Automated prediction of tissue outcome after acute ischemic stroke in computed tomography perfusion images

Pieter C. Vos; Edwin Bennink; Hugo de Jong; Birgitta K. Velthuis; Max A. Viergever; Jan Willem Dankbaar

doi:10.1117/12.2081600

20 March 2015 Automated prediction of tissue outcome after acute ischemic stroke in computed tomography perfusion images

Pieter C. Vos, Edwin Bennink, Hugo de Jong, Birgitta K. Velthuis, Max A. Viergever, Jan Willem Dankbaar

Author Affiliations +

Proceedings Volume 9414, Medical Imaging 2015: Computer-Aided Diagnosis; 941412 (2015) https://doi.org/10.1117/12.2081600
Event: SPIE Medical Imaging, 2015, Orlando, Florida, United States

Abstract

Assessment of the extent of cerebral damage on admission in patients with acute ischemic stroke could play an important role in treatment decision making. Computed tomography perfusion (CTP) imaging can be used to determine the extent of damage. However, clinical application is hindered by differences among vendors and used methodology. As a result, threshold based methods and visual assessment of CTP images has not yet shown to be useful in treatment decision making and predicting clinical outcome. Preliminary results in MR studies have shown the benefit of using supervised classifiers for predicting tissue outcome, but this has not been demonstrated for CTP. We present a novel method for the automatic prediction of tissue outcome by combining multi-parametric CTP images into a tissue outcome probability map. A supervised classification scheme was developed to extract absolute and relative perfusion values from processed CTP images that are summarized by a trained classifier into a likelihood of infarction. Training was performed using follow-up CT scans of 20 acute stroke patients with complete recanalization of the vessel that was occluded on admission. Infarcted regions were annotated by expert neuroradiologists. Multiple classifiers were evaluated in a leave-one-patient-out strategy for their discriminating performance using receiver operating characteristic (ROC) statistics. Results showed that a RandomForest classifier performed optimally with an area under the ROC of 0.90 for discriminating infarct tissue. The obtained results are an improvement over existing thresholding methods and are in line with results found in literature where MR perfusion was used.

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Pieter C. Vos, Edwin Bennink, Hugo de Jong, Birgitta K. Velthuis, Max A. Viergever, and Jan Willem Dankbaar "Automated prediction of tissue outcome after acute ischemic stroke in computed tomography perfusion images", Proc. SPIE 9414, Medical Imaging 2015: Computer-Aided Diagnosis, 941412 (20 March 2015); https://doi.org/10.1117/12.2081600

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KEYWORDS

Tissues

Computed tomography

Image segmentation

Ischemic stroke

Brain

Neuroimaging

Blood

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