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Low baseline ischemic water uptake is directly related to overestimation of CT perfusion-derived ischemic core volume

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Low baseline ischemic water uptake is directly related to overestimation of CT perfusion-derived ischemic core volume. / McDonough, Rosalie; Elsayed, Sarah; Meyer, Lukas; Ewers, Theresa; Bechstein, Matthias; Kniep, Helge; Nawka, Marie Teresa; Faizy, Tobias D; Schön, Gerhard; Thomalla, Götz; Fiehler, Jens; Hanning, Uta; Kemmling, Andre; Broocks, Gabriel.

In: SCI REP-UK, Vol. 12, No. 1, 20567, 29.11.2022.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

McDonough, R, Elsayed, S, Meyer, L, Ewers, T, Bechstein, M, Kniep, H, Nawka, MT, Faizy, TD, Schön, G, Thomalla, G, Fiehler, J, Hanning, U, Kemmling, A & Broocks, G 2022, 'Low baseline ischemic water uptake is directly related to overestimation of CT perfusion-derived ischemic core volume', SCI REP-UK, vol. 12, no. 1, 20567. https://doi.org/10.1038/s41598-022-19176-7

APA

McDonough, R., Elsayed, S., Meyer, L., Ewers, T., Bechstein, M., Kniep, H., Nawka, M. T., Faizy, T. D., Schön, G., Thomalla, G., Fiehler, J., Hanning, U., Kemmling, A., & Broocks, G. (2022). Low baseline ischemic water uptake is directly related to overestimation of CT perfusion-derived ischemic core volume. SCI REP-UK, 12(1), [20567]. https://doi.org/10.1038/s41598-022-19176-7

Vancouver

McDonough R, Elsayed S, Meyer L, Ewers T, Bechstein M, Kniep H et al. Low baseline ischemic water uptake is directly related to overestimation of CT perfusion-derived ischemic core volume. SCI REP-UK. 2022 Nov 29;12(1). 20567. https://doi.org/10.1038/s41598-022-19176-7

Bibtex

@article{3f0eeb74370e45eab4804dd67a3deac5,
title = "Low baseline ischemic water uptake is directly related to overestimation of CT perfusion-derived ischemic core volume",
abstract = "Computed-tomography perfusion (CTP) is frequently used to screen acute ischemic stroke (AIS) patients for endovascular treatment (EVT), despite known problems with ischemic {"}core{"} overestimation. This potentially leads to the unfair exclusion of patients from EVT. We propose that net water uptake (NWU) can be used in addition to CTP to more accurately assess the extent and/or stage of tissue infarction. Patients treated for AIS between 06/2015 and 07/2020 were retrospectively analyzed. Baseline CTP-derived core volume (pCore) and NWU were determined. Logistic regression tested the relationship between baseline clinical and imaging variables and core-overestimation (primary outcome). The secondary outcomes comprised 90-day functional independence (modified Rankin score) and lesion growth. 284 patients were included. Median NWU was 7.2% (IQR 2.6-12.8). ASPECTS (RR 1.28, 95% CI 1.09-1.51), NWU (RR 0.94, 95% CI 0.89-0.98), onset to recanalization (RR 1.00, 95% CI 0.99-1.00) and imaging (RR 1.00, 95% CI 1.00-1.00) times, and pCore (RR 1.02, 95% CI 1.01-1.02) were significantly associated with core overestimation. Core-overestimation was more likely to occur in patients with large pCores and low NWU at baseline. NWU was significantly correlated with lesion growth. We conclude that NWU can be used as a supplemental tool to CTP during admission imaging to more accurately assess the extent of ischemia, particularly relevant for patients with large CTP-defined cores who would otherwise be excluded from treatment.",
keywords = "Humans, Water, Ischemic Stroke, Cytidine Triphosphate, Retrospective Studies, Ischemia, Tomography, X-Ray Computed, Perfusion",
author = "Rosalie McDonough and Sarah Elsayed and Lukas Meyer and Theresa Ewers and Matthias Bechstein and Helge Kniep and Nawka, {Marie Teresa} and Faizy, {Tobias D} and Gerhard Sch{\"o}n and G{\"o}tz Thomalla and Jens Fiehler and Uta Hanning and Andre Kemmling and Gabriel Broocks",
note = "{\textcopyright} 2022. The Author(s).",
year = "2022",
month = nov,
day = "29",
doi = "10.1038/s41598-022-19176-7",
language = "English",
volume = "12",
journal = "SCI REP-UK",
issn = "2045-2322",
publisher = "NATURE PUBLISHING GROUP",
number = "1",

}

RIS

TY - JOUR

T1 - Low baseline ischemic water uptake is directly related to overestimation of CT perfusion-derived ischemic core volume

AU - McDonough, Rosalie

AU - Elsayed, Sarah

AU - Meyer, Lukas

AU - Ewers, Theresa

AU - Bechstein, Matthias

AU - Kniep, Helge

AU - Nawka, Marie Teresa

AU - Faizy, Tobias D

AU - Schön, Gerhard

AU - Thomalla, Götz

AU - Fiehler, Jens

AU - Hanning, Uta

AU - Kemmling, Andre

AU - Broocks, Gabriel

N1 - © 2022. The Author(s).

PY - 2022/11/29

Y1 - 2022/11/29

N2 - Computed-tomography perfusion (CTP) is frequently used to screen acute ischemic stroke (AIS) patients for endovascular treatment (EVT), despite known problems with ischemic "core" overestimation. This potentially leads to the unfair exclusion of patients from EVT. We propose that net water uptake (NWU) can be used in addition to CTP to more accurately assess the extent and/or stage of tissue infarction. Patients treated for AIS between 06/2015 and 07/2020 were retrospectively analyzed. Baseline CTP-derived core volume (pCore) and NWU were determined. Logistic regression tested the relationship between baseline clinical and imaging variables and core-overestimation (primary outcome). The secondary outcomes comprised 90-day functional independence (modified Rankin score) and lesion growth. 284 patients were included. Median NWU was 7.2% (IQR 2.6-12.8). ASPECTS (RR 1.28, 95% CI 1.09-1.51), NWU (RR 0.94, 95% CI 0.89-0.98), onset to recanalization (RR 1.00, 95% CI 0.99-1.00) and imaging (RR 1.00, 95% CI 1.00-1.00) times, and pCore (RR 1.02, 95% CI 1.01-1.02) were significantly associated with core overestimation. Core-overestimation was more likely to occur in patients with large pCores and low NWU at baseline. NWU was significantly correlated with lesion growth. We conclude that NWU can be used as a supplemental tool to CTP during admission imaging to more accurately assess the extent of ischemia, particularly relevant for patients with large CTP-defined cores who would otherwise be excluded from treatment.

AB - Computed-tomography perfusion (CTP) is frequently used to screen acute ischemic stroke (AIS) patients for endovascular treatment (EVT), despite known problems with ischemic "core" overestimation. This potentially leads to the unfair exclusion of patients from EVT. We propose that net water uptake (NWU) can be used in addition to CTP to more accurately assess the extent and/or stage of tissue infarction. Patients treated for AIS between 06/2015 and 07/2020 were retrospectively analyzed. Baseline CTP-derived core volume (pCore) and NWU were determined. Logistic regression tested the relationship between baseline clinical and imaging variables and core-overestimation (primary outcome). The secondary outcomes comprised 90-day functional independence (modified Rankin score) and lesion growth. 284 patients were included. Median NWU was 7.2% (IQR 2.6-12.8). ASPECTS (RR 1.28, 95% CI 1.09-1.51), NWU (RR 0.94, 95% CI 0.89-0.98), onset to recanalization (RR 1.00, 95% CI 0.99-1.00) and imaging (RR 1.00, 95% CI 1.00-1.00) times, and pCore (RR 1.02, 95% CI 1.01-1.02) were significantly associated with core overestimation. Core-overestimation was more likely to occur in patients with large pCores and low NWU at baseline. NWU was significantly correlated with lesion growth. We conclude that NWU can be used as a supplemental tool to CTP during admission imaging to more accurately assess the extent of ischemia, particularly relevant for patients with large CTP-defined cores who would otherwise be excluded from treatment.

KW - Humans

KW - Water

KW - Ischemic Stroke

KW - Cytidine Triphosphate

KW - Retrospective Studies

KW - Ischemia

KW - Tomography, X-Ray Computed

KW - Perfusion

U2 - 10.1038/s41598-022-19176-7

DO - 10.1038/s41598-022-19176-7

M3 - SCORING: Journal article

C2 - 36446862

VL - 12

JO - SCI REP-UK

JF - SCI REP-UK

SN - 2045-2322

IS - 1

M1 - 20567

ER -