A SYSTEMATIC REVIEW OF THE DIAGNOSTIC PERFORMANCE OF COMPUTED TOMOGRAPHY PERFUSION IMAGING

Abstract

Background: Computed Tomography Perfusion (CTP) has become an important imaging modality for evaluating cerebral perfusion, particularly in acute ischemic stroke, where timely and accurate diagnosis is critical. Objective: This systematic review aimed to assess the diagnostic accuracy of CTP in detecting perfusion deficits and its role in guiding therapeutic decisions in acute ischemic stroke. Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science to identify studies evaluating the sensitivity, specificity, and predictive values of CTP. Eligible studies included original research assessing the diagnostic performance of CTP in acute stroke patients. Data extraction and quality assessment were performed according to predefined inclusion criteria. Results: Twenty studies met the eligibility criteria. Overall, CTP demonstrated high sensitivity and moderate specificity for detecting cerebral perfusion abnormalities in acute ischemic stroke. Nonetheless, considerable variability was observed across studies due to differences in imaging protocols, post-processing software, and diagnostic thresholds, which influenced reported accuracy measures. Conclusion: CTP is a valuable diagnostic tool in the evaluation of acute ischemic stroke, offering reliable sensitivity for detecting perfusion deficits. However, standardization of imaging protocols and analytical methods is essential to improve its diagnostic reliability and facilitate broader clinical application.