{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:38:29Z","timestamp":1792139909893,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NS138756"],"award-info":[{"award-number":["R01NS138756"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>We evaluated agreement and performance of non\u2010contrast head\u2010computerized tomography (NCHCT) and CT\u2010perfusion (CTP) in identifying large core infarct in acute ischemic stroke (AIS) due to large vessel occlusion (LVO) undergoing endovascular therapy (EVT), using MRI as reference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From our prospective multicenter registry, we identified patients with LVO\u2010AIS due to internal carotid artery or middle cerebral artery M1occlusions who underwent EVT between 2017 and 2024. Final infarct volume (FIV) was defined using 24\u201348\u00a0h post\u2010EVT diffusion\u2010weighted imaging magnetic resonance imaging (MRI\u2010FIV). To limit infarct growth bias, only patients with CTP\u2010to\u2010EVT start time &lt;3 h were included. Large core infarct was defined at FIV thresholds: 50, 70, and 100\u00a0mL. The primary outcome was agreement between NCHCT and CTP in identifying large core infarct using kappa\u2010statistics. Large core was considered if NCHCT\u2010ASPECTS&lt;6 or rCBF&lt;30% volume&gt;70\u00a0mL on CTP (RAPID\/Viz.AI). Secondary outcomes included classification accuracy of each modality relative to MRI\u2010FIV using the area under the receiver operating characteristic curve (AUC\u2010ROC). Sensitivity analyses were performed in subgroups with TICI 2c\u22123 and cases processed by RAPID.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 241 EVT\u2010treated LVO\u2010AIS patients, median NIHSS was 15 [IQR: 10\u221220], MRI\u2010FIV 13.8 Ml [IQR: 5\u221241.0], ASPECTS 8 [IQR: 7\u221210], and CTP\u2010predicted core 8\u00a0mL [IQR: 0\u221231.0]. CTP and NCHCT showed slight agreement in identifying large core (\u03ba = 0.192) and weak\u2010to\u2010acceptable discrimination for identifying large core infarcts (AUC\u2010ROC: 0.61\u22120.72 across MRI\u2010FIV thresholds). Both modalities showed limited predictive ability for 90\u2010day functional independence (AUC\u2010ROC: 0.63\u22120.65). Similar findings were observed in sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among LVO\u2010AIS EVT\u2010treated patients, NCHCT and CTP demonstrated slight agreement in classifying small versus large core, and neither technique was effective at predicting FIV or clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70130","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:17:11Z","timestamp":1772986631000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Defining Large Core Infarction: Comparing the Accuracy of Non\u2010Contrast CT ASPECTS Versus CT Perfusion Core Volume"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5395-7127","authenticated-orcid":false,"given":"Ngoc 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