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Proceedings Paper

Automated prediction of tissue outcome after acute ischemic stroke in computed tomography perfusion images
Author(s): Pieter C. Vos; Edwin Bennink; Hugo de Jong; Birgitta K. Velthuis; Max A. Viergever; Jan Willem Dankbaar
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Paper 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.

Paper Details

Date Published: 20 March 2015
PDF: 7 pages
Proc. SPIE 9414, Medical Imaging 2015: Computer-Aided Diagnosis, 941412 (20 March 2015); doi: 10.1117/12.2081600
Show Author Affiliations
Pieter C. Vos, Univ. Medical Ctr. Utrecht (Netherlands)
Edwin Bennink, Univ. Medical Ctr. Utrecht (Netherlands)
Hugo de Jong, Univ. Medical Ctr. Utrecht (Netherlands)
Birgitta K. Velthuis, Univ. Medical Ctr. Utrecht (Netherlands)
Max A. Viergever, Univ. Medical Ctr. Utrecht (Netherlands)
Jan Willem Dankbaar, Univ. Medical Ctr. Utrecht (Netherlands)

Published in SPIE Proceedings Vol. 9414:
Medical Imaging 2015: Computer-Aided Diagnosis
Lubomir M. Hadjiiski; Georgia D. Tourassi, Editor(s)

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