A comparative analysis of SCALE-CTP and RAPID in determining the affected brain volumes of patients with ischemic stroke

IF 2.1 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI:10.1016/j.jstrokecerebrovasdis.2025.108517

Jundong Hwang , Hyeon Sik Yang , Gi-Youn Kim , Regina EY Kim , Minho Lee , Donghyeon Kim , Jin Wook Choi , Woo Sang Jung , Kijeong Lee

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引用次数: 0

Abstract

Background

Computed tomography perfusion (CTP) is widely used to treat acute strokes. The affected brain volume, measured based on the threshold value in the calculated CTP map, has helped guide treatment decisions. We proposed a new software program developed for CTP analysis, SCALE-CTP, and compared the affected brain volumes estimated using RAPID and SCALE-CTP.

Methods

We recruited 362 individuals from the local hospital to evaluate the concordance between SCALE-CTP and RAPID in predicting affected brain volumes, including relative cerebral blood flow (rCBF) <30 % and time-to-maximum concentration (Tmax) > 6 s, and the mismatch volumes. Concordance correlation coefficients (CCC) and Bland–Altman plots were used to assess agreement. Subgroup analyses and comparisons with DWI-derived infarction areas were also performed, along with an evaluation of differences in clinical decision-making.

Results

The calculated volumes from two different software showed excellent concordance (rCBF < 30 % volume: 0.91, Tmax > 6s: 0.88 volume, mismatch volume: 0.82). The concordance between the two software programs remains excellent in the subgroup analysis. In the subset of 38 cases, the differences between DWI-derived infarction area and rCBF < 30 % volume from both software were similar, while SCALE-CTP showed more variability. Their differences in clinical decision making were slightly different.

Conclusion

SCALE-CTP demonstrated strong agreement with RAPID in predicting affected brain volumes and shows potential as a reliable tool for guiding hyperacute ischemic stroke treatment. Further validation is needed to confirm its clinical utility.

查看原文本刊更多论文

SCALE-CTP与RAPID测定缺血性脑卒中患者脑容量的比较分析。

背景：计算机断层扫描灌注（CTP）被广泛应用于急性脑卒中的治疗。根据计算的CTP图中的阈值来测量受影响的脑容量，有助于指导治疗决策。我们提出了一种新的CTP分析软件，SCALE-CTP，并比较了使用RAPID和SCALE-CTP估计的受影响的脑容量。方法：我们从当地医院招募了362名患者，评估SCALE-CTP和RAPID在预测影响脑容量（包括相对脑血流量（rCBF） 6s和不匹配容量）方面的一致性。一致性相关系数（CCC）和Bland-Altman图用于评估一致性。还进行了亚组分析和与dwi衍生梗死区域的比较，并评估了临床决策的差异。结果：两种不同软件计算的体积具有良好的一致性（rCBF < 30%体积：0.91，Tmax bbb6s体积：0.88，错配体积：0.82）。在亚群分析中，两个软件程序之间的一致性仍然很好。在38例的子集中，两种软件得出的dwi衍生的梗死面积和rCBF < 30%体积之间的差异相似，而SCALE-CTP显示出更多的可变性。他们在临床决策方面的差异略有不同。结论：SCALE-CTP与RAPID在预测受影响脑容量方面表现出强烈的一致性，并显示出作为指导超急性缺血性脑卒中治疗的可靠工具的潜力。需要进一步验证以确认其临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.