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Computed Tomographic Perfusion Imaging Variables Versus Time From Stroke Onset to Acute Reperfusion Therapy in Predicting Functional Outcome.

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Title: Computed Tomographic Perfusion Imaging Variables Versus Time From Stroke Onset to Acute Reperfusion Therapy in Predicting Functional Outcome.
Authors: Mannismäki, Laura (AUTHOR), Martinez-Majander, Nicolas (AUTHOR), Suomalainen, Olli P. (AUTHOR), Sihvonen, Aleksi J. (AUTHOR), Sibolt, Gerli (AUTHOR), Nybondas, Miranda (AUTHOR), Girfanova, Maria (AUTHOR), Sartanen, Anni (AUTHOR), Curtze, Sami (AUTHOR), Dhoundiyal, Ankit (AUTHOR)
Source: Acta Neurologica Scandinavica. 5/22/2026, Vol. 2026, p1-10. 10p.
Subjects: Perfusion imaging, Endovascular surgery, Nerve tissue, Functional status, Reperfusion injury, Computer-assisted image analysis (Medicine), Thrombolytic therapy
Abstract: Background: The rate of infarct growth from a yet salvageable penumbra into an ischemic core varies between individuals. Thus, computed tomographic perfusion (CTP) may improve patient selection for intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT). We aimed to assess whether treatment delay and pretreatment CTP parameters are independent predictors of functional outcome. Materials and Methods: Consecutive patients who underwent CTP and received reperfusion therapy with a known stroke onset were identified retrospectively at Helsinki University Hospital between 1/2016 and 12/2023. Ordinal regression was used to analyze the association between the CTP parameters estimated by RAPID, an automated CTP postprocessing software, and onset‐to‐treatment time with an unfavorable shift on the 3‐month modified Rankin Scale (mRS) in the entire cohort, in IVT‐only patients, and in EVT patients with or without reperfusion. Results: In the univariable analyses of the total of 948 patients, increasing onset‐to‐treatment time (odds ratio 1.17, 95% confidence interval 1.11–1.25), ischemic core (12.5, 8.33–20.0), and penumbra (2.27, 1.89–2.70) volumes were associated with worse outcomes. In the multivariable analyses, ischemic core volume (4.76, 2.94–7.69) and onset‐to‐treatment time (1.20, 1.14–1.28) were significant predictors of worse outcomes, but not baseline penumbra volume (1.06, 0.86–1.30), which was compatible in IVT‐only patients and in EVT patients with reperfusion. Also, larger severe hypoperfusion volume, higher hypoperfusion intensity ratio, and cerebral blood volume index were associated with functional outcomes in the total cohort. Conclusions: Both ischemic core and penumbra volumes and onset‐to‐treatment time predicted a worse outcome, but of these, only ischemic core and onset‐to‐treatment time were independent predictors. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell 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.)
Database: Psychology and Behavioral Sciences Collection
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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Computed Tomographic Perfusion Imaging Variables Versus Time From Stroke Onset to Acute Reperfusion Therapy in Predicting Functional Outcome.
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  Data: <searchLink fieldCode="AR" term="%22Mannismäki%2C+Laura%22">Mannismäki, Laura</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Martinez-Majander%2C+Nicolas%22">Martinez-Majander, Nicolas</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Suomalainen%2C+Olli+P%2E%22">Suomalainen, Olli P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sihvonen%2C+Aleksi+J%2E%22">Sihvonen, Aleksi J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sibolt%2C+Gerli%22">Sibolt, Gerli</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nybondas%2C+Miranda%22">Nybondas, Miranda</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Girfanova%2C+Maria%22">Girfanova, Maria</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sartanen%2C+Anni%22">Sartanen, Anni</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Curtze%2C+Sami%22">Curtze, Sami</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dhoundiyal%2C+Ankit%22">Dhoundiyal, Ankit</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. 5/22/2026, Vol. 2026, p1-10. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Perfusion+imaging%22">Perfusion imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Endovascular+surgery%22">Endovascular surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Nerve+tissue%22">Nerve tissue</searchLink><br /><searchLink fieldCode="DE" term="%22Functional+status%22">Functional status</searchLink><br /><searchLink fieldCode="DE" term="%22Reperfusion+injury%22">Reperfusion injury</searchLink><br /><searchLink fieldCode="DE" term="%22Computer-assisted+image+analysis+%28Medicine%29%22">Computer-assisted image analysis (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Thrombolytic+therapy%22">Thrombolytic therapy</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: The rate of infarct growth from a yet salvageable penumbra into an ischemic core varies between individuals. Thus, computed tomographic perfusion (CTP) may improve patient selection for intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT). We aimed to assess whether treatment delay and pretreatment CTP parameters are independent predictors of functional outcome. Materials and Methods: Consecutive patients who underwent CTP and received reperfusion therapy with a known stroke onset were identified retrospectively at Helsinki University Hospital between 1/2016 and 12/2023. Ordinal regression was used to analyze the association between the CTP parameters estimated by RAPID, an automated CTP postprocessing software, and onset‐to‐treatment time with an unfavorable shift on the 3‐month modified Rankin Scale (mRS) in the entire cohort, in IVT‐only patients, and in EVT patients with or without reperfusion. Results: In the univariable analyses of the total of 948 patients, increasing onset‐to‐treatment time (odds ratio 1.17, 95% confidence interval 1.11–1.25), ischemic core (12.5, 8.33–20.0), and penumbra (2.27, 1.89–2.70) volumes were associated with worse outcomes. In the multivariable analyses, ischemic core volume (4.76, 2.94–7.69) and onset‐to‐treatment time (1.20, 1.14–1.28) were significant predictors of worse outcomes, but not baseline penumbra volume (1.06, 0.86–1.30), which was compatible in IVT‐only patients and in EVT patients with reperfusion. Also, larger severe hypoperfusion volume, higher hypoperfusion intensity ratio, and cerebral blood volume index were associated with functional outcomes in the total cohort. Conclusions: Both ischemic core and penumbra volumes and onset‐to‐treatment time predicted a worse outcome, but of these, only ischemic core and onset‐to‐treatment time were independent predictors. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell 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.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1155/ane/1792956
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      – Code: eng
        Text: English
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        PageCount: 10
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    Subjects:
      – SubjectFull: Perfusion imaging
        Type: general
      – SubjectFull: Endovascular surgery
        Type: general
      – SubjectFull: Nerve tissue
        Type: general
      – SubjectFull: Functional status
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      – SubjectFull: Reperfusion injury
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      – SubjectFull: Computer-assisted image analysis (Medicine)
        Type: general
      – SubjectFull: Thrombolytic therapy
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      – TitleFull: Computed Tomographic Perfusion Imaging Variables Versus Time From Stroke Onset to Acute Reperfusion Therapy in Predicting Functional Outcome.
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              Text: 5/22/2026
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