Anna Kufner1, Anke Wouters2, Luc Bracoud2, Rico Laage2, Armin Schneider2, Wolf-Rüdiger Schäbitz2, Marc Hermier2, Vincent Thijs2, Jochen B Fiebach2. 1. From the Department of Neurology, Center for Stroke Research Berlin, Charité University Hospital Berlin, Germany (A.K., J.B.F.); Experimental Neurology, Department of Neurosciences, KU Leuven-University of Leuven, Leuven, Belgium (A.W., V.T.); Department of Neurology, BioClinica Bio-Imaging Technologies, Lyon France (L.B.); Department of Neurology, Sygnis Bioscience, Im Neuenheimer Feld 515, Heidelberg, Germany (R.L., A.S.); Department of Neurology, Evangelisches Krankenhaus Bielefeld, Germany (W.-R.S.); Department of Neuroradiology, Hospices Civils de Lyon, France (M.H.); VIB, Vesalius Research Center, Laboratory of Neurobiology, B-3000 Leuven, Belgium (V.T.); and Department of Neurology, University Hospitals Leuven, Leuven, Belgium (V.T.). anna.kufner@charite.de. 2. From the Department of Neurology, Center for Stroke Research Berlin, Charité University Hospital Berlin, Germany (A.K., J.B.F.); Experimental Neurology, Department of Neurosciences, KU Leuven-University of Leuven, Leuven, Belgium (A.W., V.T.); Department of Neurology, BioClinica Bio-Imaging Technologies, Lyon France (L.B.); Department of Neurology, Sygnis Bioscience, Im Neuenheimer Feld 515, Heidelberg, Germany (R.L., A.S.); Department of Neurology, Evangelisches Krankenhaus Bielefeld, Germany (W.-R.S.); Department of Neuroradiology, Hospices Civils de Lyon, France (M.H.); VIB, Vesalius Research Center, Laboratory of Neurobiology, B-3000 Leuven, Belgium (V.T.); and Department of Neurology, University Hospitals Leuven, Leuven, Belgium (V.T.).
Abstract
BACKGROUND AND PURPOSE: We investigated whether hyperintensities with a diameter of at least 3, 3.5, and 4 cm and visible on at least 3 slices on diffusion-weighted imaging enables patient selection with an infarct volume of ≥15 mL. METHODS: Consecutive acute stroke patients were screened for the AXIS2 trial and examined according to a standardized magnetic resonance imaging protocol in 65 sites. Diffusion-weighted lesion diameters were measured and compared with volumetric assessments. RESULTS: Out of 238 patients, 86.2% (N=206) had infarct diameter of at least 3 cm. Volumetric assessments showed infarct volume of ≥15 mL in 157 patients. A cut-off value of 3 cm led to 96.8% sensitivity and 33.3% specificity for predicting lesion volume of ≥15 mL. Analogously, a 3.5 cm cut-off led to 96.8% sensitivity and 50.6% specificity and a 4 cm cut-off led to 91.7% sensitivity and 61.7% specificity. CONCLUSIONS: Lesion diameter measures may enable multicentric patient recruitment with a prespecified minimal infarct volume. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00927836.
BACKGROUND AND PURPOSE: We investigated whether hyperintensities with a diameter of at least 3, 3.5, and 4 cm and visible on at least 3 slices on diffusion-weighted imaging enables patient selection with an infarct volume of ≥15 mL. METHODS: Consecutive acute strokepatients were screened for the AXIS2 trial and examined according to a standardized magnetic resonance imaging protocol in 65 sites. Diffusion-weighted lesion diameters were measured and compared with volumetric assessments. RESULTS: Out of 238 patients, 86.2% (N=206) had infarct diameter of at least 3 cm. Volumetric assessments showed infarct volume of ≥15 mL in 157 patients. A cut-off value of 3 cm led to 96.8% sensitivity and 33.3% specificity for predicting lesion volume of ≥15 mL. Analogously, a 3.5 cm cut-off led to 96.8% sensitivity and 50.6% specificity and a 4 cm cut-off led to 91.7% sensitivity and 61.7% specificity. CONCLUSIONS: Lesion diameter measures may enable multicentric patient recruitment with a prespecified minimal infarct volume. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00927836.
Authors: Jochen B Fiebach; Jonas D Stief; Ramanan Ganeshan; Benjamin Hotter; Ann-Christin Ostwaldt; Christian H Nolte; Kersten Villringer Journal: PLoS One Date: 2015-10-08 Impact factor: 3.240