemic stroke patients. Automated postprocessing of raw CTP data is routinely used, but it can fail. In reviewing 176 consecutive acute ischemic stroke patients, failures occurred in 20 patients (11%) during automated postprocessing by the RAPID software. Failures were caused by motion (n = 11, 73%), streak artifacts (n = 2, 13%), and poor contrast bolus arrival (n = 2, 13%). Stroke physicians should review CTP results with care before they are being integrated in their decision-making process.

MeSH terms

Aged
Aged, 80 and over
Brain Ischemia / diagnostic imaging*
Electronic Data Processing / methods*
Female
Humans
Male
Middle Aged
Perfusion Imaging / methods
Radiographic Image Interpretation, Computer-Assisted / methods*
Risk Factors
Sensitivity and Specificity
Software
Stroke / diagnostic imaging*
Tomography, X-Ray Computed