RAPID perfusion CT in acute ischemic stroke: an educational pictorial review of common patterns, pearls, and…

Abstract

Rapid processing of Perfusion and Diffusion (RAPID) software for CT perfusion (CTP) is a valuable tool for the evaluation of acute ischemic stroke and therapeutic decision-making in extended therapeutic windows. However, automated maps should not be interpreted in isolation. A structured, pattern-based approach, integrating qualitative visual assessment with automated quantitative output and clinical information to refine therapeutic selection, remains essential to mitigate pitfalls and optimize patient care. The aim of this article is to provide an educational pictorial review based on selected illustrative cases of the most common imaging patterns, interpretive pitfalls, and technical features of CTP processed with RAPID software in acute ischemic stroke, that may serve as a practical guide for radiologists and neuroradiologists.

Key Points: Question How can radiologists effectively interpret automated RAPID CT perfusion maps in acute ischemic stroke while avoiding common technical traps, diagnostic pitfalls, and anatomical limitations?

Findings Integrating qualitative visual assessment, quantitative RAPID outputs, and clinical-vascular data within a structured workflow minimizes diagnostic errors and optimizes patient selection for reperfusion.

Critical relevance statement This educational pictorial review provides a practical, pattern-based approach to RAPID CT perfusion interpretation, highlighting clinical applications, technical limitations, software variability, and diagnostic pitfalls to advance everyday neuroradiological practice and personalized stroke management.

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BibTeX RIS

BibTeX

@article{buoso2026rapid,
  title = {{RAPID perfusion CT in acute ischemic stroke: an educational pictorial review of common patterns, pearls, and pitfalls}},
  author = {Andrea Buoso and Caterina Bernetti and Michele Tondo and Ilenia Barbalace and Teresa Giannarelli and Michele Pillitteri and Andrea Romano and Alessandro Bozzao and Bruno Beomonte Zobel and Carlo A. Mallio},
  journal = {Insights into imaging},
  year = {2026},
  month = oct,
  doi = {10.1186/s13244-026-02427-w},
  url = {https://europepmc.org/article/PMC/PMC13661866},
  note = {CC BY},
}

RIS

TY  - JOUR
TI  - RAPID perfusion CT in acute ischemic stroke: an educational pictorial review of common patterns, pearls, and pitfalls
AU  - Andrea Buoso
AU  - Caterina Bernetti
AU  - Michele Tondo
AU  - Ilenia Barbalace
AU  - Teresa Giannarelli
AU  - Michele Pillitteri
AU  - Andrea Romano
AU  - Alessandro Bozzao
AU  - Bruno Beomonte Zobel
AU  - Carlo A. Mallio
PY  - 2026
DA  - 2026/10/13
JO  - Insights into imaging
DO  - 10.1186/s13244-026-02427-w
UR  - https://europepmc.org/article/PMC/PMC13661866
AB  - Rapid processing of Perfusion and Diffusion (RAPID) software for CT perfusion (CTP) is a valuable tool for the evaluation of acute ischemic stroke and therapeutic decision-making in extended therapeutic windows. However, automated maps should not be interpreted in isolation. A structured, pattern-based approach, integrating qualitative visual assessment with automated quantitative output and clinical information to refine therapeutic selection, remains essential to mitigate pitfalls and optimize patient care. The aim of this article is to provide an educational pictorial review based on selected illustrative cases of the most common imaging patterns, interpretive pitfalls, and technical features of CTP processed with RAPID software in acute ischemic stroke, that may serve as a practical guide for radiologists and neuroradiologists.  Key Points: Question How can radiologists effectively interpret automated RAPID CT perfusion maps in acute ischemic stroke while avoiding common technical traps, diagnostic pitfalls, and anatomical limitations?  Findings Integrating qualitative visual assessment, quantitative RAPID outputs, and clinical-vascular data within a structured workflow minimizes diagnostic errors and optimizes patient selection for reperfusion.  Critical relevance statement This educational pictorial review provides a practical, pattern-based approach to RAPID CT perfusion interpretation, highlighting clinical applications, technical limitations, software variability, and diagnostic pitfalls to advance everyday neuroradiological practice and personalized stroke management.
SN  - 1869-4101
ER  -

Abstract

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