4D-CTA improves diagnostic certainty and accuracy in the detection of proximal intracranial anterior circulation occlusion in acute ischemic stroke
In acute ischemic stroke, imaging of the cranio-cervical vessels is essential for intra-arterial treatment selection. Fast, reliable and easy accessible imaging is necessary 24 hours a day, 7 days a week. Radiologists in training and non-expert readers often perform initial reviewing. In this pilot...
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| Veröffentlicht in: | PloS one 2017-02, Vol.12 (2), p.e0172356-e0172356 |
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| creator | Wagemans, Bart A J M van Zwam, Wim H Nelemans, Patricia J van Oostenbrugge, Robert J Postma, Alida A |
| description | In acute ischemic stroke, imaging of the cranio-cervical vessels is essential for intra-arterial treatment selection. Fast, reliable and easy accessible imaging is necessary 24 hours a day, 7 days a week. Radiologists in training and non-expert readers often perform initial reviewing. In this pilot study, the potential benefit of adding 4Dimensional-CT Angiography (4D-CTA) to the patient selection protocol for intra-arterial therapy is investigated.
Twenty-five datasets of prospectively recruited patients, eligible for intra-arterial treatment, were enrolled. Four radiologists-in-training consecutively reviewed CTA, CT-Perfusion and 4D-CTA (post-processed from CTP datasets) and scored: occlusion-presence and diagnostic certainty (scale 1-10). Time-to-diagnosis was registered.
Arterial occlusion was present in 8 patients. Accuracy improved from 88-92% after CTA and CTP assessment to 96-100% after 4D-CTA assessment (P-values >0,05). Mean diagnostic certainty improved from 7,2-8,6 to 8,8-9,3 (P-values all < 0,05). Mean time to diagnosis increased from 3, 5, 5 and 4 minutes after CTA to 9, 14, 12, and 10 minutes after 4D-CTA.
4D-CTA as an additive to regular CTA and CT-Perfusion in patients with acute ischemic stroke eligible for intra-arterial treatment shows a tendency to increase diagnostic accuracy and improves diagnostic certainty, when reviewed by radiologist in training, while only mildly prolonging time to diagnosis. |
| doi_str_mv | 10.1371/journal.pone.0172356 |
| format | Article |
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Twenty-five datasets of prospectively recruited patients, eligible for intra-arterial treatment, were enrolled. Four radiologists-in-training consecutively reviewed CTA, CT-Perfusion and 4D-CTA (post-processed from CTP datasets) and scored: occlusion-presence and diagnostic certainty (scale 1-10). Time-to-diagnosis was registered.
Arterial occlusion was present in 8 patients. Accuracy improved from 88-92% after CTA and CTP assessment to 96-100% after 4D-CTA assessment (P-values >0,05). Mean diagnostic certainty improved from 7,2-8,6 to 8,8-9,3 (P-values all < 0,05). Mean time to diagnosis increased from 3, 5, 5 and 4 minutes after CTA to 9, 14, 12, and 10 minutes after 4D-CTA.
4D-CTA as an additive to regular CTA and CT-Perfusion in patients with acute ischemic stroke eligible for intra-arterial treatment shows a tendency to increase diagnostic accuracy and improves diagnostic certainty, when reviewed by radiologist in training, while only mildly prolonging time to diagnosis.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0172356</identifier><identifier>PMID: 28234928</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Angiography ; Automation ; Biology and Life Sciences ; Blood vessels ; Brain Ischemia - diagnostic imaging ; Brain Ischemia - physiopathology ; Brain Ischemia - therapy ; Care and treatment ; CAT scans ; Cerebral Angiography - methods ; Cerebrovascular Circulation - physiology ; Computed tomography ; Computed Tomography Angiography - methods ; Datasets ; Diagnosis ; Diagnostic imaging ; Diagnostic systems ; Female ; Humans ; Ischemia ; Male ; Medical diagnosis ; Medical imaging ; Medicine and Health Sciences ; Neuroimaging ; Occlusion ; Patients ; People and Places ; Perfusion ; Perfusion Imaging - methods ; Research and Analysis Methods ; Stroke ; Stroke - diagnostic imaging ; Stroke - physiopathology ; Stroke - therapy ; Thrombolytic Therapy ; Tomography, X-Ray Computed - methods ; Training</subject><ispartof>PloS one, 2017-02, Vol.12 (2), p.e0172356-e0172356</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Wagemans et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Wagemans et al 2017 Wagemans et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c791t-1d84039c0a845c5afc0c1b76ffd834fd6bd99b7b6e80f53a381d58d59b6843b23</citedby><cites>FETCH-LOGICAL-c791t-1d84039c0a845c5afc0c1b76ffd834fd6bd99b7b6e80f53a381d58d59b6843b23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325270/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325270/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28234928$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Meckel, Stephan</contributor><creatorcontrib>Wagemans, Bart A J M</creatorcontrib><creatorcontrib>van Zwam, Wim H</creatorcontrib><creatorcontrib>Nelemans, Patricia J</creatorcontrib><creatorcontrib>van Oostenbrugge, Robert J</creatorcontrib><creatorcontrib>Postma, Alida A</creatorcontrib><title>4D-CTA improves diagnostic certainty and accuracy in the detection of proximal intracranial anterior circulation occlusion in acute ischemic stroke</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>In acute ischemic stroke, imaging of the cranio-cervical vessels is essential for intra-arterial treatment selection. Fast, reliable and easy accessible imaging is necessary 24 hours a day, 7 days a week. Radiologists in training and non-expert readers often perform initial reviewing. In this pilot study, the potential benefit of adding 4Dimensional-CT Angiography (4D-CTA) to the patient selection protocol for intra-arterial therapy is investigated.
Twenty-five datasets of prospectively recruited patients, eligible for intra-arterial treatment, were enrolled. Four radiologists-in-training consecutively reviewed CTA, CT-Perfusion and 4D-CTA (post-processed from CTP datasets) and scored: occlusion-presence and diagnostic certainty (scale 1-10). Time-to-diagnosis was registered.
Arterial occlusion was present in 8 patients. Accuracy improved from 88-92% after CTA and CTP assessment to 96-100% after 4D-CTA assessment (P-values >0,05). Mean diagnostic certainty improved from 7,2-8,6 to 8,8-9,3 (P-values all < 0,05). Mean time to diagnosis increased from 3, 5, 5 and 4 minutes after CTA to 9, 14, 12, and 10 minutes after 4D-CTA.
4D-CTA as an additive to regular CTA and CT-Perfusion in patients with acute ischemic stroke eligible for intra-arterial treatment shows a tendency to increase diagnostic accuracy and improves diagnostic certainty, when reviewed by radiologist in training, while only mildly prolonging time to diagnosis.</description><subject>Analysis</subject><subject>Angiography</subject><subject>Automation</subject><subject>Biology and Life Sciences</subject><subject>Blood vessels</subject><subject>Brain Ischemia - diagnostic imaging</subject><subject>Brain Ischemia - physiopathology</subject><subject>Brain Ischemia - therapy</subject><subject>Care and treatment</subject><subject>CAT scans</subject><subject>Cerebral Angiography - methods</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Computed tomography</subject><subject>Computed Tomography Angiography - methods</subject><subject>Datasets</subject><subject>Diagnosis</subject><subject>Diagnostic imaging</subject><subject>Diagnostic systems</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Medicine and Health Sciences</subject><subject>Neuroimaging</subject><subject>Occlusion</subject><subject>Patients</subject><subject>People and Places</subject><subject>Perfusion</subject><subject>Perfusion Imaging - 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Fast, reliable and easy accessible imaging is necessary 24 hours a day, 7 days a week. Radiologists in training and non-expert readers often perform initial reviewing. In this pilot study, the potential benefit of adding 4Dimensional-CT Angiography (4D-CTA) to the patient selection protocol for intra-arterial therapy is investigated.
Twenty-five datasets of prospectively recruited patients, eligible for intra-arterial treatment, were enrolled. Four radiologists-in-training consecutively reviewed CTA, CT-Perfusion and 4D-CTA (post-processed from CTP datasets) and scored: occlusion-presence and diagnostic certainty (scale 1-10). Time-to-diagnosis was registered.
Arterial occlusion was present in 8 patients. Accuracy improved from 88-92% after CTA and CTP assessment to 96-100% after 4D-CTA assessment (P-values >0,05). Mean diagnostic certainty improved from 7,2-8,6 to 8,8-9,3 (P-values all < 0,05). Mean time to diagnosis increased from 3, 5, 5 and 4 minutes after CTA to 9, 14, 12, and 10 minutes after 4D-CTA.
4D-CTA as an additive to regular CTA and CT-Perfusion in patients with acute ischemic stroke eligible for intra-arterial treatment shows a tendency to increase diagnostic accuracy and improves diagnostic certainty, when reviewed by radiologist in training, while only mildly prolonging time to diagnosis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28234928</pmid><doi>10.1371/journal.pone.0172356</doi><tpages>e0172356</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Angiography Automation Biology and Life Sciences Blood vessels Brain Ischemia - diagnostic imaging Brain Ischemia - physiopathology Brain Ischemia - therapy Care and treatment CAT scans Cerebral Angiography - methods Cerebrovascular Circulation - physiology Computed tomography Computed Tomography Angiography - methods Datasets Diagnosis Diagnostic imaging Diagnostic systems Female Humans Ischemia Male Medical diagnosis Medical imaging Medicine and Health Sciences Neuroimaging Occlusion Patients People and Places Perfusion Perfusion Imaging - methods Research and Analysis Methods Stroke Stroke - diagnostic imaging Stroke - physiopathology Stroke - therapy Thrombolytic Therapy Tomography, X-Ray Computed - methods Training |
| title | 4D-CTA improves diagnostic certainty and accuracy in the detection of proximal intracranial anterior circulation occlusion in acute ischemic stroke |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T23%3A34%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=4D-CTA%20improves%20diagnostic%20certainty%20and%20accuracy%20in%20the%20detection%20of%20proximal%20intracranial%20anterior%20circulation%20occlusion%20in%20acute%20ischemic%20stroke&rft.jtitle=PloS%20one&rft.au=Wagemans,%20Bart%20A%20J%20M&rft.date=2017-02-24&rft.volume=12&rft.issue=2&rft.spage=e0172356&rft.epage=e0172356&rft.pages=e0172356-e0172356&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0172356&rft_dat=%3Cgale_plos_%3EA482540602%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1871800995&rft_id=info:pmid/28234928&rft_galeid=A482540602&rft_doaj_id=oai_doaj_org_article_96cbc7baee0448b1af6df3960caf9947&rfr_iscdi=true |