Article Figures & Data
Figures
- Fig 1.
Expansion of core infarct size (area of selected axial section) between the admission DWI scan and the coregistered follow-up CT or MR imaging was an inclusion criterion, and was present in all patients (left). Sample ROC curves (right) showing the sensitivity/specificity of different CTP parameter thresholds used to define “at-risk” penumbra destined to infarct, comparing maps processed by using standard software. Green curves represent rMTT; blue curves, rCBF; orange, rCBV; and purple, the rCBF*rCBV voxel product value maps.
- Fig 2.
Example of thresholded MTT map prediction of penumbra destined to infarct in a 70-year-old woman presenting with left hemispheric stroke symptoms. Ictus-to-CTP imaging time was 5 hours 33 minutes, admission NIHSS score was 6, and follow-up MR imaging was performed 44 hours after admission CTP scanning; NIHSS score was 12. Infarct core is segmented on the admission DWI scan (A, and red overlays on D, E), and final infarct volume is segmented on follow-up DWI scan (B). CT-MTT map shows blue/green regions with increased mean transit time (C). D and E, respectively, show the optimally thresholded absolute-MTT (12 seconds threshold) and relative-MTT (249% threshold) maps, both postprocessed by using standard algorithm, which distinguish benign oligemia (green overlays) from true “at-risk” ischemic penumbra (blue overlays).
Tables
Optimal absolute and rMTT thresholds for identification of penumbra destined to infarct
aMTT AUC aT (s) Sens Spec rMTT AUC rT (%) Sens Spec Std software All 0.76 12.0 0.650 0.761 All 0.78 249 0.646 0.796 GM 0.76 12.0 0.662 0.750 GM 0.78 250 0.657 0.785 WM 0.77 13.1 0.648 0.778 WM 0.78 250 0.676 0.778 BG 0.61 13.3 0.289 0.938 BG 0.63 198 0.326 0.922 DC software All 0.72 13.5 0.639 0.704 All 0.71 150 0.649 0.692 GM 0.73 12.0 0.732 0.636 GM 0.73 142 0.713 0.663 WM 0.71 14.4 0.615 0.718 WM 0.70 167 0.599 0.725 BG 0.63 13.8 0.377 0.796 BG 0.63 114 0.542 0.641 -
Note:—All whole-brain optimal thresholds. GM indicates gray matter; BG, basal ganglia region-specific thresholds; aT, absolute thresholds (sec); rT, relative thresholds; sens, sensitivity; spec, specificity; std, standard algorithm; DC, delay-corrected algorithm; aMTT, absolute MTT.
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