Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study

Lars Peder Pallesen; Johannes Gerber; Imanuel Dzialowski; Erik J R J van der Hoeven; Patrik Michel; Thomas Pfefferkorn; Christoph Ozdoba; L. Jaap Kappelle; Baerbel Wiedemann; Andrei Khomenko; Ale Algra; Michael D. Hill; Ruediger von Kummer; Andrew M. Demchuk; Wouter J. Schonewille; Volker Puetz; A. M. Weber; G. A. Donnan; V. Thijs; A. Peeters; G. de Freitas; A. B. Conforto; M. Miranda-Alves; A. Massaro; P. Ijäs; T. Bogoslovsky; P. J. Lindsberg; C. Weimar; J. Benemann; K. Kraywinkel; C. Haverkamp; D. Michalski; C. Weimar; K. Weissenborn; M. Goertler; A. Kloth; A. Bitsch; T. Mieck; J. Machetanz; P. Möller; R. Huber; S. Kaendler; C. Rueckert; H. Audebert; R. Müller; B. Vatankhah; T. Pfefferkorn; T. E. Mayer; K. Szabo; C. Disque; O. Busse; C. Berger; W. Hacke; Y. Schwammenthal; D. Orion; D. Tanne; M. Bergui; E. Pozzati; W. J. Schonewille; E. van der Hoeven; W. J. Schonewille; A. Algra; L. J. Kappelle; G. J. Luijckx; P. Vroomen; M. D. Vergouwen; Y. Roos; J. Stam; P. de Bienfait; F. E. de Leeuw; P. de Kort; P. de Kort; D. Dippel; T. Baird; K. Muir; N. McDougall; J. Pagola; M. Ribo; C. Molina; A. Gonzales; A. Gil-Peralta; B. Norrving; M. Arnold; U. Fischer; J. Gralla; H. Mattle; G. Schroth; P. Michel; S. T. Engelter; S. Wetzel; P. Lyrer; J. Gandjour; N. Michael; R. Baumgartner; B. Tettenborn; H. Hungerbuehler; C. A C Wijman; A. Finley Caulfield; M. Lansberg; N. Schwartz; C. Venkatasubramanian; Z. Garami; S. Bogaard; F. Yatzu; J. Grotta

doi:10.1111/jon.12130

Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study

Lars Peder Pallesen^*, Johannes Gerber, Imanuel Dzialowski, Erik J R J van der Hoeven, Patrik Michel, Thomas Pfefferkorn, Christoph Ozdoba, L. Jaap Kappelle, Baerbel Wiedemann, Andrei Khomenko, Ale Algra, Michael D. Hill, Ruediger von Kummer, Andrew M. Demchuk, Wouter J. Schonewille, Volker Puetz, A. M. Weber, G. A. Donnan, V. Thijs, A. PeetersG. de Freitas, A. B. Conforto, M. Miranda-Alves, A. Massaro, P. Ijäs, T. Bogoslovsky, P. J. Lindsberg, C. Weimar, J. Benemann, K. Kraywinkel, C. Haverkamp, D. Michalski, C. Weimar, K. Weissenborn, M. Goertler, A. Kloth, A. Bitsch, T. Mieck, J. Machetanz, P. Möller, R. Huber, S. Kaendler, C. Rueckert, H. Audebert, R. Müller, B. Vatankhah, T. Pfefferkorn, T. E. Mayer, K. Szabo, C. Disque, O. Busse, C. Berger, W. Hacke, Y. Schwammenthal, D. Orion, D. Tanne, M. Bergui, E. Pozzati, W. J. Schonewille, E. van der Hoeven, W. J. Schonewille, A. Algra, L. J. Kappelle, G. J. Luijckx, P. Vroomen, M. D. Vergouwen, Y. Roos, J. Stam, P. de Bienfait, F. E. de Leeuw, P. de Kort, P. de Kort, D. Dippel, T. Baird, K. Muir, N. McDougall, J. Pagola, M. Ribo, C. Molina, A. Gonzales, A. Gil-Peralta, B. Norrving, M. Arnold, U. Fischer, J. Gralla, H. Mattle, G. Schroth, P. Michel, S. T. Engelter, S. Wetzel, P. Lyrer, J. Gandjour, N. Michael, R. Baumgartner, B. Tettenborn, H. Hungerbuehler, C. A C Wijman, A. Finley Caulfield, M. Lansberg, N. Schwartz, C. Venkatasubramanian, Z. Garami, S. Bogaard, F. Yatzu, J. Grotta

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Circulatory Health

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Abstract

BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. METHODS: We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. RESULTS: CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6). CONCLUSION: CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality.

Original language	English
Pages (from-to)	384-389
Number of pages	6
Journal	Journal of Neuroimaging
Volume	25
Issue number	3
DOIs	https://doi.org/10.1111/jon.12130
Publication status	Published - 1 Jan 2015

Keywords

Basilar artery occlusion
CT perfusion
Pc-ASPECTS

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10.1111/jon.12130

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Pallesen, L. P., Gerber, J., Dzialowski, I., van der Hoeven, E. J. R. J., Michel, P., Pfefferkorn, T., Ozdoba, C., Kappelle, L. J., Wiedemann, B., Khomenko, A., Algra, A., Hill, M. D., von Kummer, R., Demchuk, A. M., Schonewille, W. J., Puetz, V., Weber, A. M., Donnan, G. A., Thijs, V., ... Grotta, J. (2015). Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study. Journal of Neuroimaging, 25(3), 384-389. https://doi.org/10.1111/jon.12130

@article{483a8096006345d0a1ba2911bf9b46f3,

title = "Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study",

abstract = "BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. METHODS: We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. RESULTS: CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6). CONCLUSION: CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality.",

keywords = "Basilar artery occlusion, CT perfusion, Pc-ASPECTS",

author = "Pallesen, {Lars Peder} and Johannes Gerber and Imanuel Dzialowski and {van der Hoeven}, {Erik J R J} and Patrik Michel and Thomas Pfefferkorn and Christoph Ozdoba and Kappelle, {L. Jaap} and Baerbel Wiedemann and Andrei Khomenko and Ale Algra and Hill, {Michael D.} and {von Kummer}, Ruediger and Demchuk, {Andrew M.} and Schonewille, {Wouter J.} and Volker Puetz and Weber, {A. M.} and Donnan, {G. A.} and V. Thijs and A. Peeters and {de Freitas}, G. and Conforto, {A. B.} and M. Miranda-Alves and A. Massaro and P. Ij{\"a}s and T. Bogoslovsky and Lindsberg, {P. J.} and C. Weimar and J. Benemann and K. Kraywinkel and C. Haverkamp and D. Michalski and C. Weimar and K. Weissenborn and M. Goertler and A. Kloth and A. Bitsch and T. Mieck and J. Machetanz and P. M{\"o}ller and R. Huber and S. Kaendler and C. Rueckert and H. Audebert and R. M{\"u}ller and B. Vatankhah and T. Pfefferkorn and Mayer, {T. E.} and K. Szabo and C. Disque and O. Busse and C. Berger and W. Hacke and Y. Schwammenthal and D. Orion and D. Tanne and M. Bergui and E. Pozzati and Schonewille, {W. J.} and {van der Hoeven}, E. and Schonewille, {W. J.} and A. Algra and Kappelle, {L. J.} and Luijckx, {G. J.} and P. Vroomen and Vergouwen, {M. D.} and Y. Roos and J. Stam and {de Bienfait}, P. and {de Leeuw}, {F. E.} and {de Kort}, P. and {de Kort}, P. and D. Dippel and T. Baird and K. Muir and N. McDougall and J. Pagola and M. Ribo and C. Molina and A. Gonzales and A. Gil-Peralta and B. Norrving and M. Arnold and U. Fischer and J. Gralla and H. Mattle and G. Schroth and P. Michel and Engelter, {S. T.} and S. Wetzel and P. Lyrer and J. Gandjour and N. Michael and R. Baumgartner and B. Tettenborn and H. Hungerbuehler and Wijman, {C. A C} and Caulfield, {A. Finley} and M. Lansberg and N. Schwartz and C. Venkatasubramanian and Z. Garami and S. Bogaard and F. Yatzu and J. Grotta",

year = "2015",

month = jan,

day = "1",

doi = "10.1111/jon.12130",

language = "English",

volume = "25",

pages = "384--389",

journal = "Journal of Neuroimaging",

issn = "1051-2284",

publisher = "Wiley-Blackwell",

number = "3",

}

Pallesen, LP, Gerber, J, Dzialowski, I, van der Hoeven, EJRJ, Michel, P, Pfefferkorn, T, Ozdoba, C, Kappelle, LJ, Wiedemann, B, Khomenko, A, Algra, A, Hill, MD, von Kummer, R, Demchuk, AM, Schonewille, WJ, Puetz, V, Weber, AM, Donnan, GA, Thijs, V, Peeters, A, de Freitas, G, Conforto, AB, Miranda-Alves, M, Massaro, A, Ijäs, P, Bogoslovsky, T, Lindsberg, PJ, Weimar, C, Benemann, J, Kraywinkel, K, Haverkamp, C, Michalski, D, Weimar, C, Weissenborn, K, Goertler, M, Kloth, A, Bitsch, A, Mieck, T, Machetanz, J, Möller, P, Huber, R, Kaendler, S, Rueckert, C, Audebert, H, Müller, R, Vatankhah, B, Pfefferkorn, T, Mayer, TE, Szabo, K, Disque, C, Busse, O, Berger, C, Hacke, W, Schwammenthal, Y, Orion, D, Tanne, D, Bergui, M, Pozzati, E, Schonewille, WJ, van der Hoeven, E, Schonewille, WJ, Algra, A , Kappelle, LJ, Luijckx, GJ, Vroomen, P, Vergouwen, MD, Roos, Y, Stam, J, de Bienfait, P, de Leeuw, FE, de Kort, P, de Kort, P, Dippel, D, Baird, T, Muir, K, McDougall, N, Pagola, J, Ribo, M, Molina, C, Gonzales, A, Gil-Peralta, A, Norrving, B, Arnold, M, Fischer, U, Gralla, J, Mattle, H, Schroth, G, Michel, P, Engelter, ST, Wetzel, S, Lyrer, P, Gandjour, J, Michael, N, Baumgartner, R, Tettenborn, B, Hungerbuehler, H, Wijman, CAC, Caulfield, AF, Lansberg, M, Schwartz, N, Venkatasubramanian, C, Garami, Z, Bogaard, S, Yatzu, F & Grotta, J 2015, 'Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study', Journal of Neuroimaging, vol. 25, no. 3, pp. 384-389. https://doi.org/10.1111/jon.12130

TY - JOUR

T1 - Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study

AU - Pallesen, Lars Peder

AU - Gerber, Johannes

AU - Dzialowski, Imanuel

AU - van der Hoeven, Erik J R J

AU - Michel, Patrik

AU - Pfefferkorn, Thomas

AU - Ozdoba, Christoph

AU - Kappelle, L. Jaap

AU - Wiedemann, Baerbel

AU - Khomenko, Andrei

AU - Algra, Ale

AU - Hill, Michael D.

AU - von Kummer, Ruediger

AU - Demchuk, Andrew M.

AU - Schonewille, Wouter J.

AU - Puetz, Volker

AU - Weber, A. M.

AU - Donnan, G. A.

AU - Thijs, V.

AU - Peeters, A.

AU - de Freitas, G.

AU - Conforto, A. B.

AU - Miranda-Alves, M.

AU - Massaro, A.

AU - Ijäs, P.

AU - Bogoslovsky, T.

AU - Lindsberg, P. J.

AU - Weimar, C.

AU - Benemann, J.

AU - Kraywinkel, K.

AU - Haverkamp, C.

AU - Michalski, D.

AU - Weimar, C.

AU - Weissenborn, K.

AU - Goertler, M.

AU - Kloth, A.

AU - Bitsch, A.

AU - Mieck, T.

AU - Machetanz, J.

AU - Möller, P.

AU - Huber, R.

AU - Kaendler, S.

AU - Rueckert, C.

AU - Audebert, H.

AU - Müller, R.

AU - Vatankhah, B.

AU - Pfefferkorn, T.

AU - Mayer, T. E.

AU - Szabo, K.

AU - Disque, C.

AU - Busse, O.

AU - Berger, C.

AU - Hacke, W.

AU - Schwammenthal, Y.

AU - Orion, D.

AU - Tanne, D.

AU - Bergui, M.

AU - Pozzati, E.

AU - Schonewille, W. J.

AU - van der Hoeven, E.

AU - Schonewille, W. J.

AU - Algra, A.

AU - Kappelle, L. J.

AU - Luijckx, G. J.

AU - Vroomen, P.

AU - Vergouwen, M. D.

AU - Roos, Y.

AU - Stam, J.

AU - de Bienfait, P.

AU - de Leeuw, F. E.

AU - de Kort, P.

AU - Dippel, D.

AU - Baird, T.

AU - Muir, K.

AU - McDougall, N.

AU - Pagola, J.

AU - Ribo, M.

AU - Molina, C.

AU - Gonzales, A.

AU - Gil-Peralta, A.

AU - Norrving, B.

AU - Arnold, M.

AU - Fischer, U.

AU - Gralla, J.

AU - Mattle, H.

AU - Schroth, G.

AU - Michel, P.

AU - Engelter, S. T.

AU - Wetzel, S.

AU - Lyrer, P.

AU - Gandjour, J.

AU - Michael, N.

AU - Baumgartner, R.

AU - Tettenborn, B.

AU - Hungerbuehler, H.

AU - Wijman, C. A C

AU - Caulfield, A. Finley

AU - Lansberg, M.

AU - Schwartz, N.

AU - Venkatasubramanian, C.

AU - Garami, Z.

AU - Bogaard, S.

AU - Yatzu, F.

AU - Grotta, J.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. METHODS: We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. RESULTS: CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6). CONCLUSION: CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality.

AB - BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. METHODS: We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. RESULTS: CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6). CONCLUSION: CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality.

KW - Basilar artery occlusion

KW - CT perfusion

KW - Pc-ASPECTS

UR - http://www.scopus.com/inward/record.url?scp=84929023897&partnerID=8YFLogxK

U2 - 10.1111/jon.12130

DO - 10.1111/jon.12130

M3 - Article

C2 - 24942473

AN - SCOPUS:84929023897

SN - 1051-2284

VL - 25

SP - 384

EP - 389

JO - Journal of Neuroimaging

JF - Journal of Neuroimaging

IS - 3

ER -

Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study

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