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Dual-Energy Computed Tomography in Stroke Imaging: Value of a New Image Acquisition Technique for Ischemia Detection after Mechanical Thrombectomy

OBJECTIVE: To assess if a new dual-energy computed tomography (DECT) technique enables an improved visualization of ischemic brain tissue after mechanical thrombectomy in acute stroke patients. MATERIAL AND METHODS: The DECT head scans with a new sequential technique (TwinSpiral DECT) were performed...

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Autores principales: Grkovski, Risto, Acu, Leyla, Ahmadli, Uzeyir, Nakhostin, Dominik, Thurner, Patrick, Wacht, Lorenz, Kulcsár, Zsolt, Alkadhi, Hatem, Winklhofer, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10450017/
https://www.ncbi.nlm.nih.gov/pubmed/36862231
http://dx.doi.org/10.1007/s00062-023-01270-6
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author Grkovski, Risto
Acu, Leyla
Ahmadli, Uzeyir
Nakhostin, Dominik
Thurner, Patrick
Wacht, Lorenz
Kulcsár, Zsolt
Alkadhi, Hatem
Winklhofer, Sebastian
author_facet Grkovski, Risto
Acu, Leyla
Ahmadli, Uzeyir
Nakhostin, Dominik
Thurner, Patrick
Wacht, Lorenz
Kulcsár, Zsolt
Alkadhi, Hatem
Winklhofer, Sebastian
author_sort Grkovski, Risto
collection PubMed
description OBJECTIVE: To assess if a new dual-energy computed tomography (DECT) technique enables an improved visualization of ischemic brain tissue after mechanical thrombectomy in acute stroke patients. MATERIAL AND METHODS: The DECT head scans with a new sequential technique (TwinSpiral DECT) were performed in 41 patients with ischemic stroke after endovascular thrombectomy and were retrospectively included. Standard mixed and virtual non-contrast (VNC) images were reconstructed. Infarct visibility and image noise were assessed qualitatively by two readers using a 4-point Likert scale. Quantitative Hounsfield units (HU) were used to assess density differences of ischemic brain tissue versus healthy tissue on the non-affected contralateral hemisphere. RESULTS: Infarct visibility was significantly better in VNC compared to mixed images for both readers R1 (VNC: median 1 (range 1–3), mixed: median 2 (range 1–4), p < 0.05) and R2 (VNC: median 2 (range 1–3), mixed: 2 (range 1–4), p < 0.05). Qualitative image noise was significantly higher in VNC compared to mixed images for both readers R1 (VNC: median 3, mixed: 2) and R2 (VNC: median 2, mixed: 1, p < 0.05, each). Mean HU were significantly different between the infarcted tissue and the reference healthy brain tissue on the contralateral hemisphere in VNC (infarct 24 ± 3) and mixed images (infarct 33 ± 5, p < 0.05, each). The mean HU difference between ischemia and reference in VNC images (mean 8 ± 3) was significantly higher (p < 0.05) compared to the mean HU difference in mixed images (mean 5 ± 4). CONCLUSION: TwinSpiral DECT allows an improved qualitative and quantitative visualization of ischemic brain tissue in ischemic stroke patients after endovascular treatment.
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spelling pubmed-104500172023-08-26 Dual-Energy Computed Tomography in Stroke Imaging: Value of a New Image Acquisition Technique for Ischemia Detection after Mechanical Thrombectomy Grkovski, Risto Acu, Leyla Ahmadli, Uzeyir Nakhostin, Dominik Thurner, Patrick Wacht, Lorenz Kulcsár, Zsolt Alkadhi, Hatem Winklhofer, Sebastian Clin Neuroradiol Original Article OBJECTIVE: To assess if a new dual-energy computed tomography (DECT) technique enables an improved visualization of ischemic brain tissue after mechanical thrombectomy in acute stroke patients. MATERIAL AND METHODS: The DECT head scans with a new sequential technique (TwinSpiral DECT) were performed in 41 patients with ischemic stroke after endovascular thrombectomy and were retrospectively included. Standard mixed and virtual non-contrast (VNC) images were reconstructed. Infarct visibility and image noise were assessed qualitatively by two readers using a 4-point Likert scale. Quantitative Hounsfield units (HU) were used to assess density differences of ischemic brain tissue versus healthy tissue on the non-affected contralateral hemisphere. RESULTS: Infarct visibility was significantly better in VNC compared to mixed images for both readers R1 (VNC: median 1 (range 1–3), mixed: median 2 (range 1–4), p < 0.05) and R2 (VNC: median 2 (range 1–3), mixed: 2 (range 1–4), p < 0.05). Qualitative image noise was significantly higher in VNC compared to mixed images for both readers R1 (VNC: median 3, mixed: 2) and R2 (VNC: median 2, mixed: 1, p < 0.05, each). Mean HU were significantly different between the infarcted tissue and the reference healthy brain tissue on the contralateral hemisphere in VNC (infarct 24 ± 3) and mixed images (infarct 33 ± 5, p < 0.05, each). The mean HU difference between ischemia and reference in VNC images (mean 8 ± 3) was significantly higher (p < 0.05) compared to the mean HU difference in mixed images (mean 5 ± 4). CONCLUSION: TwinSpiral DECT allows an improved qualitative and quantitative visualization of ischemic brain tissue in ischemic stroke patients after endovascular treatment. Springer Berlin Heidelberg 2023-03-02 2023 /pmc/articles/PMC10450017/ /pubmed/36862231 http://dx.doi.org/10.1007/s00062-023-01270-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Grkovski, Risto
Acu, Leyla
Ahmadli, Uzeyir
Nakhostin, Dominik
Thurner, Patrick
Wacht, Lorenz
Kulcsár, Zsolt
Alkadhi, Hatem
Winklhofer, Sebastian
Dual-Energy Computed Tomography in Stroke Imaging: Value of a New Image Acquisition Technique for Ischemia Detection after Mechanical Thrombectomy
title Dual-Energy Computed Tomography in Stroke Imaging: Value of a New Image Acquisition Technique for Ischemia Detection after Mechanical Thrombectomy
title_full Dual-Energy Computed Tomography in Stroke Imaging: Value of a New Image Acquisition Technique for Ischemia Detection after Mechanical Thrombectomy
title_fullStr Dual-Energy Computed Tomography in Stroke Imaging: Value of a New Image Acquisition Technique for Ischemia Detection after Mechanical Thrombectomy
title_full_unstemmed Dual-Energy Computed Tomography in Stroke Imaging: Value of a New Image Acquisition Technique for Ischemia Detection after Mechanical Thrombectomy
title_short Dual-Energy Computed Tomography in Stroke Imaging: Value of a New Image Acquisition Technique for Ischemia Detection after Mechanical Thrombectomy
title_sort dual-energy computed tomography in stroke imaging: value of a new image acquisition technique for ischemia detection after mechanical thrombectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10450017/
https://www.ncbi.nlm.nih.gov/pubmed/36862231
http://dx.doi.org/10.1007/s00062-023-01270-6
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