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Volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage
BACKGROUND: Follow-up imaging in intracerebral hemorrhage is not standardized and radiologists rely on different imaging modalities to determine hematoma growth. This study assesses the volumetric accuracy of different imaging modalities (MRI, CT angiography, postcontrast CT) to measure hematoma siz...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760700/ https://www.ncbi.nlm.nih.gov/pubmed/35033012 http://dx.doi.org/10.1186/s12880-022-00735-3 |
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author | Schlunk, Frieder Kuthe, Johannes Harmel, Peter Audebert, Heinrich Hanning, Uta Bohner, Georg Scheel, Michael Kleine, Justus Nawabi, Jawed |
author_facet | Schlunk, Frieder Kuthe, Johannes Harmel, Peter Audebert, Heinrich Hanning, Uta Bohner, Georg Scheel, Michael Kleine, Justus Nawabi, Jawed |
author_sort | Schlunk, Frieder |
collection | PubMed |
description | BACKGROUND: Follow-up imaging in intracerebral hemorrhage is not standardized and radiologists rely on different imaging modalities to determine hematoma growth. This study assesses the volumetric accuracy of different imaging modalities (MRI, CT angiography, postcontrast CT) to measure hematoma size. METHODS: 28 patients with acute spontaneous intracerebral hemorrhage referred to a tertiary stroke center were retrospectively included between 2018 and 2019. Inclusion criteria were (1) spontaneous intracerebral hemorrhage (supra- or infratentorial), (2) noncontrast CT imaging performed on admission, (3) follow-up imaging (CT angiography, postcontrast CT, MRI), and (4) absence of hematoma expansion confirmed by a third cranial image within 6 days. Two independent raters manually measured hematoma volume by drawing a region of interest on axial slices of admission noncontrast CT scans as well as on follow-up imaging (CT angiography, postcontrast CT, MRI) using a semi-automated segmentation tool (Visage image viewer; version 7.1.10). Results were compared using Bland–Altman plots. RESULTS: Mean admission hematoma volume was 18.79 ± 19.86 cc. All interrater and intrarater intraclass correlation coefficients were excellent (1; IQR 0.98–1.00). In comparison to hematoma volume on admission noncontrast CT volumetric measurements were most accurate in patients who received postcontrast CT (bias of − 2.47%, SD 4.67: n = 10), while CT angiography often underestimated hemorrhage volumes (bias of 31.91%, SD 45.54; n = 20). In MRI sequences intracerebral hemorrhage volumes were overestimated in T2* (bias of − 64.37%, SD 21.65; n = 10). FLAIR (bias of 6.05%, SD 35.45; n = 13) and DWI (bias of-14.6%, SD 31.93; n = 12) over- and underestimated hemorrhagic volumes. CONCLUSIONS: Volumetric measurements were most accurate in postcontrast CT while CT angiography and MRI sequences often substantially over- or underestimated hemorrhage volumes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12880-022-00735-3. |
format | Online Article Text |
id | pubmed-8760700 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87607002022-01-18 Volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage Schlunk, Frieder Kuthe, Johannes Harmel, Peter Audebert, Heinrich Hanning, Uta Bohner, Georg Scheel, Michael Kleine, Justus Nawabi, Jawed BMC Med Imaging Research Article BACKGROUND: Follow-up imaging in intracerebral hemorrhage is not standardized and radiologists rely on different imaging modalities to determine hematoma growth. This study assesses the volumetric accuracy of different imaging modalities (MRI, CT angiography, postcontrast CT) to measure hematoma size. METHODS: 28 patients with acute spontaneous intracerebral hemorrhage referred to a tertiary stroke center were retrospectively included between 2018 and 2019. Inclusion criteria were (1) spontaneous intracerebral hemorrhage (supra- or infratentorial), (2) noncontrast CT imaging performed on admission, (3) follow-up imaging (CT angiography, postcontrast CT, MRI), and (4) absence of hematoma expansion confirmed by a third cranial image within 6 days. Two independent raters manually measured hematoma volume by drawing a region of interest on axial slices of admission noncontrast CT scans as well as on follow-up imaging (CT angiography, postcontrast CT, MRI) using a semi-automated segmentation tool (Visage image viewer; version 7.1.10). Results were compared using Bland–Altman plots. RESULTS: Mean admission hematoma volume was 18.79 ± 19.86 cc. All interrater and intrarater intraclass correlation coefficients were excellent (1; IQR 0.98–1.00). In comparison to hematoma volume on admission noncontrast CT volumetric measurements were most accurate in patients who received postcontrast CT (bias of − 2.47%, SD 4.67: n = 10), while CT angiography often underestimated hemorrhage volumes (bias of 31.91%, SD 45.54; n = 20). In MRI sequences intracerebral hemorrhage volumes were overestimated in T2* (bias of − 64.37%, SD 21.65; n = 10). FLAIR (bias of 6.05%, SD 35.45; n = 13) and DWI (bias of-14.6%, SD 31.93; n = 12) over- and underestimated hemorrhagic volumes. CONCLUSIONS: Volumetric measurements were most accurate in postcontrast CT while CT angiography and MRI sequences often substantially over- or underestimated hemorrhage volumes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12880-022-00735-3. BioMed Central 2022-01-15 /pmc/articles/PMC8760700/ /pubmed/35033012 http://dx.doi.org/10.1186/s12880-022-00735-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Schlunk, Frieder Kuthe, Johannes Harmel, Peter Audebert, Heinrich Hanning, Uta Bohner, Georg Scheel, Michael Kleine, Justus Nawabi, Jawed Volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage |
title | Volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage |
title_full | Volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage |
title_fullStr | Volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage |
title_full_unstemmed | Volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage |
title_short | Volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage |
title_sort | volumetric accuracy of different imaging modalities in acute intracerebral hemorrhage |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760700/ https://www.ncbi.nlm.nih.gov/pubmed/35033012 http://dx.doi.org/10.1186/s12880-022-00735-3 |
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