Deans' stroke musings: Comparison of two automated CT perfusion software packages in patients with ischemic stroke presenting within 24 h of onset

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, May 20, 2024

Comparison of two automated CT perfusion software packages in patients with ischemic stroke presenting within 24 h of onset

Please show where anything in here helps get survivors recovered! Can't do it, can you? Useless, you're fired!

Comparison of two automated CT perfusion software packages in patients with ischemic stroke presenting within 24 h of onset

Nak-Hoon Kim¹

Sue Young Ha²

Gi-Hun Park²

Jong-Hyeok Park²

Dongmin Kim²

Leonard Sunwoo³

Min-Surk Kye⁴

Sung Hyun Baik³

Cheolkyu Jung³

Wi-Sun Ryu²^*

Beom Joon Kim¹^*

¹Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
²Artificial Intelligence Research Center, JLK Inc., Seoul, Republic of Korea
³Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
⁴Department of Neurology, Seongnam Citizens Medical Center, Seongnam, Republic of Korea

Background: We compared the ischemic core and hypoperfused tissue volumes estimated by RAPID and JLK-CTP, a newly developed automated computed tomography 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).

Methods: This 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 h of onset. The concordance correlation coefficient (ρ) 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 h from CTP) follow-up infarct volumes on diffusion-weighted imaging (n = 217) was also evaluated.

Results: The mean age was 70.7 ± 13.0 and 137 (41.9%) were female. Ischemic core volumes by JLK-CTP and RAPID at the threshold of relative cerebral blood flow (rCBF) < 30% showed 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 (T_max) > 6 s between JLK-CTP and RAPID (ρ = 0.835 [95% CI, 0.806 to 0.863]). Although early follow-up infarct volume showed substantial agreement in both packages (JLK-CTP, ρ = 0.751 and RAPID, ρ = 0.632), ischemic core volumes at the threshold of rCBF <30% tended to overestimate ischemic core volumes.

Conclusion: JLK-CTP and RAPID demonstrated remarkable concordance in estimating the volumes of the ischemic core and hypoperfused area based on CTP within 24 h from onset.