Rani Gupta Sah1,2,3, Christopher D d'Esterre1,2,3,4, Michael D Hill1,2,4, Moiz Hafeez1,2, Sana Tariq2,4, Nils D Forkert3,4, Andrew M Demchuk1,2,4, Mayank Goyal1,2,3,4, Philip A Barber5,6,7,8. 1. Calgary Stroke Program, Departments of Clinical Neurosciences, University of Calgary, 3330 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada. 2. Seaman Family Centre, Foothills Medical Centre, Calgary, Canada. 3. Department of Radiology, University of Calgary, Calgary, Canada. 4. Hotchkiss Brain Institute, University of Calgary, Calgary, Canada. 5. Calgary Stroke Program, Departments of Clinical Neurosciences, University of Calgary, 3330 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada. pabarber@ucalgary.ca. 6. Seaman Family Centre, Foothills Medical Centre, Calgary, Canada. pabarber@ucalgary.ca. 7. Department of Radiology, University of Calgary, Calgary, Canada. pabarber@ucalgary.ca. 8. Hotchkiss Brain Institute, University of Calgary, Calgary, Canada. pabarber@ucalgary.ca.
Abstract
PURPOSE: Infarct lesion segmentation has been problematic as there are a wide range of relative and absolute diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) thresholds that have been used for this purpose. We examined differences of stroke lesion volume and evolution evaluated by magnetic resonance imaging (MRI) during the immediate post-treatment phase (<5 h) and at 24 h. METHODS: In this study 33 acute ischemic stroke patients were imaged with MRI <5 h and 24 h post-reperfusion treatment. Lesion volumes were segmented on ADC maps and average DWI using literature cited absolute ADC and relative DWI thresholds. The segmented lesion volumes within both time points were compared and the absolute change in lesion volume (infarct growth) between the two time points was calculated and compared using Bland-Altman analysis. RESULTS: Lesion volumes differed significantly when different relative DWI or absolute ADC thresholds were used (p < 0.05), which held true for baseline as well as follow-up lesions. The median absolute changes in lesion volume from baseline to follow-up for ADC thresholds of 550 × 10-6 mm2/s, 600 × 10-6 mm2/s, 630 × 10-6 mm2/s and 650 × 10-6 mm2/s were 3.5 ml, 4.2 ml, 4.5 ml, and 6.5 ml, respectively (p < 0.05). Likewise, the median absolute changes in lesion volume from baseline to follow-up for DWI thresholds, k = 0.85, 1.28, 1.64, 1.96, and 2.7 were 10.1 ml, 7.3 ml, 5.7 ml, 5.4 ml and 4.2 ml, respectively (p < 0.05). CONCLUSION: Absolute lesion volumes and changes in lesion volumes (infarct growth) measured after recanalization treatment were dependent on absolute ADC and relative DWI thresholds, which may have clinical significance. Standardization of techniques for measuring DWI lesion volumes requires immediate attention.
PURPOSE:Infarct lesion segmentation has been problematic as there are a wide range of relative and absolute diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) thresholds that have been used for this purpose. We examined differences of stroke lesion volume and evolution evaluated by magnetic resonance imaging (MRI) during the immediate post-treatment phase (<5 h) and at 24 h. METHODS: In this study 33 acute ischemic strokepatients were imaged with MRI <5 h and 24 h post-reperfusion treatment. Lesion volumes were segmented on ADC maps and average DWI using literature cited absolute ADC and relative DWI thresholds. The segmented lesion volumes within both time points were compared and the absolute change in lesion volume (infarct growth) between the two time points was calculated and compared using Bland-Altman analysis. RESULTS: Lesion volumes differed significantly when different relative DWI or absolute ADC thresholds were used (p < 0.05), which held true for baseline as well as follow-up lesions. The median absolute changes in lesion volume from baseline to follow-up for ADC thresholds of 550 × 10-6 mm2/s, 600 × 10-6 mm2/s, 630 × 10-6 mm2/s and 650 × 10-6 mm2/s were 3.5 ml, 4.2 ml, 4.5 ml, and 6.5 ml, respectively (p < 0.05). Likewise, the median absolute changes in lesion volume from baseline to follow-up for DWI thresholds, k = 0.85, 1.28, 1.64, 1.96, and 2.7 were 10.1 ml, 7.3 ml, 5.7 ml, 5.4 ml and 4.2 ml, respectively (p < 0.05). CONCLUSION: Absolute lesion volumes and changes in lesion volumes (infarct growth) measured after recanalization treatment were dependent on absolute ADC and relative DWI thresholds, which may have clinical significance. Standardization of techniques for measuring DWI lesion volumes requires immediate attention.
Entities:
Keywords:
Diffusion weighted magnetic resonance imaging; Infarction; Ischemic; Reperfusion
Authors: C C McDougall; L Chan; S Sachan; J Guo; R G Sah; B K Menon; A M Demchuk; M D Hill; N D Forkert; C D d'Esterre; P A Barber Journal: AJNR Am J Neuroradiol Date: 2020-10-01 Impact factor: 3.825
Authors: Christopher D d'Esterre; Rani Gupta Sah; Zarina Assis; Aron S Talai; Andrew M Demchuk; Michael D Hill; Mayank Goyal; Ting-Yim Lee; Nils D Forkert; Philip A Barber Journal: Br J Radiol Date: 2020-09-17 Impact factor: 3.039
Authors: Anna Christina Alegiani; Simon MacLean; Hanna Braass; Susanne Gellißen; Tae-Hee Cho; Laurent Derex; Marc Hermier; Yves Berthezene; Norbert Nighoghossian; Christian Gerloff; Jens Fiehler; Götz Thomalla Journal: Front Neurol Date: 2019-02-26 Impact factor: 4.003
Authors: Malte Grosser; Susanne Gellißen; Patrick Borchert; Jan Sedlacik; Jawed Nawabi; Jens Fiehler; Nils D Forkert Journal: PLoS One Date: 2020-11-05 Impact factor: 3.240