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Usefulness of Non-Contrast Electron Density Imaging for the Identification of Brain Tissue Changes in Large Vessel Occlusion Acute Ischemic Stroke.

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Title: Usefulness of Non-Contrast Electron Density Imaging for the Identification of Brain Tissue Changes in Large Vessel Occlusion Acute Ischemic Stroke.
Authors: de Erausquin, Santiago1, Polania, Andres1 polaniaalvarezandres@gmail.com, Rodriguez-Granillo, Gaston A.2 grodriguezgranillo@gmail.com, Diluca, Pablo1, Bleise, Carlos3, Lylyk, Pedro3
Source: Journal of Integrative Neuroscience. May2026, Vol. 25 Issue 5, p1-7. 7p.
Subjects: Ischemic stroke, Brain abnormalities, Dual energy CT (Tomography), Diagnostic examinations, Cerebral arteries, Arterial occlusions, Computed tomography, Diagnostic imaging
Abstract: Background: Electron density (ED) imaging has shown the ability to discriminate between different soft tissue components in preliminary studies. We hypothesized that ED might improve the identification of brain tissue abnormalities in patients with large vessel occlusion acute ischemic stroke (AIS). Methods: We retrospectively included a series of patients with large vessel occlusion AIS comprising the middle cerebral artery (MCA) territory. All patients underwent non-contrast brain computed tomography (CT) and CT angiography using a dual-layer spectral CT scanner. Using a multiparameter display including conventional CT images (Hounsfield units, HU), ED relative to water (%EDW), and effective atomic number (Zeff), we evaluated the brain tissue territory distal to the occlusion, and the contralateral hemisphere. Results: Twenty-eight patients were included, with a mean age of 75.7 ± 10.9 years. The brain tissue distal to the MCA occlusion showed significant differences compared with the contralateral hemisphere only using conventional CT (25.0 ± 2.7 HU vs. 29.2 ± 2.4 HU, p < 0.0001) and ED imaging (102.2 ± 0.3 %EDW vs. 102.6 ± 0.2 %EDW, p < 0.0001), whereas the Zeff (7.37 ± 0.1 vs. 7.37 ± 0.1, p = 0.36) showed similar values. ED imaging was associated with a significantly higher diagnostic confidence for the identification of abnormal findings, both for the evaluation of the hyperdense MCA (conventional CT 3.46 ± 1.3 vs. ED imaging 4.79 ± 0.4 vs. Zeff imaging 2.07 ± 1.0, p < 0.0001) as well as for the subtended brain parenchyma (conventional CT 3.30 ± 1.3 vs. ED imaging 4.30 ± 0.8 vs. Zeff 1.44 ± 0.6, p < 0.0001). Conclusions: In this study, ED imaging enabled a more confident identification of brain tissue changes related to large vessel occlusion AIS compared with conventional CT imaging. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Integrative Neuroscience is the property of IMR Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Usefulness of Non-Contrast Electron Density Imaging for the Identification of Brain Tissue Changes in Large Vessel Occlusion Acute Ischemic Stroke.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22de+Erausquin%2C+Santiago%22&quot;&gt;de Erausquin, Santiago&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Polania%2C+Andres%22&quot;&gt;Polania, Andres&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; polaniaalvarezandres@gmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rodriguez-Granillo%2C+Gaston+A%2E%22&quot;&gt;Rodriguez-Granillo, Gaston A.&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;i&gt; grodriguezgranillo@gmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Diluca%2C+Pablo%22&quot;&gt;Diluca, Pablo&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bleise%2C+Carlos%22&quot;&gt;Bleise, Carlos&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lylyk%2C+Pedro%22&quot;&gt;Lylyk, Pedro&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Journal+of+Integrative+Neuroscience%22&quot;&gt;Journal of Integrative Neuroscience&lt;/searchLink&gt;. May2026, Vol. 25 Issue 5, p1-7. 7p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Ischemic+stroke%22&quot;&gt;Ischemic stroke&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Brain+abnormalities%22&quot;&gt;Brain abnormalities&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Dual+energy+CT+%28Tomography%29%22&quot;&gt;Dual energy CT (Tomography)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Diagnostic+examinations%22&quot;&gt;Diagnostic examinations&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cerebral+arteries%22&quot;&gt;Cerebral arteries&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Arterial+occlusions%22&quot;&gt;Arterial occlusions&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Computed+tomography%22&quot;&gt;Computed tomography&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Diagnostic+imaging%22&quot;&gt;Diagnostic imaging&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Electron density (ED) imaging has shown the ability to discriminate between different soft tissue components in preliminary studies. We hypothesized that ED might improve the identification of brain tissue abnormalities in patients with large vessel occlusion acute ischemic stroke (AIS). Methods: We retrospectively included a series of patients with large vessel occlusion AIS comprising the middle cerebral artery (MCA) territory. All patients underwent non-contrast brain computed tomography (CT) and CT angiography using a dual-layer spectral CT scanner. Using a multiparameter display including conventional CT images (Hounsfield units, HU), ED relative to water (%EDW), and effective atomic number (Zeff), we evaluated the brain tissue territory distal to the occlusion, and the contralateral hemisphere. Results: Twenty-eight patients were included, with a mean age of 75.7 &#177; 10.9 years. The brain tissue distal to the MCA occlusion showed significant differences compared with the contralateral hemisphere only using conventional CT (25.0 &#177; 2.7 HU vs. 29.2 &#177; 2.4 HU, p &lt; 0.0001) and ED imaging (102.2 &#177; 0.3 %EDW vs. 102.6 &#177; 0.2 %EDW, p &lt; 0.0001), whereas the Zeff (7.37 &#177; 0.1 vs. 7.37 &#177; 0.1, p = 0.36) showed similar values. ED imaging was associated with a significantly higher diagnostic confidence for the identification of abnormal findings, both for the evaluation of the hyperdense MCA (conventional CT 3.46 &#177; 1.3 vs. ED imaging 4.79 &#177; 0.4 vs. Zeff imaging 2.07 &#177; 1.0, p &lt; 0.0001) as well as for the subtended brain parenchyma (conventional CT 3.30 &#177; 1.3 vs. ED imaging 4.30 &#177; 0.8 vs. Zeff 1.44 &#177; 0.6, p &lt; 0.0001). Conclusions: In this study, ED imaging enabled a more confident identification of brain tissue changes related to large vessel occlusion AIS compared with conventional CT imaging. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Journal of Integrative Neuroscience is the property of IMR Press and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.31083/JIN50299
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      – Code: eng
        Text: English
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        PageCount: 7
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    Subjects:
      – SubjectFull: Ischemic stroke
        Type: general
      – SubjectFull: Brain abnormalities
        Type: general
      – SubjectFull: Dual energy CT (Tomography)
        Type: general
      – SubjectFull: Diagnostic examinations
        Type: general
      – SubjectFull: Cerebral arteries
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      – SubjectFull: Arterial occlusions
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      – SubjectFull: Computed tomography
        Type: general
      – SubjectFull: Diagnostic imaging
        Type: general
    Titles:
      – TitleFull: Usefulness of Non-Contrast Electron Density Imaging for the Identification of Brain Tissue Changes in Large Vessel Occlusion Acute Ischemic Stroke.
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            NameFull: de Erausquin, Santiago
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            NameFull: Polania, Andres
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            NameFull: Rodriguez-Granillo, Gaston A.
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            NameFull: Diluca, Pablo
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            NameFull: Bleise, Carlos
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            – D: 01
              M: 05
              Text: May2026
              Type: published
              Y: 2026
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              Value: 25
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