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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Deutschmann, H; Hinteregger, N; Wießpeiner, U; Kneihsl, M; Fandler-Höfler, S; Michenthaler, M; Enzinger, C; Hassler, E; Leber, S; Reishofer, G.
Automated MRI perfusion-diffusion mismatch estimation may be significantly different in individual patients when using different software packages.
Eur Radiol. 2021; 31(2):658-665 Doi: 10.1007/s00330-020-07150-8 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Deutschmann Hannes
Reishofer Gernot
Co-Autor*innen der Med Uni Graz
Enzinger Christian
Fandler-Höfler Simon
Hassler Eva Maria
Hinteregger Nicole
Kneihsl Markus
Leber Stefan
Michenthaler Manuela Christine
Wießpeiner Ulrike Josefine

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OBJECTIVE: To compare two established software applications in terms of apparent diffusion coefficient (ADC) lesion volumes, volume of critically hypoperfused brain tissue, and calculated volumes of perfusion-diffusion mismatch in brain MRI of patients with acute ischemic stroke. METHODS: Brain MRI examinations of 81 patients with acute stroke due to large vessel occlusion of the anterior circulation were analyzed. The volume of hypoperfused brain tissue, ADC volume, and the volume of perfusion-diffusion mismatch were calculated automatically with two different software packages. The calculated parameters were compared quantitatively using formal statistics. RESULTS: Significant difference was found for the volume of hypoperfused tissue (median 91.0 ml vs. 102.2 ml; p < 0.05) and the ADC volume (median 30.0 ml vs. 23.9 ml; p < 0.05) between different software packages. The volume of the perfusion-diffusion mismatch differed significantly (median 47.0 ml vs. 67.2 ml; p < 0.05). Evaluation of the results on a single-subject basis revealed a mean absolute difference of 20.5 ml for hypoperfused tissue, 10.8 ml for ADC volumes, and 27.6 ml for mismatch volumes, respectively. Application of the DEFUSE 3 threshold of 70 ml infarction core would have resulted in dissenting treatment decisions in 6/81 (7.4%) patients. CONCLUSION: Volume segmentation in different software products may lead to significantly different results in the individual patient and may thus seriously influence the decision for or against mechanical thrombectomy. KEY POINTS: • Automated calculation of MRI perfusion-diffusion mismatch helps clinicians to apply inclusion and exclusion criteria derived from randomized trials. • Infarct volume segmentation plays a crucial role and lead to significantly different result for different computer programs. • Perfusion-diffusion mismatch estimation from different computer programs may influence the decision for or against mechanical thrombectomy.
Find related publications in this database (using NLM MeSH Indexing)
Brain Ischemia - diagnostic imaging
Cerebrovascular Circulation - administration & dosage
Diffusion Magnetic Resonance Imaging - administration & dosage
Humans - administration & dosage
Magnetic Resonance Imaging - administration & dosage
Perfusion - administration & dosage
Software - administration & dosage
Stroke - diagnostic imaging

Find related publications in this database (Keywords)
Magnetic resonance imaging
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