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Automated infarction core delineation using cerebral and perfused blood volume maps

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Thrombolytic therapy in patients with acute ischemic stroke is contraindicated when the infarction core exceeds a given threshold. To date, there are no standardized guidelines for computed tomography infarction core assessment. Current practice involves use of thresholding methods, where the results are further adjusted by an experienced physician. An automated method for infarction core delineation and volume measurement was developed and tested.

Materials and methods

CT postprocessing software was developed for analysis of whole brain perfused blood volume (PBV) and cerebral blood volume (CBV) maps. The program was designed for potential use with mean transit time (MTT) or cerebral blood flow (CBF) maps. The proposed method was tested on a set of 12 patients on both PBV and CBV maps with whole brain coverage by comparison with the results of a simple thresholding method and with manually marked findings provided by two independent physicians.

Results

The proposed method produced a marked infarct core volume corresponding to 53 % of the manually delineated volumes. The simple thresholding method with the optimal threshold, using the same dataset, marked 15\(\times \) larger volume compared to the volume delineated by physicians.

Conclusion

An automated infarction core segmentation method based on local neighborhood features was developed and tested, demonstrating its utility in distinguishing between infarcted and non-infarcted areas, as well as reduction in the number of false positives and volume error.

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Acknowledgments

The research was supported by a grant from the Grant Agency of the Czech Republic—Microstructure-oriented hierarchical modeling of brain perfusion for CT-based cerebral blood flow evaluation, no. 106/09/0740.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Computer Science and Engineering, University of West Bohemia, Univerzitní 22, 306 14, Pilsen, Czech Republic

    Petr Maule & Jana Klečková

  2. Department of Neurology, The University Hospital, Pilsen, Czech Republic

    Vladimír Rohan

  3. Department of Radiology, The University Hospital, Pilsen, Czech Republic

    Vladimír Rohan & Radek Tupý

Authors
  1. Petr Maule
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  2. Jana Klečková
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  3. Vladimír Rohan
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  4. Radek Tupý
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Correspondence to Petr Maule.

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Maule, P., Klečková, J., Rohan, V. et al. Automated infarction core delineation using cerebral and perfused blood volume maps. Int J CARS 8, 787–797 (2013). https://doi.org/10.1007/s11548-013-0815-9

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  • DOI: https://doi.org/10.1007/s11548-013-0815-9

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