title: Diagnostic accuracy of CT perfusion imaging for detecting acute ischemic stroke: a systematic review and meta-analysis.
abstract: BACKGROUND
  The aim of the current study was to determine the sensitivity and specificity of CT perfusion (CTP) for the detection of ischemic stroke by performing a systematic review and meta-analysis of published reports.
  
  
  METHODS
  We searched PubMed, Embase and the Cochrane library using the terms 'perfusion computed tomography', 'ischemic stroke' and synonyms. We included studies that: (1) reported original data, (2) studied the diagnostic value of CTP for detecting ischemic stroke, (3) used MRI-DWI, follow-up MRI or follow-up CT as the reference standard, (4) included at least 10 patients who were suspected of ischemic stroke, and (5) reported the number of true positives, true negatives, false positives and false negatives for the diagnosis of ischemic stroke.
  
  
  RESULTS
  Fifteen studies were finally included in the current review with a total of 1,107 patients. A pooled analysis resulted in a sensitivity of 80% (95% confidence interval, CI: 72-86%) and a specificity of 95% (95% CI: 86-98%). Almost two thirds of the false negatives were due to small lacunar infarcts; the remaining false negatives were mostly due to limited coverage.
  
  
  CONCLUSIONS
  The current systematic review shows that CTP has a high sensitivity and a very high specificity for detecting infarcts.
authors.affiliation: Department of Radiology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Biesbroek
authors.forename: J M
authors.initials: JM
authors.lastname: Niesten
authors.forename: J W
authors.initials: JW
authors.lastname: Dankbaar
authors.forename: G J
authors.initials: GJ
authors.lastname: Biessels
authors.forename: B K
authors.initials: BK
authors.lastname: Velthuis
authors.forename: J B
authors.initials: JB
authors.lastname: Reitsma
authors.forename: I C
authors.initials: IC
authors.lastname: van der Schaaf
mesh_terms: D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D016001:Confidence Intervals; D006801:Humans; D055420:Perfusion Imaging / Q000379:methods; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods