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Iterative Reconstruction Improves Both Objective and Subjective Image Quality in Acute Stroke CTP

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Iterative Reconstruction Improves Both Objective and Subjective Image Quality in Acute Stroke CTP. / Flottmann, Fabian; Kabath, Jan; Illies, Till; Schneider, Tanja; Buhk, Jan-Hendrik; Fiehler, Jens; Kemmling, André.

in: PLOS ONE, Jahrgang 11, Nr. 3, 2016, S. e0150103.

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

Harvard

Flottmann, F, Kabath, J, Illies, T, Schneider, T, Buhk, J-H, Fiehler, J & Kemmling, A 2016, 'Iterative Reconstruction Improves Both Objective and Subjective Image Quality in Acute Stroke CTP', PLOS ONE, Jg. 11, Nr. 3, S. e0150103. https://doi.org/10.1371/journal.pone.0150103

APA

Flottmann, F., Kabath, J., Illies, T., Schneider, T., Buhk, J-H., Fiehler, J., & Kemmling, A. (2016). Iterative Reconstruction Improves Both Objective and Subjective Image Quality in Acute Stroke CTP. PLOS ONE, 11(3), e0150103. https://doi.org/10.1371/journal.pone.0150103

Vancouver

Flottmann F, Kabath J, Illies T, Schneider T, Buhk J-H, Fiehler J et al. Iterative Reconstruction Improves Both Objective and Subjective Image Quality in Acute Stroke CTP. PLOS ONE. 2016;11(3):e0150103. https://doi.org/10.1371/journal.pone.0150103

Bibtex

@article{5ed55bd6d60a4bb3820ec9d0fc1a8c86,
title = "Iterative Reconstruction Improves Both Objective and Subjective Image Quality in Acute Stroke CTP",
abstract = "PURPOSE: Computed tomography perfusion (CTP) imaging in acute ischemic stroke (AIS) suffers from measurement errors due to image noise. The purpose of this study was to investigate if iterative reconstruction (IR) algorithms can be used to improve the diagnostic value of standard-dose CTP in AIS.METHODS: Twenty-three patients with AIS underwent CTP with standardized protocol and dose. Raw data were reconstructed with filtered back projection (FBP) and IR with intensity levels 3, 4, 5. Image quality was objectively (quantitative perfusion values, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)) and subjectively (overall image quality) assessed. Ischemic core and perfusion mismatch were visually rated. Discriminative power for tissue outcome prediction was determined by the area under the receiver operating characteristic curve (AUC) resulting from the overlap between follow-up infarct lesions and stepwise thresholded CTP maps.RESULTS: With increasing levels of IR, objective image quality (SNR and CNR in white matter and gray matter, elimination of error voxels) and subjective image quality improved. Using IR, mean transit time (MTT) was higher in ischemic lesions, while there was no significant change of cerebral blood volume (CBV) and cerebral blood flow (CBF). Visual assessments of perfusion mismatch changed in 4 patients, while the ischemic core remained constant in all cases. Discriminative power for infarct prediction as represented by AUC was not significantly changed in CBV, but increased in CBF and MTT (mean (95% CI)): 0.72 (0.67-0.76) vs. 0.74 (0.70-0.78) and 0.65 (0.62-0.67) vs 0.67 (0.64-0.70).CONCLUSION: In acute stroke patients, IR improves objective and subjective image quality when applied to standard-dose CTP. This adds to the overall confidence of CTP in acute stroke triage.",
keywords = "Aged, Aged, 80 and over, Algorithms, Brain, Brain Ischemia, Cerebrovascular Circulation, Female, Humans, Male, Middle Aged, Radiographic Image Enhancement, Radiographic Image Interpretation, Computer-Assisted, Signal-To-Noise Ratio, Stroke, Journal Article",
author = "Fabian Flottmann and Jan Kabath and Till Illies and Tanja Schneider and Jan-Hendrik Buhk and Jens Fiehler and Andr{\'e} Kemmling",
year = "2016",
doi = "10.1371/journal.pone.0150103",
language = "English",
volume = "11",
pages = "e0150103",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "3",

}

RIS

TY - JOUR

T1 - Iterative Reconstruction Improves Both Objective and Subjective Image Quality in Acute Stroke CTP

AU - Flottmann, Fabian

AU - Kabath, Jan

AU - Illies, Till

AU - Schneider, Tanja

AU - Buhk, Jan-Hendrik

AU - Fiehler, Jens

AU - Kemmling, André

PY - 2016

Y1 - 2016

N2 - PURPOSE: Computed tomography perfusion (CTP) imaging in acute ischemic stroke (AIS) suffers from measurement errors due to image noise. The purpose of this study was to investigate if iterative reconstruction (IR) algorithms can be used to improve the diagnostic value of standard-dose CTP in AIS.METHODS: Twenty-three patients with AIS underwent CTP with standardized protocol and dose. Raw data were reconstructed with filtered back projection (FBP) and IR with intensity levels 3, 4, 5. Image quality was objectively (quantitative perfusion values, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)) and subjectively (overall image quality) assessed. Ischemic core and perfusion mismatch were visually rated. Discriminative power for tissue outcome prediction was determined by the area under the receiver operating characteristic curve (AUC) resulting from the overlap between follow-up infarct lesions and stepwise thresholded CTP maps.RESULTS: With increasing levels of IR, objective image quality (SNR and CNR in white matter and gray matter, elimination of error voxels) and subjective image quality improved. Using IR, mean transit time (MTT) was higher in ischemic lesions, while there was no significant change of cerebral blood volume (CBV) and cerebral blood flow (CBF). Visual assessments of perfusion mismatch changed in 4 patients, while the ischemic core remained constant in all cases. Discriminative power for infarct prediction as represented by AUC was not significantly changed in CBV, but increased in CBF and MTT (mean (95% CI)): 0.72 (0.67-0.76) vs. 0.74 (0.70-0.78) and 0.65 (0.62-0.67) vs 0.67 (0.64-0.70).CONCLUSION: In acute stroke patients, IR improves objective and subjective image quality when applied to standard-dose CTP. This adds to the overall confidence of CTP in acute stroke triage.

AB - PURPOSE: Computed tomography perfusion (CTP) imaging in acute ischemic stroke (AIS) suffers from measurement errors due to image noise. The purpose of this study was to investigate if iterative reconstruction (IR) algorithms can be used to improve the diagnostic value of standard-dose CTP in AIS.METHODS: Twenty-three patients with AIS underwent CTP with standardized protocol and dose. Raw data were reconstructed with filtered back projection (FBP) and IR with intensity levels 3, 4, 5. Image quality was objectively (quantitative perfusion values, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)) and subjectively (overall image quality) assessed. Ischemic core and perfusion mismatch were visually rated. Discriminative power for tissue outcome prediction was determined by the area under the receiver operating characteristic curve (AUC) resulting from the overlap between follow-up infarct lesions and stepwise thresholded CTP maps.RESULTS: With increasing levels of IR, objective image quality (SNR and CNR in white matter and gray matter, elimination of error voxels) and subjective image quality improved. Using IR, mean transit time (MTT) was higher in ischemic lesions, while there was no significant change of cerebral blood volume (CBV) and cerebral blood flow (CBF). Visual assessments of perfusion mismatch changed in 4 patients, while the ischemic core remained constant in all cases. Discriminative power for infarct prediction as represented by AUC was not significantly changed in CBV, but increased in CBF and MTT (mean (95% CI)): 0.72 (0.67-0.76) vs. 0.74 (0.70-0.78) and 0.65 (0.62-0.67) vs 0.67 (0.64-0.70).CONCLUSION: In acute stroke patients, IR improves objective and subjective image quality when applied to standard-dose CTP. This adds to the overall confidence of CTP in acute stroke triage.

KW - Aged

KW - Aged, 80 and over

KW - Algorithms

KW - Brain

KW - Brain Ischemia

KW - Cerebrovascular Circulation

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Radiographic Image Enhancement

KW - Radiographic Image Interpretation, Computer-Assisted

KW - Signal-To-Noise Ratio

KW - Stroke

KW - Journal Article

U2 - 10.1371/journal.pone.0150103

DO - 10.1371/journal.pone.0150103

M3 - SCORING: Journal article

C2 - 26930290

VL - 11

SP - e0150103

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 3

ER -