Universität zu Köln

Zaro-Weber, Olivier, Moeller-Hartmann, Walter, Siegmund, Dora, Kandziora, Alexandra, Schuster, Alexander, Heiss, Wolf-Dieter and Sobesky, Jan (2017). MRI-based mismatch detection in acute ischemic stroke: Optimal PWI maps and thresholds validated with PET. J. Cereb. Blood Flow Metab., 37 (9). S. 3176 - 3184. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 1559-7016

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Abstract

Perfusion-weighted (PW) magnetic resonance imaging (MRI) is used to detect penumbral tissue in acute stroke, but the selection of optimal PW-maps and thresholds for tissue at risk detection remains a matter of debate. We validated the performance of PW-maps with 15O-water-positron emission tomography (PET) in a large comparative PET-MR cohort of acute stroke patients. In acute and subacute stroke patients with back-to-back MRI and PET imaging, PW-maps were validated with 15O-water-PET. We pooled two different cerebral blood flow (CBF) PET-maps to define the critical flow (CF) threshold, (i) quantitative (q) CBF-PET with the CF threshold <20 ml/100 g/min and (ii) normalized non-quantitative (nq) CBF-PET with a CF threshold of <70% (corresponding to < 20 ml/100 g/min according to a previously published normogram). A receiver operating characteristic (ROC) curve analysis was performed to specify the accuracy and the optimal critical flow threshold of each PW-map as defined by PET. In 53 patients, (stroke to imaging: 9.8 h; PET to MRI: 52 min) PW-time-to-maximum (Tmax) with a threshold >6.1 s (AUC = 0.94) and non-deconvolved PW-time-to-peak (TTP) >4.8 s (AUC = 0.93) showed the best performance to detect the CF threshold as defined by PET. PW-Tmax with a threshold >6.1 s and TTP with a threshold >4.8 s are the most predictive in detecting the CF threshold for MR-based mismatch definition.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zaro-Weber, Olivier UNSPECIFIED UNSPECIFIED UNSPECIFIED Moeller-Hartmann, Walter UNSPECIFIED UNSPECIFIED UNSPECIFIED Siegmund, Dora UNSPECIFIED UNSPECIFIED UNSPECIFIED Kandziora, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Schuster, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Heiss, Wolf-Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Sobesky, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-220265
DOI:	10.1177/0271678X16685574
Journal or Publication Title:	J. Cereb. Blood Flow Metab.
Volume:	37
Number:	9
Page Range:	S. 3176 - 3184
Date:	2017
Publisher:	SAGE PUBLICATIONS INC
Place of Publication:	THOUSAND OAKS
ISSN:	1559-7016
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CEREBRAL-BLOOD-FLOW; POSITRON-EMISSION-TOMOGRAPHY; ARTERIAL INPUT FUNCTION; PENUMBRAL FLOW; DIFFUSION; BRAIN; TIME; CT; THROMBOLYSIS; REPERFUSION Multiple languages Endocrinology & Metabolism; Hematology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22026