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Accuracy of thin-slice model-based iterative reconstruction designed for brain CT to diagnose acute ischemic stroke in the middle cerebral artery territory: a multicenter study

  • Diagnostic Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Purpose

Model-based iterative reconstruction (MBIR) yields higher spatial resolution and a lower image noise than conventional reconstruction methods. We hypothesized that thin-slice MBIR designed for brain CT could improve the detectability of acute ischemic stroke in the middle cerebral artery (MCA) territory.

Methods

Included were 41 patients with acute ischemic stroke in the MCA territory; they were seen at 4 medical centers. The controls were 39 subjects without acute stroke. Images were reconstructed with hybrid IR and with MBIR designed for brain CT at slice thickness of 2 mm. We measured the image noise in the ventricle and compared the contrast-to-noise ratio (CNR) in the ischemic lesion. We analyzed the ability of reconstructed images to detect ischemic lesions using receiver operating characteristics (ROC) analysis; 8 observers read the routine clinical hybrid IR with 5 mm-thick images, while referring to 2 mm-thick hybrid IR images or MBIR images.

Results

The image noise was significantly lower on MBIR- than hybrid IR images (1.2 vs. 3.4, p < 0.001). The CNR was significantly higher with MBIR than hybrid IR (6.3 vs. 1.6, p < 0.001). The mean area under the ROC curve was also significantly higher on hybrid IR plus MBIR than hybrid IR (0.55 vs. 0.48, p < 0.036). Sensitivity, specificity, and accuracy were 41.2%, 88.8%, and 65.7%, respectively, for hybrid IR; they were 58.8%, 86.1%, and 72.9%, respectively, for hybrid IR plus MBIR.

Conclusion

The additional thin-slice MBIR designed for brain CT may improve the detection of acute MCA stroke.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

FBP:

Filtered back projection

IR:

Iterative reconstruction

MBIR:

Model-based iterative reconstruction

BHE:

Beam-hardening effect

LCD:

Low-contrast detectability

MCA:

Middle cerebral artery

ASPECTS:

Alberta Stroke Program Early CT score

AIDR 3D:

Three-dimensional adaptive iterative dose reduction

FIRST:

Forward-projected model-based solution: FIRST

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Funding

This work was supported by Canon Medical Systems (Grant number 0G20KA7109).

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Hidenori Mitani, Fuminari Tatsugami, Toru Higaki, Yoko Kaichi, Yuko Nakamura & Kazuo Awai

  2. Department of Radiology, Nuclear Medicine and Anatomy, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, Netherlands

    Ewoud Smit & Mathias Prokop

  3. Department of Diagnostic Radiology, Hiroshima City Asa Citizens Hospital, 2-1-1, Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan

    Chiaki Ono

  4. Department of Radiology, Shin Koga Hospital, 120, Tenjinmachi, Kurume, Fukuoka, 830-8577, Japan

    Ken Ono

  5. Department of Radiology, University of Occupational and Environmental Health School of Medicine, 1-1, Iseigaoka, Yahatanishi-ku, 807-8555, Kitakyushu-shi, Fukuoka, Japan

    Yukunori Korogi

Authors
  1. Hidenori Mitani
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  2. Fuminari Tatsugami
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Corresponding author

Correspondence to Hidenori Mitani.

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Ethical approval

Institutional review board approval was obtained from each institution (Hiroshima University Hospital, Hiroshima City Asa Citizens Hospitals, Shin Koga Hospital, Japan, and Radboud University Medical Center, the Netherlands).

Informed consent

Informed consent was waived because of the retrospective nature of the study.

Conflicts of interests

Financial interests: Kazuo Awai and Yukunori Korogi have received research support from Canon Medical Systems. Ewoud Smit has received speaker honorarium and research support from Canon Medical Systems. Mathias Prokop has received speaker honorariums from Bayer, Bracco, Canon Medical Systems, and Siemens Healthineers, and has received research support from Canon Medical Systems and Siemens Healthineers. The other authors declare that they have no conflict of interest.

Non-financial interests: none.

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Mitani, H., Tatsugami, F., Higaki, T. et al. Accuracy of thin-slice model-based iterative reconstruction designed for brain CT to diagnose acute ischemic stroke in the middle cerebral artery territory: a multicenter study. Neuroradiology 63, 2013–2021 (2021). https://doi.org/10.1007/s00234-021-02745-4

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