Improving the prediction of final infarct size in acute stroke with bolus delay–corrected perfusion MRI measures

Rose, Stephen E., Janke, Andrew L., Griffin, Mark, Strudwick, Mark W., Finnigan, Simon, Semple, James and Chalk, Jonathan B. (2004) Improving the prediction of final infarct size in acute stroke with bolus delay–corrected perfusion MRI measures. Journal of Magnetic Resonance Imaging, 20 6: 941-947. doi:10.1002/jmri.20216


Author Rose, Stephen E.
Janke, Andrew L.
Griffin, Mark
Strudwick, Mark W.
Finnigan, Simon
Semple, James
Chalk, Jonathan B.
Title Improving the prediction of final infarct size in acute stroke with bolus delay–corrected perfusion MRI measures
Journal name Journal of Magnetic Resonance Imaging   Check publisher's open access policy
ISSN 1053-1807
1522-2586
Publication date 2004-12
Sub-type Article (original research)
DOI 10.1002/jmri.20216
Volume 20
Issue 6
Start page 941
End page 947
Total pages 7
Editor C. L. Partain
Place of publication New York, U.S.A.
Publisher John Wiley & Sons
Collection year 2004
Language eng
Subject C1
249902 Medical Physics
730305 Diagnostic methods
1702 Cognitive Sciences
1103 Clinical Sciences
0903 Biomedical Engineering
Formatted abstract
Purpose:
To investigate whether bolus delay-corrected dynamic susceptibility contrast (DSC) perfusion MRI measures allowed a more accurate estimation of eventual infarct volume in 14 acute stroke patients using a predictive tissue classifier algorithm.

Materials and Methods:

Tissue classification was performed using a expectation maximization and k-means clustering algorithm utilizing diffusion and T2 measures (diffusion-weighted imaging [DWI], apparent diffusion coefficient [ADC], and T2) combined with uncorrected perfusion measures cerebral blood flow ((CBF) and mean transit time [MTT]), bolus delay-corrected perfusion measures (cCBF and cMTT), and bolus delay-corrected perfusion indices (cCBF and cMTT with bolus delay).

Results:
The mean similarity index (SI), a kappa-based correlation statistic reflecting the pixel-by-pixel classification agreement between predicted and 30-day T2 lesion volumes, were 0.55 ± 0.19, 0.61 ± 0.15 (P < 0.02) and 0.60 ± 0.17 (P <0.03), respectively. Spearman's correlation coefficients, comparing predicted and final lesion volumes were 0.56 (P < 0.05), 0.70 (P < 0.01), and 0.84 (P < 0.001), respectively. We found a more significant correlation between predicted infarct volumes derived from bolus delay-corrected perfusion measures than from conventional perfusion measures when combined with diffusion measures and compared with final lesion volumes measured on 30-day T2 MRI scans.

Conclusion:
Bolus delay-corrected perfusion measures enable an improved prediction of infarct evolution and evaluation of the hemodynamic status of neuronal tissue in acute stroke.
© 2004 Wiley-Liss, Inc.
Keyword Radiology, Nuclear Medicine & Medical Imaging
Cerebral ischemia
Diffusion weighted MRI
Perfusion weighted MRI
Acute stroke
MRI
Diffusion
Flow
Q-Index Code C1

 
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Created: Wed, 15 Aug 2007, 03:55:12 EST