Cargando…
Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging
AIMS: We reprocessed the Extending the time for Thrombolysis in Emergency Neurological Deficits (EXTEND) perfusion imaging with a different automated software with the aim of comparing mismatch eligibility and outcomes. METHODS: EXTEND baseline perfusion imaging data were reprocessed using autoMISta...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8673699/ https://www.ncbi.nlm.nih.gov/pubmed/34786868 http://dx.doi.org/10.1111/cns.13756 |
_version_ | 1784615504816635904 |
---|---|
author | Bivard, Andrew Churilov, Leonid Ma, Henry Levi, Christopher Campbell, Bruce Yassi, Nawaf Meretoja, Atte Zhao, Henry Sharma, Gagan Chen, Chushuang Davis, Stephen Donnan, Geoffrey Yan, Bernard Parsons, Mark |
author_facet | Bivard, Andrew Churilov, Leonid Ma, Henry Levi, Christopher Campbell, Bruce Yassi, Nawaf Meretoja, Atte Zhao, Henry Sharma, Gagan Chen, Chushuang Davis, Stephen Donnan, Geoffrey Yan, Bernard Parsons, Mark |
author_sort | Bivard, Andrew |
collection | PubMed |
description | AIMS: We reprocessed the Extending the time for Thrombolysis in Emergency Neurological Deficits (EXTEND) perfusion imaging with a different automated software with the aim of comparing mismatch eligibility and outcomes. METHODS: EXTEND baseline perfusion imaging data were reprocessed using autoMIStar software to identify patients who were eligible based on the same target mismatch criteria as per the original trial. RESULTS: From the 225 patients fulfilling RAPID‐based mismatch criteria randomized in the EXTEND study, 196 (87%) patients met the revised mismatch criteria. Most common reasons for not meeting revised criteria were core >70 ml (n = 9), and no perfusion lesion/lack of penumbral tissue (n = 20). The revised perfusion lesion volumes were significantly smaller compared to the original RAPID volumes (median 68 ml IQR 34–102 ml vs. 42 ml 16–92 ml, p = 0.036). Of the patients who met the revised mismatch criteria, 40% receiving alteplase had modified Rankin Scale (mRS) 0–1 at 3‐month compared to 28% with placebo (Adjusted Odds Ratio (OR) = 2.23, CI 1.08–4.58, p = 0.028). In contrast, in the original mismatch cohort, 35% receiving alteplase had mRS 0–1 at 3‐month compared to 30% with placebo (adjusted OR = 1.88, p = 0.056). CONCLUSIONS: These data reinforce the benefit of alteplase in the later time window, and suggest that differences in automated perfusion imaging software outputs may be clinically relevant. |
format | Online Article Text |
id | pubmed-8673699 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-86736992021-12-22 Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging Bivard, Andrew Churilov, Leonid Ma, Henry Levi, Christopher Campbell, Bruce Yassi, Nawaf Meretoja, Atte Zhao, Henry Sharma, Gagan Chen, Chushuang Davis, Stephen Donnan, Geoffrey Yan, Bernard Parsons, Mark CNS Neurosci Ther Original Articles AIMS: We reprocessed the Extending the time for Thrombolysis in Emergency Neurological Deficits (EXTEND) perfusion imaging with a different automated software with the aim of comparing mismatch eligibility and outcomes. METHODS: EXTEND baseline perfusion imaging data were reprocessed using autoMIStar software to identify patients who were eligible based on the same target mismatch criteria as per the original trial. RESULTS: From the 225 patients fulfilling RAPID‐based mismatch criteria randomized in the EXTEND study, 196 (87%) patients met the revised mismatch criteria. Most common reasons for not meeting revised criteria were core >70 ml (n = 9), and no perfusion lesion/lack of penumbral tissue (n = 20). The revised perfusion lesion volumes were significantly smaller compared to the original RAPID volumes (median 68 ml IQR 34–102 ml vs. 42 ml 16–92 ml, p = 0.036). Of the patients who met the revised mismatch criteria, 40% receiving alteplase had modified Rankin Scale (mRS) 0–1 at 3‐month compared to 28% with placebo (Adjusted Odds Ratio (OR) = 2.23, CI 1.08–4.58, p = 0.028). In contrast, in the original mismatch cohort, 35% receiving alteplase had mRS 0–1 at 3‐month compared to 30% with placebo (adjusted OR = 1.88, p = 0.056). CONCLUSIONS: These data reinforce the benefit of alteplase in the later time window, and suggest that differences in automated perfusion imaging software outputs may be clinically relevant. John Wiley and Sons Inc. 2021-11-16 /pmc/articles/PMC8673699/ /pubmed/34786868 http://dx.doi.org/10.1111/cns.13756 Text en © 2021 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Bivard, Andrew Churilov, Leonid Ma, Henry Levi, Christopher Campbell, Bruce Yassi, Nawaf Meretoja, Atte Zhao, Henry Sharma, Gagan Chen, Chushuang Davis, Stephen Donnan, Geoffrey Yan, Bernard Parsons, Mark Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging |
title | Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging |
title_full | Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging |
title_fullStr | Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging |
title_full_unstemmed | Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging |
title_short | Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging |
title_sort | does variability in automated perfusion software outputs for acute ischemic stroke matter? reanalysis of extend perfusion imaging |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8673699/ https://www.ncbi.nlm.nih.gov/pubmed/34786868 http://dx.doi.org/10.1111/cns.13756 |
work_keys_str_mv | AT bivardandrew doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT churilovleonid doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT mahenry doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT levichristopher doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT campbellbruce doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT yassinawaf doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT meretojaatte doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT zhaohenry doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT sharmagagan doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT chenchushuang doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT davisstephen doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT donnangeoffrey doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT yanbernard doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT parsonsmark doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging AT doesvariabilityinautomatedperfusionsoftwareoutputsforacuteischemicstrokematterreanalysisofextendperfusionimaging |