ASPECTS estimation using dual-energy CTA-derived virtual non-contrast in large vessel occlusion acute ischemic stroke: a dose reduction opportunity for patients undergoing repeat CT?
Purpose: Recent studies have shown the feasibility of dual-energy CT (DECT) virtual non-contrast (VNC) for determining infarct extent. In this study, patients presenting with large-vessel occlusion (LVO) acute ischemic stroke (AIS), we assess whether ASPECTS on DECTA-VNC differs from non-contrast CT...
| Publicado en: | Neuroradiology Vol. 64; no. 3; pp. 483 - 492 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=155281107&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155281107 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283940 NYZ jtl: Neuroradiology issn: 00283940 maglogo: N pubinfo: dt: Mar2022 vid: 64 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 155281107 151852005 155281107 155281107 10.1007/s00234-021-02773-0 155281107 ppf: 483 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: ASPECTS estimation using dual-energy CTA-derived virtual non-contrast in large vessel occlusion acute ischemic stroke: a dose reduction opportunity for patients undergoing repeat CT? aug: au: van den Broek, Maarten Byrne, Danielle Lyndon, Daniel Niu, Bonnie Yu, Shu Min Rohr, Axel Settecase, Fabio affil: Division of Neuroradiology, Vancouver General Hospital, Room G861, V5Z 1M9, Vancouver, BC, Canada sug: subj: Ischemic Stroke Tomography, X-Ray Computed Methods Coronary Occlusion Contrast Media Human Record Review Retrospective Design Male Female Aged Aged, 80 and Over Sensitivity and Specificity Predictive Value of Tests Radiation Dosage Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: Recent studies have shown the feasibility of dual-energy CT (DECT) virtual non-contrast (VNC) for determining infarct extent. In this study, patients presenting with large-vessel occlusion (LVO) acute ischemic stroke (AIS), we assess whether ASPECTS on DECTA-VNC differs from non-contrast CT (NCCT). Methods: After IRB approval, LVO-AIS patients undergoing NCCT and DECTA between October 2016 and September 2018 were retrospectively reviewed. DECTA-VNC images were derived using Syngo.via (Siemens, Erlangen, Germany). ASPECTS was scored by two blinded neuroradiologists. Square-weighted kappa statistic, diagnostic performance, Wilcoxon signed-rank tests between groups, and CT doses were calculated. Results: Fifty-one patients met inclusion criteria, with median age of 76 (IQR 67–82); 26/51 (51%) were female. Median time between last-known-well and CT was 120 min (IQR 60–252). DECTA-VNC ASPECTS score differed by ≤ 1 from consensus NCCT in 49/51 (96%) patients for reader 1 and in 46/51 (90%) for reader 2. ASPECTS on DECTA-SI and consensus NCCT differed by ≤ 1 in 45/51 (88%) for both readers. On a per ASPECTS-region basis, DECTA-VNC had 87% sensitivity, 95% specificity, 0.82% PPV, and 0.96% NPV. ASPECTS inter-rater agreement was highest for DECTA-VNC (κ = 0.71), DECTA-SI (κ = 0.48), and NCCT (κ = 0.40). NCCT median CTDIvol was 63.7 mGy (IQR 60.7–67.2); DLP was 1060.0 mGy·cm (IQR 981.0–1151.5). DECTA-VNC dose was lower: median CTDIvol was 20.9 mGy (IQR 19.8–22.2); DLP was 804.1 (IQR 691.6–869.4), p < 0.0001. Conclusion: DECTA-derived VNC yielded similar ASPECTS scores as NCCT and is therefore non-inferior in early ischemia-related low attenuation edema/infarct detection in acute LVO-AIS patients. Further evaluation of the role of DECTA-VNC in AIS imaging is warranted. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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