Time-to-Maximum of the Tissue Residue Function Improves Diagnostic Performance for Detecting Distal Vessel Occlusions on CT Angiography

• DOI: 10.3174/ajnr.a6891
• Publication Date: 2021-01-11T18:00:57Z
• Authors: S.A. Amukotuwa; A. Wu; K. Zhou; I. Page; P. Brotchie; R. Bammer
• Keywords: Male; Computed Tomography Angiography; Arterial Occlusive Diseases; Neuroimaging; Middle Aged; Cerebral Angiography; 03 medical and health sciences; 0302 clinical medicine; ROC Curve; Image Interpretation, Computer-Assisted; Humans; Female; Tomography, X-Ray Computed; Aged; Ischemic Stroke; Retrospective Studies

Detecting intracranial distal arterial occlusions on CTA is challenging but increasingly relevant to clinical decision-making. Our purpose was determine whether the use of CTP-derived time-to-maximum tissue residue function maps improves diagnostic performance for detecting these occlusions.Seventy consecutive patients with a occlusion and 70 randomly selected controls who underwent multimodal CT CTP suspected acute ischemic stroke were included in this retrospective study. Four readers different levels experience independently read CTAs 2 separate sessions, without maps, recording presence or absence an occlusion, confidence, interpretation time. Accuracy assessed using receiver operating characteristic analysis, areas under curves compared assess accuracy improved function. Changes confidence time Wilcoxon signed rank test.Mean sensitivity increased from 70.7% 90.4% maps. Diagnostic significantly 4 (P < .001), increasing by 0.186, 0.136, 0.114, 0.121, respectively. speed also increased.All metrics encouraging their aid both experienced inexperienced readers. These findings show added value including imaging protocol.