Optimising MR Perfusion Imaging: Comparison of Different Software-based Approaches in Acute Ischaemic Stroke

Overview

Journal Eur Radiol

Specialty Radiology

Date 2016 Feb 8

PMID 26852218

Citations 2

Authors

Lars-Arne Schaafs

David Porter

Heinrich J Audebert

Jochen B Fiebach

Kersten Villringer

Affiliations

Soon will be listed here.

Abstract

Objectives: Perfusion imaging (PI) is susceptible to confounding factors such as motion artefacts as well as delay and dispersion (D/D). We evaluate the influence of different post-processing algorithms on hypoperfusion assessment in PI analysis software packages to improve the clinical accuracy of stroke PI.

Methods: Fifty patients with acute ischaemic stroke underwent MRI imaging in the first 24 h after onset. Diverging approaches to motion and D/D correction were applied. The calculated MTT and CBF perfusion maps were assessed by volumetry of lesions and tested for agreement with a standard approach and with the final lesion volume (FLV) on day 6 in patients with persisting vessel occlusion.

Results: MTT map lesion volumes were significantly smaller throughout the software packages with correction of motion and D/D when compared to the commonly used approach with no correction (p = 0.001-0.022). Volumes on CBF maps did not differ significantly (p = 0.207-0.925). All packages with advanced post-processing algorithms showed a high level of agreement with FLV (ICC = 0.704-0.879).

Conclusions: Correction of D/D had a significant influence on estimated lesion volumes and leads to significantly smaller lesion volumes on MTT maps. This may improve patient selection.

Key Points: • Assessment on hypoperfusion using advanced post-processing with correction for motion and D/D. • CBF appears to be more robust regarding differences in post-processing. • Tissue at risk is estimated more accurately by correcting software algorithms. • Advanced post-processing algorithms show a higher agreement with the final lesion volume.

Citing Articles

Neural Network-derived Perfusion Maps for the Assessment of Lesions in Patients with Acute Ischemic Stroke.

Meier R, Lux P, Med B, Jung S, Fischer U, Gralla J Radiol Artif Intell. 2021; 1(5):e190019.

PMID: 33937801 PMC: 8017390. DOI: 10.1148/ryai.2019190019.

The impact of injector-based contrast agent administration in time-resolved MRA.

Budjan J, Attenberger U, Schoenberg S, Pietsch H, Jost G Eur Radiol. 2017; 28(5):2246-2253.

PMID: 29218620 DOI: 10.1007/s00330-017-5178-0.

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