Impact of Window Setting Optimization on Accuracy of Computed Tomography and Computed Tomography Angiography Source Image-based Alberta Stroke Program Early Computed Tomography Score

The use of narrower window width settings on computed tomography (CT) improves sensitivity for detection of early ischemic changes in acute ischemic stroke. This study analyzed the effect of optimization of window settings on the accuracy of Alberta Stroke Program Early Computed Tomography Score (AS...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2014, Vol.23 (1), p.12-16
Main Authors: Arsava, Ethem Murat, MD, Saarinen, Jukka T., MD, Unal, Ali, MD, Akpinar, Erhan, MD, Oguz, Kader K., MD, Topcuoglu, Mehmet Akif, MD
Format: Article
Language:English
Subjects:
Adult
Aged
Alberta
Brain - diagnostic imaging
Brain Ischemia - diagnosis
Brain Ischemia - diagnostic imaging
Brain Ischemia - pathology
Cardiovascular
Cerebral Angiography - methods
Cerebral Angiography - standards
Disease Progression
Early ischemic changes
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neurology
Observer Variation
Reproducibility of Results
Stroke - diagnosis
Stroke - diagnostic imaging
Stroke - pathology
Thrombolytic Therapy
Tomography, X-Ray Computed - methods
Tomography, X-Ray Computed - standards
window width and center
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Summary:The use of narrower window width settings on computed tomography (CT) improves sensitivity for detection of early ischemic changes in acute ischemic stroke. This study analyzed the effect of optimization of window settings on the accuracy of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) performed on noncontrast CT (NCCT) and CT angiography source images (CTA-SI). ASPECTS was calculated on NCCT and CTA-SI with standard and optimized window width/center settings in a consecutive series of patients with acute ishcemic stroke. The difference between CT-based ASPECTS and ASPECTS performed on follow-up magnetic resonance imaging (MRI) were calculated to determine the disparity between initial estimates of the extent of ischemia on CT and follow-up lesion imaging by MRI. Forty-four patients were included into the study. The mean difference with respect to follow-up MRI-ASPECTS was 4.1 ± 2.2 for standard NCCT-ASPECTS, 3.7 ± 2.3 for optimized NCCT-ASPECTS, 3.0 ± 2.2 for standard CTA-SI-ASPECTS, and 2.7 ± 2.1 for optimized CTA-SI-ASPECTS. The improvement introduced by the optimization of window settings and use of CTA-SI was statistically significant ( P  
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2012.05.012