Int J Comput Assist Radiol Surg - Automated infarction core delineation using cerebral and perfused blood volume maps.

Tópicos

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Resumo

RPOSE: Thrombolytic therapy in patients with acute ischemic stroke is contraindicated when the infarction core exceeds a given threshold. To date, there are no standardized guidelines for computed tomography infarction core assessment. Current practice involves use of thresholding methods, where the results are further adjusted by an experienced physician. An automated method for infarction core delineation and volume measurement was developed and tested.MATERIALS AND METHODS: CT postprocessing software was developed for analysis of whole brain perfused blood volume (PBV) and cerebral blood volume (CBV) maps. The program was designed for potential use with mean transit time (MTT) or cerebral blood flow (CBF) maps. The proposed method was tested on a set of 12 patients on both PBV and CBV maps with whole brain coverage by comparison with the results of a simple thresholding method and with manually marked findings provided by two independent physicians.RESULTS: The proposed method produced a marked infarct core volume corresponding to 53?% of the manually delineated volumes. The simple thresholding method with the optimal threshold, using the same dataset, marked 15[Formula: see text] larger volume compared to the volume delineated by physicians.CONCLUSION: An automated infarction core segmentation method based on local neighborhood features was developed and tested, demonstrating its utility in distinguishing between infarcted and non-infarcted areas, as well as reduction in the number of false positives and volume error.

Resumo Limpo

rpose thrombolyt therapi patient acut ischem stroke contraind infarct core exceed given threshold date standard guidelin comput tomographi infarct core assess current practic involv use threshold method result adjust experienc physician autom method infarct core delin volum measur develop testedmateri method ct postprocess softwar develop analysi whole brain perfus blood volum pbv cerebr blood volum cbv map program design potenti use mean transit time mtt cerebr blood flow cbf map propos method test set patient pbv cbv map whole brain coverag comparison result simpl threshold method manual mark find provid two independ physiciansresult propos method produc mark infarct core volum correspond manual delin volum simpl threshold method optim threshold use dataset mark formula see text larger volum compar volum delin physiciansconclus autom infarct core segment method base local neighborhood featur develop test demonstr util distinguish infarct noninfarct area well reduct number fals posit volum error

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