PMID- 33025043 OWN - NLM STAT- MEDLINE DCOM- 20210929 LR - 20210929 IS - 1432-1920 (Electronic) IS - 0028-3940 (Linking) VI - 63 IP - 5 DP - 2021 May TI - Early prediction of final infarct volume with material decomposition images of dual-energy CT after mechanical thrombectomy. PG - 695-704 LID - 10.1007/s00234-020-02563-0 [doi] AB - PURPOSE: Evaluation of water material density images (wMDIm) of dual-energy CT (DECT) for earlier prediction of final infarct volume (fiV) in follow-up single-energy CT (SECT) and correlation with clinical outcome. METHODS: Fifty patients (69 years, +/- 12.1, 40-90, 50% female) with middle cerebral artery (MCA) occlusions were included. Early infarct volumes were analyzed in monoenergetic images (MonoIm) and wMDIm at 60 keV and compared with the fiV in SECT 4.9 days (+/- 4) after thrombectomy. Association between infarct volume and functional outcome was tested by linear regression analysis. RESULTS: wMDIm shows a prior visible infarct demarcation (60.7 ml, +/- 74.9 ml) compared with the MonoIm (37.57 ml, +/- 76.7 ml). Linear regression analysis, Bland-Altman plots and Pearson correlation coefficients show a close correlation of infarct volume in wMDIm to the fiV in SECT (r = 0.86; 95% CI 0.76-0.92), compared with MonoIm and SECT (r = 0.81; 95% CI 0.69-0.89). The agreement with SECT is substantially higher in patients with infarct volumes < 70 ml (n = 33; 66%). Coefficients were smaller with r = 0.59 (95% CI 0.31; 0.78) for MonoIm and SECT compared with r = 0.77 (95% CI 0.57; 0.88) for wMDIm and SECT. At admission, the mean NIHSS score and mRS were 17.02 (+/- 4.7) and 4.9 (+/- 0.2). mRS