CT Angiography ASPECTS Predicts Outcome Much Better Than Noncontrast CT in Patients with Stroke Treated Endovascularly

F Sallustio, C Motta, S Pizzuto, M Diomedi, B Rizzato, M Panella, F Alemseged, M Stefanini, S Fabiano, R Gandini, R Floris, P Stanzione, G Koch

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Noncontrast CT ASPECTS has been investigated as a predictor of outcome in patients with acute ischemic stroke. Our purpose was to investigate whether CTA source images are a better predictor of clinical and radiologic outcomes than NCCT ASPECTS in candidates for endovascular stroke therapy.

MATERIALS AND METHODS: CT scans of patients (n= 124) were independently evaluated by 2 readers for baseline NCCT and CTA source image ASPECTS and for follow-up ASPECTS. An mRS of ≤2 at 3 months was considered a favorable outcome. Receiver operating characteristic curve analysis was used to assess the ability of NCCT and CTA source image ASPECTS to identify patients with favorable outcomes. A stepwise multiple regression analysis was performed to find independent predictors of outcome.

RESULTS: Baseline CTA source image ASPECTS correlated better than NCCT ASPECTS with follow-up ASPECTS (r= 0.76 versusr= 0.51;Pfor comparison of the 2 coefficients < .001). Receiver operating characteristic curve analysis showed that baseline CTA source image ASPECTS compared with NCCT ASPECTS can better identify patients with favorable outcome (CTA source image area under the curve = 0.83; 95% CI, 0.76-0.91; NCCT area under the curve = 0.67; 95% CI, 0.58-0.77;P< .001). Finally, the stepwise regression analysis showed that lower age, good recanalization, lower time to recanalization, and good baseline CTA source image ASPECTS, not NCCT ASPECTS, were independent predictors of favorable outcome.

CONCLUSIONS: CTA source image ASPECTS predicts outcome better than NCCT ASPECTS; this finding suggests CTA rather than NCCT as a main step in the decision-making process for patients with acute ischemic stroke.

Original languageEnglish
Pages (from-to)1569-1573
Number of pages5
JournalAmerican Journal of Neuroradiology
Volume38
Issue number8
DOIs
Publication statusPublished - Aug 2017

Fingerprint

Stroke
ROC Curve
Area Under Curve
Regression Analysis
Aptitude
Decision Making
Computed Tomography Angiography
Therapeutics

Cite this

CT Angiography ASPECTS Predicts Outcome Much Better Than Noncontrast CT in Patients with Stroke Treated Endovascularly. / Sallustio, F; Motta, C; Pizzuto, S; Diomedi, M; Rizzato, B; Panella, M; Alemseged, F; Stefanini, M; Fabiano, S; Gandini, R; Floris, R; Stanzione, P; Koch, G.

In: American Journal of Neuroradiology, Vol. 38, No. 8, 08.2017, p. 1569-1573.

Research output: Contribution to journalArticle

Sallustio, F, Motta, C, Pizzuto, S, Diomedi, M, Rizzato, B, Panella, M, Alemseged, F, Stefanini, M, Fabiano, S, Gandini, R, Floris, R, Stanzione, P & Koch, G 2017, 'CT Angiography ASPECTS Predicts Outcome Much Better Than Noncontrast CT in Patients with Stroke Treated Endovascularly', American Journal of Neuroradiology, vol. 38, no. 8, pp. 1569-1573. https://doi.org/10.3174/ajnr.A5264
Sallustio, F ; Motta, C ; Pizzuto, S ; Diomedi, M ; Rizzato, B ; Panella, M ; Alemseged, F ; Stefanini, M ; Fabiano, S ; Gandini, R ; Floris, R ; Stanzione, P ; Koch, G. / CT Angiography ASPECTS Predicts Outcome Much Better Than Noncontrast CT in Patients with Stroke Treated Endovascularly. In: American Journal of Neuroradiology. 2017 ; Vol. 38, No. 8. pp. 1569-1573.
@article{a7c640c67edb4e119076ff660c8f0025,
title = "CT Angiography ASPECTS Predicts Outcome Much Better Than Noncontrast CT in Patients with Stroke Treated Endovascularly",
abstract = "BACKGROUND AND PURPOSE: Noncontrast CT ASPECTS has been investigated as a predictor of outcome in patients with acute ischemic stroke. Our purpose was to investigate whether CTA source images are a better predictor of clinical and radiologic outcomes than NCCT ASPECTS in candidates for endovascular stroke therapy.MATERIALS AND METHODS: CT scans of patients (n= 124) were independently evaluated by 2 readers for baseline NCCT and CTA source image ASPECTS and for follow-up ASPECTS. An mRS of ≤2 at 3 months was considered a favorable outcome. Receiver operating characteristic curve analysis was used to assess the ability of NCCT and CTA source image ASPECTS to identify patients with favorable outcomes. A stepwise multiple regression analysis was performed to find independent predictors of outcome.RESULTS: Baseline CTA source image ASPECTS correlated better than NCCT ASPECTS with follow-up ASPECTS (r= 0.76 versusr= 0.51;Pfor comparison of the 2 coefficients < .001). Receiver operating characteristic curve analysis showed that baseline CTA source image ASPECTS compared with NCCT ASPECTS can better identify patients with favorable outcome (CTA source image area under the curve = 0.83; 95{\%} CI, 0.76-0.91; NCCT area under the curve = 0.67; 95{\%} CI, 0.58-0.77;P< .001). Finally, the stepwise regression analysis showed that lower age, good recanalization, lower time to recanalization, and good baseline CTA source image ASPECTS, not NCCT ASPECTS, were independent predictors of favorable outcome.CONCLUSIONS: CTA source image ASPECTS predicts outcome better than NCCT ASPECTS; this finding suggests CTA rather than NCCT as a main step in the decision-making process for patients with acute ischemic stroke.",
author = "F Sallustio and C Motta and S Pizzuto and M Diomedi and B Rizzato and M Panella and F Alemseged and M Stefanini and S Fabiano and R Gandini and R Floris and P Stanzione and G Koch",
note = "{\circledC} 2017 by American Journal of Neuroradiology.",
year = "2017",
month = "8",
doi = "10.3174/ajnr.A5264",
language = "English",
volume = "38",
pages = "1569--1573",
journal = "American Journal of Neuroradiology",
issn = "0195-6108",
publisher = "American Society of Neuroradiology",
number = "8",

}

TY - JOUR

T1 - CT Angiography ASPECTS Predicts Outcome Much Better Than Noncontrast CT in Patients with Stroke Treated Endovascularly

AU - Sallustio, F

AU - Motta, C

AU - Pizzuto, S

AU - Diomedi, M

AU - Rizzato, B

AU - Panella, M

AU - Alemseged, F

AU - Stefanini, M

AU - Fabiano, S

AU - Gandini, R

AU - Floris, R

AU - Stanzione, P

AU - Koch, G

N1 - © 2017 by American Journal of Neuroradiology.

PY - 2017/8

Y1 - 2017/8

N2 - BACKGROUND AND PURPOSE: Noncontrast CT ASPECTS has been investigated as a predictor of outcome in patients with acute ischemic stroke. Our purpose was to investigate whether CTA source images are a better predictor of clinical and radiologic outcomes than NCCT ASPECTS in candidates for endovascular stroke therapy.MATERIALS AND METHODS: CT scans of patients (n= 124) were independently evaluated by 2 readers for baseline NCCT and CTA source image ASPECTS and for follow-up ASPECTS. An mRS of ≤2 at 3 months was considered a favorable outcome. Receiver operating characteristic curve analysis was used to assess the ability of NCCT and CTA source image ASPECTS to identify patients with favorable outcomes. A stepwise multiple regression analysis was performed to find independent predictors of outcome.RESULTS: Baseline CTA source image ASPECTS correlated better than NCCT ASPECTS with follow-up ASPECTS (r= 0.76 versusr= 0.51;Pfor comparison of the 2 coefficients < .001). Receiver operating characteristic curve analysis showed that baseline CTA source image ASPECTS compared with NCCT ASPECTS can better identify patients with favorable outcome (CTA source image area under the curve = 0.83; 95% CI, 0.76-0.91; NCCT area under the curve = 0.67; 95% CI, 0.58-0.77;P< .001). Finally, the stepwise regression analysis showed that lower age, good recanalization, lower time to recanalization, and good baseline CTA source image ASPECTS, not NCCT ASPECTS, were independent predictors of favorable outcome.CONCLUSIONS: CTA source image ASPECTS predicts outcome better than NCCT ASPECTS; this finding suggests CTA rather than NCCT as a main step in the decision-making process for patients with acute ischemic stroke.

AB - BACKGROUND AND PURPOSE: Noncontrast CT ASPECTS has been investigated as a predictor of outcome in patients with acute ischemic stroke. Our purpose was to investigate whether CTA source images are a better predictor of clinical and radiologic outcomes than NCCT ASPECTS in candidates for endovascular stroke therapy.MATERIALS AND METHODS: CT scans of patients (n= 124) were independently evaluated by 2 readers for baseline NCCT and CTA source image ASPECTS and for follow-up ASPECTS. An mRS of ≤2 at 3 months was considered a favorable outcome. Receiver operating characteristic curve analysis was used to assess the ability of NCCT and CTA source image ASPECTS to identify patients with favorable outcomes. A stepwise multiple regression analysis was performed to find independent predictors of outcome.RESULTS: Baseline CTA source image ASPECTS correlated better than NCCT ASPECTS with follow-up ASPECTS (r= 0.76 versusr= 0.51;Pfor comparison of the 2 coefficients < .001). Receiver operating characteristic curve analysis showed that baseline CTA source image ASPECTS compared with NCCT ASPECTS can better identify patients with favorable outcome (CTA source image area under the curve = 0.83; 95% CI, 0.76-0.91; NCCT area under the curve = 0.67; 95% CI, 0.58-0.77;P< .001). Finally, the stepwise regression analysis showed that lower age, good recanalization, lower time to recanalization, and good baseline CTA source image ASPECTS, not NCCT ASPECTS, were independent predictors of favorable outcome.CONCLUSIONS: CTA source image ASPECTS predicts outcome better than NCCT ASPECTS; this finding suggests CTA rather than NCCT as a main step in the decision-making process for patients with acute ischemic stroke.

U2 - 10.3174/ajnr.A5264

DO - 10.3174/ajnr.A5264

M3 - Article

C2 - 28619833

VL - 38

SP - 1569

EP - 1573

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 8

ER -