Universität zu Köln

Reimer, Johanna, Montag, Cornelia, Schuster, Alexander, Moeller-Hartmann, Walter, Sobesky, Jan, Heiss, Wolf-Dieter and Zaro-Weber, Olivier (2018). Is Perfusion MRI without Deconvolution Reliable for Mismatch Detection in Acute Stroke? Validation with O-15-Positron Emission Tomography. Cerebrovasc. Dis., 46 (1-2). S. 16 - 24. BASEL: KARGER. ISSN 1421-9786

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Abstract

Background: In acute stroke, the magnetic resonance (MR) imaging-based mismatch concept is used to select patients with tissue at risk of infarction for reperfusion therapies. There is however a controversy if non-deconvolved or deconvolved perfusion weighted (PW) parameter maps perform better in tissue at risk prediction and which parameters and thresholds should be used to guide treatment decisions. Methods: In a group of 22 acute stroke patients with consecutive MR and quantitative positron emission tomography (PET) imaging, non-deconvolved parameters were validated with the gold standard for penumbral-flow (PF) detection 15O-water PET. Performance of PW parameters was assessed by a receiver operating characteristic curve analysis to identify the accuracy of each PWI map to detect the - upper PF threshold as defined by PET cerebral blood flow < 20 mL/100 g/min. Results: Among normalized non-deconvolved parameters, PW-first moment without delay correction (FM without DC) > 3.6 s (area under the curve [AUC] = 0.89, interquartile range [IQR] 0.85-0.94), PW-maximum of the concentration curve (Cmax) < 0.66 (AUC = 0.92, IQR 0.84-0.96) and PW-time to peak (TTP) > 4.0 s (AUC = 0.92, IQR 0.87-0.94) perform significantly better than other non-deconvolved parameters to detect the PF threshold as defined by PET. Conclusions: Non-deconvolved parameters FM without DC, Cmax and TTP are an observer-independent alternative to established deconvolved parameters (e. g., Tmax) to guide treatment decisions in acute stroke. (c) 2018 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Reimer, Johanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Montag, Cornelia UNSPECIFIED UNSPECIFIED UNSPECIFIED Schuster, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Moeller-Hartmann, Walter UNSPECIFIED UNSPECIFIED UNSPECIFIED Sobesky, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Heiss, Wolf-Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Zaro-Weber, Olivier UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-201917
DOI:	10.1159/000490424
Journal or Publication Title:	Cerebrovasc. Dis.
Volume:	46
Number:	1-2
Page Range:	S. 16 - 24
Date:	2018
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9786
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; CEREBRAL-BLOOD-FLOW; PENUMBRAL FLOW; ENDOVASCULAR THERAPY; CT; TIME; REPERFUSION; PARAMETERS; DISPERSION; THRESHOLD Multiple languages Clinical Neurology; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20191