- Title
- Does variability in automated perfusion software outputs for acute ischemic stroke matter? Reanalysis of EXTEND perfusion imaging
- Creator
- Bivard, Andrew; Churilov, Leonid; Davis, Stephen; Donnan, Geoffrey; Yan, Bernard; Parsons, Mark; Ma, Henry; Levi, Christopher; Campbell, Bruce; Yassi, Nawaf; Meretoja, Atte; Zhao, Henry; Sharma, Gagan; Chen, Chushuang
- Relation
- CNS Neuroscience & Therapeutics Vol. 28, Issue 1, p. 139-144
- Publisher Link
- http://dx.doi.org/10.1111/cns.13756
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2022
- 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.
- Subject
- CT perfusion; ischemic stroke; target mismatch; thombolysis; SDG 3; SDG 10; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1462498
- Identifier
- uon:46485
- Identifier
- ISSN:1755-5930
- Rights
- © 2021 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd.
- Language
- eng
- Full Text
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Goal 10: Reduced Inequalities
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