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Computed tomography-based quantification of lesion water uptake identifies patients within 4.5 hours of stroke onset: A multicenter observational study

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Computed tomography-based quantification of lesion water uptake identifies patients within 4.5 hours of stroke onset: A multicenter observational study. / Minnerup, Jens; Broocks, Gabriel; Kalkoffen, Judith; Langner, Soenke; Knauth, Michael; Psychogios, Marios Nikos; Wersching, Heike; Teuber, Anja; Heindel, Walter; Eckert, Bernd; Wiendl, Heinz; Schramm, Peter; Fiehler, Jens; Kemmling, André.

in: ANN NEUROL, Jahrgang 80, Nr. 6, 01.12.2016, S. 924-934.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Minnerup, J, Broocks, G, Kalkoffen, J, Langner, S, Knauth, M, Psychogios, MN, Wersching, H, Teuber, A, Heindel, W, Eckert, B, Wiendl, H, Schramm, P, Fiehler, J & Kemmling, A 2016, 'Computed tomography-based quantification of lesion water uptake identifies patients within 4.5 hours of stroke onset: A multicenter observational study', ANN NEUROL, Jg. 80, Nr. 6, S. 924-934. https://doi.org/10.1002/ana.24818

APA

Minnerup, J., Broocks, G., Kalkoffen, J., Langner, S., Knauth, M., Psychogios, M. N., Wersching, H., Teuber, A., Heindel, W., Eckert, B., Wiendl, H., Schramm, P., Fiehler, J., & Kemmling, A. (2016). Computed tomography-based quantification of lesion water uptake identifies patients within 4.5 hours of stroke onset: A multicenter observational study. ANN NEUROL, 80(6), 924-934. https://doi.org/10.1002/ana.24818

Vancouver

Minnerup J, Broocks G, Kalkoffen J, Langner S, Knauth M, Psychogios MN et al. Computed tomography-based quantification of lesion water uptake identifies patients within 4.5 hours of stroke onset: A multicenter observational study. ANN NEUROL. 2016 Dez 1;80(6):924-934. https://doi.org/10.1002/ana.24818

Bibtex

@article{3bf5cc4c1a0f48f1af70defd1c1b91d2,
title = "Computed tomography-based quantification of lesion water uptake identifies patients within 4.5 hours of stroke onset: A multicenter observational study",
abstract = "OBJECTIVE: Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours, the time window of thrombolysis.METHODS: Perfusion CT was used to identify ischemic brain tissue, and its density was measured in native CT and related to the density of the corresponding area of the contralateral hemisphere to quantify lesion water uptake. The optimal cutoff value of water uptake distinguishing stroke onset within and beyond 4.5 hours was calculated in patients with proximal middle cerebral artery occlusion (derivation cohort) with known time of symptom onset. The so-derived cutoff value was validated in a prospective cohort from other stroke centers.RESULTS: Of 178 patients of the derivation cohort, 147 (82.6%) had CT within 4.5 hours. Percentage water uptake was significantly lower in patients with stroke onset within compared to beyond 4.5 hours. The area under the receiver operating characteristic curve for distinguishing these patient groups according to percentage water uptake was 0.999 (95% confidence interval = 0.996-1.000, p < 0.001) with an optimal cutoff value of 11.5%. Applying this cutoff to the validation cohort of 240 patients, sensitivity was 98.6%, specificity 90.5%, positive predictive value 99.1%, and negative predictive value 86.4%.INTERPRETATION: Quantification of brain water uptake identifies stroke patients with symptom onset within 4.5 hours with high accuracy and may guide the decision to use thrombolysis in patients with unknown time of stroke onset. Ann Neurol 2016;80:924-934.",
author = "Jens Minnerup and Gabriel Broocks and Judith Kalkoffen and Soenke Langner and Michael Knauth and Psychogios, {Marios Nikos} and Heike Wersching and Anja Teuber and Walter Heindel and Bernd Eckert and Heinz Wiendl and Peter Schramm and Jens Fiehler and Andr{\'e} Kemmling",
note = "{\textcopyright} 2016 American Neurological Association.",
year = "2016",
month = dec,
day = "1",
doi = "10.1002/ana.24818",
language = "English",
volume = "80",
pages = "924--934",
journal = "ANN NEUROL",
issn = "0364-5134",
publisher = "John Wiley and Sons Inc.",
number = "6",

}

RIS

TY - JOUR

T1 - Computed tomography-based quantification of lesion water uptake identifies patients within 4.5 hours of stroke onset: A multicenter observational study

AU - Minnerup, Jens

AU - Broocks, Gabriel

AU - Kalkoffen, Judith

AU - Langner, Soenke

AU - Knauth, Michael

AU - Psychogios, Marios Nikos

AU - Wersching, Heike

AU - Teuber, Anja

AU - Heindel, Walter

AU - Eckert, Bernd

AU - Wiendl, Heinz

AU - Schramm, Peter

AU - Fiehler, Jens

AU - Kemmling, André

N1 - © 2016 American Neurological Association.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - OBJECTIVE: Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours, the time window of thrombolysis.METHODS: Perfusion CT was used to identify ischemic brain tissue, and its density was measured in native CT and related to the density of the corresponding area of the contralateral hemisphere to quantify lesion water uptake. The optimal cutoff value of water uptake distinguishing stroke onset within and beyond 4.5 hours was calculated in patients with proximal middle cerebral artery occlusion (derivation cohort) with known time of symptom onset. The so-derived cutoff value was validated in a prospective cohort from other stroke centers.RESULTS: Of 178 patients of the derivation cohort, 147 (82.6%) had CT within 4.5 hours. Percentage water uptake was significantly lower in patients with stroke onset within compared to beyond 4.5 hours. The area under the receiver operating characteristic curve for distinguishing these patient groups according to percentage water uptake was 0.999 (95% confidence interval = 0.996-1.000, p < 0.001) with an optimal cutoff value of 11.5%. Applying this cutoff to the validation cohort of 240 patients, sensitivity was 98.6%, specificity 90.5%, positive predictive value 99.1%, and negative predictive value 86.4%.INTERPRETATION: Quantification of brain water uptake identifies stroke patients with symptom onset within 4.5 hours with high accuracy and may guide the decision to use thrombolysis in patients with unknown time of stroke onset. Ann Neurol 2016;80:924-934.

AB - OBJECTIVE: Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours, the time window of thrombolysis.METHODS: Perfusion CT was used to identify ischemic brain tissue, and its density was measured in native CT and related to the density of the corresponding area of the contralateral hemisphere to quantify lesion water uptake. The optimal cutoff value of water uptake distinguishing stroke onset within and beyond 4.5 hours was calculated in patients with proximal middle cerebral artery occlusion (derivation cohort) with known time of symptom onset. The so-derived cutoff value was validated in a prospective cohort from other stroke centers.RESULTS: Of 178 patients of the derivation cohort, 147 (82.6%) had CT within 4.5 hours. Percentage water uptake was significantly lower in patients with stroke onset within compared to beyond 4.5 hours. The area under the receiver operating characteristic curve for distinguishing these patient groups according to percentage water uptake was 0.999 (95% confidence interval = 0.996-1.000, p < 0.001) with an optimal cutoff value of 11.5%. Applying this cutoff to the validation cohort of 240 patients, sensitivity was 98.6%, specificity 90.5%, positive predictive value 99.1%, and negative predictive value 86.4%.INTERPRETATION: Quantification of brain water uptake identifies stroke patients with symptom onset within 4.5 hours with high accuracy and may guide the decision to use thrombolysis in patients with unknown time of stroke onset. Ann Neurol 2016;80:924-934.

U2 - 10.1002/ana.24818

DO - 10.1002/ana.24818

M3 - SCORING: Journal article

C2 - 28001316

VL - 80

SP - 924

EP - 934

JO - ANN NEUROL

JF - ANN NEUROL

SN - 0364-5134

IS - 6

ER -