Comparison of stroke infarction between CT perfusion and diffusion weighted imaging: preliminary results

In this paper we present preliminary results of comparison of automatic segmentations of the infarct core, between that obtained from CT perfusion (based on time to peak parameter) and diffusion weighted imaging (DWI). For each patient, the two imaging volumes were automatically co-registered to a common frame of reference based on an acquired CT angiography image. The accuracy of image registration is measured by the overlap of the segmented brain from both images (CT perfusion and DWI), measured within their common field of view. Due to the limitations of the study, DWI was acquired as a follow up scan up to a week after initial CT based imaging. However, we found significant overlap of the segmented brain (Jaccard indices of approximately 0.8) and the percentage of infarcted brain tissue from the two modalities were still fairly highly correlated (correlation coefficient of approximately 0.9). The results are promising with more data needed in future for clinical inference.

[1]  G. Hunter,et al.  CT Perfusion Identifies Increased Salvage of Tissue in Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator within 3 Hours of Stroke Onset , 2008, American Journal of Neuroradiology.

[2]  Reto Meuli,et al.  Perfusion-CT Assessment of Infarct Core and Penumbra: Receiver Operating Characteristic Curve Analysis in 130 Patients Suspected of Acute Hemispheric Stroke , 2006, Stroke.

[3]  Klaus Sartor,et al.  Comparison of Perfusion Computed Tomography and Computed Tomography Angiography Source Images With Perfusion-Weighted Imaging and Diffusion-Weighted Imaging in Patients With Acute Stroke of Less Than 6 Hours’ Duration , 2004, Stroke.

[4]  M Wintermark,et al.  Comparison of CT perfusion and angiography and MRI in selecting stroke patients for acute treatment , 2007, Neurology.

[5]  Yue Cao,et al.  High b-value diffusion imaging. , 2002, Neuroimaging clinics of North America.

[6]  S. Warach,et al.  Recommendations for imaging of acute ischemic stroke: a scientific statement from the American Heart Association. , 2009, Stroke.

[7]  N. Otsu A threshold selection method from gray level histograms , 1979 .

[8]  Lee H. Schwamm,et al.  In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core? , 2015, PloS one.

[9]  J. Baron,et al.  Perfusion CT helps decision making for thrombolysis when there is no clear time of onset , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[10]  Roger S. Blumenthal,et al.  A Scientific Statement From the American Heart Association Exercise Training for Type 2 Diabetes Mellitus: Impact on Cardiovascular Risk: , 2010 .

[11]  Israna Hossain Arka,et al.  Simultaneous tilt correction and registration of CT angiography and dynamic CT brain images , 2015, 2015 International Conference on BioSignal Analysis, Processing and Systems (ICBAPS).