Detection of suspected brain infarctions on CT can be significantly improved with temporal subtraction images.

Objective: To assess whether temporal subtraction (TS) images of brain CT improve the detection of suspected brain infarctions.Methods: Study protocols were approved by our institutional review board, and informed consent was waived because of the retrospective nature of this study. Forty-two sets o...

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Publicado en:European Radiology Vol. 29; no. 2; pp. 759 - 770
Autores principales: Akasaka, Thai, Yakami, Masahiro, Nishio, Mizuho, Onoue, Koji, Aoyama, Gakuto, Nakagomi, Keita, Iizuka, Yoshio, Kubo, Takeshi, Emoto, Yutaka, Satoh, Kiyohide, Yamamoto, Hiroyuki, Togashi, Kaori
Formato: Journal Article
Publicado: Springer Nature Feb2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2019
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-018-5655-0
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        atl: Detection of suspected brain infarctions on CT can be significantly improved with temporal subtraction images.
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        au:
          Akasaka, Thai
          Yakami, Masahiro
          Nishio, Mizuho
          Onoue, Koji
          Aoyama, Gakuto
          Nakagomi, Keita
          Iizuka, Yoshio
          Kubo, Takeshi
          Emoto, Yutaka
          Satoh, Kiyohide
          Yamamoto, Hiroyuki
          Togashi, Kaori
        affil: Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Kyoto, Japan
      sug:
        subj:
          Infarction
          Subtraction Technique
          Tomography, X-Ray Computed Methods
          Male
          Algorithms
          Radiographic Image Interpretation, Computer-Assisted Methods
          Female
          Aged
          Aged, 80 and Over
          Sensitivity and Specificity
          Retrospective Design
          ROC Curve
          Middle Age
          Scales
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objective: To assess whether temporal subtraction (TS) images of brain CT improve the detection of suspected brain infarctions.Methods: Study protocols were approved by our institutional review board, and informed consent was waived because of the retrospective nature of this study. Forty-two sets of brain CT images of 41 patients, each consisting of a pair of brain CT images scanned at two time points (previous and current) between January 2011 and November 2016, were collected for an observer performance study. The 42 sets consisted of 23 cases with a total of 77 newly developed brain infarcts or hyperdense artery signs confirmed by two radiologists who referred to additional clinical information and 19 negative control cases. To create TS images, the previous images were registered to the current images by partly using a non-rigid registration algorithm and then subtracted. Fourteen radiologists independently interpreted the images to identify the lesions with and without TS images with an interval of over 4 weeks. A figure of merit (FOM) was calculated along with the jackknife alternative free-response receiver-operating characteristic analysis. Sensitivity, number of false positives per case (FPC) and reading time were analyzed by the Wilcoxon signed-rank test.Results: The mean FOM increased from 0.528 to 0.737 with TS images (p < 0.0001). The mean sensitivity and FPC improved from 26.5% and 0.243 to 56.0% and 0.153 (p < 0.0001 and p = 0.239), respectively. The mean reading time was 173 s without TS and 170 s with TS (p = 0.925).Conclusion: The detectability of suspected brain infarctions was significantly improved with TS CT images.Key Points: • Although it is established that MRI is superior to CT in the detection of strokes, the first choice of modality for suspected stroke patients is often CT. • An observer performance study with 14 radiologists was performed to evaluate whether temporal subtraction images derived from a non-rigid transformation algorithm can significantly improve the detectability of newly developed brain infarcts on CT. • Temporal subtraction images were shown to significantly improve the detectability of newly developed brain infarcts on CT.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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