13 Nov 20. Featured Paper
Feasibility & diagnostic accuracy of using brain attenuation changes on CT to estimate time of ischemic stroke onset.
We measured the attenuation of ischemic lesions & contralateral normal brain to derive attenuation ratio.
We assigned scans to development (75%) or test (25%) datasets.
We plotted the relationship between attenuation ratio & elapsed time in the development dataset & derived a best-fit curve.
We calculated estimated time in the test dataset using only the attenuation ratio curve.
We compared estimated time to elapsed time & derived absolute error for estimated time.
We assessed area under the receiver operating characteristic (AUROC) curve for identifying scans ≤ 4.5 h elapsed time.
Results: We included 342 scans from 200 patients (41% male, median age 83 years).
Elapsed time range: 22 min to 36 days.
Estimation errors were least at early elapsed times (r = 0.82, p < 0.0001): median absolute error was 23, 106, 1030 & 1933 min for scans acquired ≤ 3, > 3–9, > 9–30 & > 30 h from stroke onset, respectively. AUROC was high at 0.955.
Our method was most accurate 0–9 h from onset & may be useful for treatment eligibility assessment, especially where imaging resources are limited.
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Featured paper: Feasibility & diagnostic accuracy of using brain attenuation changes on CT to estimate time of ischemic stroke onset. @IST_3 #Stroke #CT