Evaluating the effect of noise reduction strategies in CT perfusion imaging for predicting infarct core with deep learning

This study evaluates the efficacy of deep learning models in identifying infarct tissue on computed tomography perfusion (CTP) scans from patients with acute ischemic stroke due to large vessel occlusion, specifically addressing the potential influence of varying noise reduction techniques implemented by different vendors. We analyzed CTP scans from 60 patients who underwent mechanical thrombectomy achieving a modified thrombolysis in cerebral infarction (mTICI) score of 2c or 3, ensuring minimal changes in the infarct core between the initial CTP and follow-up MR imaging. Noise reduction techniques, including principal component analysis (PCA), wavelet, non-local means (NLM), and a no denoising approach, were employed to create hemodynamic parameter maps. Infarct regions identified on follow-up diffusion-weighted imaging (DWI) within 48 hours were co-registered with initial CTP scans and refined with ADC maps to serve as ground truth for training a data-augmented U-Net model. The performance of this convolutional neural network (CNN) was assessed using Dice coefficients across different denoising methods and infarct sizes, visualized through box plots for each parameter map. Our findings show no significant differences in model accuracy between PCA and other denoising methods, with minimal variation in Dice scores across techniques. This study confirms that CNNs are adaptable and capable of handling diverse processing schemas, indicating their potential to streamline diagnostic processes and effectively manage CTP input data quality variations.