Temporal similarity perfusion mapping: A standardized and model-free method for detecting perfusion deficits in stroke.

Published online

Journal Article

INTRODUCTION: Interpretation of the extent of perfusion deficits in stroke MRI is highly dependent on the method used for analyzing the perfusion-weighted signal intensity time-series after gadolinium injection. In this study, we introduce a new model-free standardized method of temporal similarity perfusion (TSP) mapping for perfusion deficit detection and test its ability and reliability in acute ischemia. MATERIALS AND METHODS: Forty patients with an ischemic stroke or transient ischemic attack were included. Two blinded readers compared real-time generated interactive maps and automatically generated TSP maps to traditional TTP/MTT maps for presence of perfusion deficits. Lesion volumes were compared for volumetric inter-rater reliability, spatial concordance between perfusion deficits and healthy tissue and contrast-to-noise ratio (CNR). RESULTS: Perfusion deficits were correctly detected in all patients with acute ischemia. Inter-rater reliability was higher for TSP when compared to TTP/MTT maps and there was a high similarity between the lesion volumes depicted on TSP and TTP/MTT (r(18) = 0.73). The Pearson's correlation between lesions calculated on TSP and traditional maps was high (r(18) = 0.73, p<0.0003), however the effective CNR was greater for TSP compared to TTP (352.3 vs 283.5, t(19) = 2.6, p<0.03.) and MTT (228.3, t(19) = 2.8, p<0.03). DISCUSSION: TSP maps provide a reliable and robust model-free method for accurate perfusion deficit detection and improve lesion delineation compared to traditional methods. This simple method is also computationally faster and more easily automated than model-based methods. This method can potentially improve the speed and accuracy in perfusion deficit detection for acute stroke treatment and clinical trial inclusion decision-making.

Full Text

Duke Authors

Cited Authors

  • Song, S; Bokkers, RPH; Luby, M; Edwardson, MA; Brown, T; Shah, S; Cox, RW; Saad, ZS; Reynolds, RC; Glen, DR; Cohen, LG; Latour, LL

Published Date

  • 2017

Published In

Volume / Issue

  • 12 / 10

Start / End Page

  • e0185552 -

PubMed ID

  • 28973000

Pubmed Central ID

  • 28973000

Electronic International Standard Serial Number (EISSN)

  • 1932-6203

Digital Object Identifier (DOI)

  • 10.1371/journal.pone.0185552

Language

  • eng

Conference Location

  • United States