Rethinking the shoe: is CT perfusion the optimal screening tool for acute stroke patients?

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CT perfusion (CTP) is increasingly used for acute stroke screening despite higher radiation doses compared to MRI perfusion (MRP).
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Automated post-processing tools for CTP can aid in identifying suitable patients for treatment, but results may be compromised by various factors.
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Research indicates that patients with large core infarcts show better outcomes with endovascular thrombectomy than standard care, highlighting the importance of accurate imaging.
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Non-contrast CT and multiphase CT angiography (mCTA) may provide effective alternatives for stroke detection without the radiation burden of CTP.
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There is a need for more research on optimizing MRI availability and exploring AI models for early stroke detection to improve patient outcomes.

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