Data science of stroke imaging and enlightenment of the penumbra

Frontiers in Neurology
Fabien ScalzoDavid S Liebeskind

Abstract

Imaging protocols of acute ischemic stroke continue to hold significant uncertainties regarding patient selection for reperfusion therapy with thrombolysis and mechanical thrombectomy. Given that patient inclusion criteria can easily introduce biases that may be unaccounted for, the reproducibility and reliability of the patient screening method is of utmost importance in clinical trial design. The optimal imaging screening protocol for selection in targeted populations remains uncertain. Acute neuroimaging provides a snapshot in time of the brain parenchyma and vasculature. By identifying the at-risk but still viable penumbral tissue, imaging can help estimate the potential benefit of a reperfusion therapy in these patients. This paper provides a perspective about the assessment of the penumbral tissue in the context of acute stroke and reviews several neuroimaging models that have recently been developed to assess the penumbra in a more reliable fashion. The complexity and variability of imaging features and techniques used in stroke will ultimately require advanced data driven software tools to provide quantitative measures of risk/benefit of recanalization therapy and help aid in making the most favorable clinical decisions.

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Citations

Sep 15, 2015·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Yao LiuPeiwei Hong
Sep 19, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Kyo NoguchiSatoshi Kuroda
Jan 9, 2017·Acta Neuropathologica·Clemens J Sommer
Sep 29, 2017·Journal of Neurointerventional Surgery·Rui FengEric K Oermann
May 18, 2019·Proteomics. Clinical Applications·Xiao-Min PangJing-Li Liu
Feb 19, 2021·Reviews in the Neurosciences·Guangchen HeYueqi Zhu
May 29, 2021·Journal of Neuroscience Research·Andre Obenaus, Jérôme Badaut

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Methods Mentioned

BETA
x-ray imaging
imaging techniques

Software Mentioned

- PRIME
MR CLEAN
DEFUSE
EXTEND
perfAngio
IA
ESCAPE
ISODATA
SWIFT

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