Comparison between voxel-based and subtraction methods for measuring diffusion-weighted imaging lesion growth after thrombolysis

International Journal of Stroke : Official Journal of the International Stroke Society
Wajih Ben HassenCatherine Oppenheim

Abstract

Infarct growth (IG) is used as surrogate end-point in therapeutic trials. For practical reasons, infarct growth is commonly assessed using simple subtraction of acute from follow-up diffusion-weighted imaging (DWI) lesion volumes. However, the volume subtraction method will underestimate true infarct growth in case of diffusion-weighted imaging lesion reversal. To measure the size of the difference between true infarct growth on voxel-based coregistration and infarct growth approximated with simple volume subtraction. We retrospectively analyzed 322 consecutive stroke patients (median (IQR) age: 70 years (57-80), National Institute of Health Stroke Score at admission 14 (8-19)), who underwent a magnetic resonance imaging before (DWI1) and ≈24 h (DWI2) after i.v.-thrombolysis. IGvoxel-based was defined as the volume of signal changes on DWI2 that did not overlap with that on coregistered DWI1. This was compared with simply subtracting DWI1 from DWI2 lesion volume (IGsubtracted). We also compared these two metrics for the prediction of three-month unfavorable outcome (mRS ≥ 2) using c-statistics of multivariable models, adjusted for age, and National Institute of Health Stroke Score. Infarct growth volume metrics were strongly co...Continue Reading

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Citations

Jun 14, 2018·Stroke; a Journal of Cerebral Circulation·George W J HarstonJames Kennedy
Mar 17, 2016·Stroke; a Journal of Cerebral Circulation·Marie TisserandCatherine Oppenheim
Oct 21, 2017·Clinical Neuroradiology·Rani Gupta SahPhilip A Barber
Mar 10, 2017·Annals of Clinical and Translational Neurology·George W J HarstonJames Kennedy
Sep 9, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·W Ben HassenO Naggara
Apr 20, 2021·Stroke; a Journal of Cerebral Circulation·Estelle Pruvost-RobieuxMartine Gavaret

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Software Mentioned

MANGO
Linear Image Registration Tool ; FLIRT
MedCalc13
SPSS
FMRIB
EPITHET

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