P.056 Dual-energy CT for differentiating intracerebral hemorrhage from Contrast Extravasation after Acute Ischemic Stroke Intervention (DECT-ICH)

Abstract

Background: Thrombolysis (tPA) and endovascular thrombectomy (EVT) are interventions for acute ischemic stroke (AIS) that can be accompanied by intracerebral hemorrhage (ICH), which can alter the patient’s management, or contrast extravasation (CE), which is relatively benign. Previous retrospective studies have shown that dual-energy CT (DECT) is significantly more accurate for differentiating ICH from CE compared to conventional, single-energy CT (SECT). We are performing a prospective study to investigate this question. Methods: Our primary outcome is the sensitivity and specificity of DECT in differentiating ICH from CE. In AIS patients who receive intervention, we will be performing a DECT scan at the same time as the standard-of-care SECT scan at 24 hours post-intervention. In patients who have a hyperdensity on CT, a repeat scan will be done at 72-hours, which will be used as the gold-standard to determine if the hyperdensity was ICH or CE. Results: We expect that DECT will be significantly more sensitive and specific for differentiating ICH from CE compared to SECT. Conclusions: This study will determine if DECT is superior to SECT in differentiating ICH from CE, validate the use of DECT in AIS patients who receive intervention, and potentially change the imaging paradigm for acute stroke in the future.