AUTHOR=Kim Nakhoon , Ha Sue Young , Park Gi-Hun , Park Jong-Hyeok , Kim Dongmin , Sunwoo Leonard , Kye Min-Surk , Baik Sung Hyun , Jung Cheolkyu , Ryu Wi-Sun , Kim Beom Joon 

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

JOURNAL=Frontiers in Neuroscience

VOLUME=18

YEAR=2024

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2024.1398889

DOI=10.3389/fnins.2024.1398889

ISSN=1662-453X

ABSTRACT=<sec id="sec1"><title>Background</title><p>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).</p></sec><sec id="sec2"><title>Methods</title><p>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 (<italic>ρ</italic>) 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 (<italic>n</italic> = 217) was also evaluated.</p></sec><sec id="sec3"><title>Results</title><p>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) &lt; 30% showed excellent agreement (<italic>ρ</italic> = 0.958 [95% CI, 0.949 to 0.966]). Excellent agreement was also observed for time to a maximum of the residue function (<italic>T</italic><sub>max</sub>) &gt; 6 s between JLK-CTP and RAPID (<italic>ρ</italic> = 0.835 [95% CI, 0.806 to 0.863]). Although early follow-up infarct volume showed substantial agreement in both packages (JLK-CTP, <italic>ρ</italic> = 0.751 and RAPID, <italic>ρ</italic> = 0.632), ischemic core volumes at the threshold of rCBF &lt;30% tended to overestimate ischemic core volumes.</p></sec><sec id="sec4"><title>Conclusion</title><p>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.</p></sec>