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MRI based diffusion and perfusion predictive model to estimate stroke evolution

Rose, S. E., Chalk, J. B., Griffin, M. P., Janke, A. L., Chen, F., McLachan, G. J., Peel, D., Zelaya, F. O., Markus, H. S., Jones, Derek K., Simmons, A., O'Sullivan, M., Jarosz, J. M., Strugnell, W., Doddrell, D. M. and Semple, J. 2001. MRI based diffusion and perfusion predictive model to estimate stroke evolution. Magnetic Resonance Imaging 19 (8) , pp. 1043-1053. 10.1016/S0730-725X(01)00435-0

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In this study we present a novel automated strategy for predicting infarct evolution, based on MR diffusion and perfusion images acquired in the acute stage of stroke. The validity of this methodology was tested on novel patient data including data acquired from an independent stroke clinic. Regions-of-interest (ROIs) defining the initial diffusion lesion and tissue with abnormal hemodynamic function as defined by the mean transit time (MTT) abnormality were automatically extracted from DWI/PI maps. Quantitative measures of cerebral blood flow (CBF) and volume (CBV) along with ratio measures defined relative to the contralateral hemisphere (raCBF and raCBV) were calculated for the MTT ROIs. A parametric normal classifier algorithm incorporating these measures was used to predict infarct growth. The mean raCBF and raCBV values for eventually infarcted MTT tissue were 0.70 ± 0.19 and 1.20 ± 0.36. For recovered tissue the mean values were 0.99 ± 0.25 and 1.87 ± 0.71, respectively. There was a significant difference between these two regions for both measures (p < 0.003 and p < 0.001, respectively). Mean absolute measures of CBF (ml/100g/min) and CBV (ml/100g) for the total infarcted territory were 33.9 ± 9.7 and 4.2 ± 1.9. For recovered MTT tissue, the mean values were 41.5 ± 7.2 and 5.3 ± 1.2, respectively. A significant difference was also found for these regions (p < 0.009 and p < 0.036, respectively). The mean measures of sensitivity, specificity, positive and negative predictive values for modeling infarct evolution for the validation patient data were 0.72 ± 0.05, 0.97 ± 0.02, 0.68 ± 0.07 and 0.97 ± 0.02. We propose that this automated strategy may allow possible guided therapeutic intervention to stroke patients and evaluation of efficacy of novel stroke compounds in clinical drug trials.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Uncontrolled Keywords: Acute stroke; Magnetic resonance imaging; Diffusion and perfusion
Publisher: Elsevier
ISSN: 0730-725X
Last Modified: 04 Jun 2017 04:15

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