Abstract
ABSTRACTBackgroundWe compared the ischemic core and hypoperfused tissue volumes estimated by RAPID and JBS-10K, a newly developed automated CT perfusion (CTP) analysis package. We also assessed agreement between ischemic core volumes by two software packages against early follow-up infarct volumes on diffusion-weighted images (DWI).MethodsThis retrospective study analyzed 327 patients admitted to a single stroke center in Korea from January 2021 to May 2023, who underwent CTP scans within 24 hours of onset. The concordance correlation coefficient and Bland-Altman plots were utilized to compare the volumes of ischemic core and hypoperfused tissue volumes between the software packages. Agreement with early (within 3 hours from CTP) follow-up infarct volumes on diffusion-weighted imaging (n=217) was also evaluated.ResultsThe mean age was 70.7±13.0 and 137 (41.9%) were female. Ischemic core volumes by JBS-10K and RAPID in the threshold of relative cerebral blood flow (rCBF) < 30% had excellent agreement (ρ = 0.958 [95% CI, 0.949 to 0.966]). Excellent agreement was also observed for time to a maximum of the residue function (Tmax) > 6 seconds between JBS-10K and RAPID (ρ = 0.835 [95% CI, 0.806 to 0.863]). Although early follow-up infarct volume showed substantial agreement in both packages (JBS-10K ρ = 0.751 and RAPID ρ = 0.632), ischemic core volumes at the threshold of rCBF <30% tended to overestimate ischemic core volumes.ConclusionJBS-10K and RAPID demonstrated remarkable concordance in estimating the volumes of the ischemic core and hypoperfused area based on CTP within 24 hours from onset.
Publisher
Cold Spring Harbor Laboratory