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Computer-aided detection scheme for identification of hypoattenuation of acute stroke in unenhanced CT

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Abstract

Our purpose in this study was to develop a computer-aided detection scheme for identification of hypoattenuation of acute stroke on unenhanced CT images to select patients for thrombolysis of acute stroke. This method is based on a z-score mapping method. The algorithm of the developed method consisted of five main steps: anatomic standardization, calculation of the z-score with a normal reference database, extraction of candidate voxels for hypoattenuation, feature extraction, and classification. The territory of the middle cerebral artery was divided into ten specified regions, according to a visually quantitative CT scoring system, the Alberta Stroke Programme Early CT Score (ASPECTS) method. Each of the ASPECTS-defined regions was classified as hypoattenuation or normality by linear discriminate analysis. The method was applied to 26 patients who had hypoattenuation areas (<6 h). The performance of this scheme for classification of hypoattenuation was evaluated using a leave-one-case-out method. As a result, an average sensitivity of 89.7% and an average specificity of 85.2% for automatically classifying hypoattenuation regions in the lentiform nucleus and the insular regions were obtained, and the average accuracy for the classification of hypoattenuation per patient was 84.6% (range 55.6–100%). The newly developed method has the potential accurately to identify hypoattenuation of acute stroke in the ASPECTS-defined regions.

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Authors and Affiliations

  1. Department of Radiological Technology, Sendai City Hospital, 3-1 Shimizukouji, Wakabayashi-ku, Sendai, Miyagi, 984-8501, Japan

    Noriyuki Takahashi & Naoki Ouchi

  2. Department of Radiological Technology, School of Health Sciences, Niigata University, 2-746 Asahimachi-dori, Chuou-ku, Niigata, Niigata, 951-8518, Japan

    Yongbum Lee & Du-Yih Tsai

  3. Department of Radiology, Research Institute of Brain and Blood Vessels-Akita, 6-10 Sensyukubota-machi, Akita, Akita, 010-0874, Japan

    Toshibumi Kinoshita

  4. Department of Radiology, Sendai City Hospital, 3-1 Shimizukouji, Wakabayashi-ku, Sendai, Miyagi, 984-8501, Japan

    Kiyoshi Ishii

Authors
  1. Noriyuki Takahashi
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  2. Yongbum Lee
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  3. Du-Yih Tsai
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  4. Toshibumi Kinoshita
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  5. Naoki Ouchi
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  6. Kiyoshi Ishii
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Correspondence to Noriyuki Takahashi.

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Takahashi, N., Lee, Y., Tsai, DY. et al. Computer-aided detection scheme for identification of hypoattenuation of acute stroke in unenhanced CT. Radiol Phys Technol 5, 98–104 (2012). https://doi.org/10.1007/s12194-011-0143-0

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  • DOI: https://doi.org/10.1007/s12194-011-0143-0

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