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MRI software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome
OBJECTIVE: Impact of different MR perfusion software on selection and outcome of patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO) treated by endovascular thrombectomy (EVT) is unclear. We aimed at comparing two commercial MRI software, semi-automated with unadjusted (method...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794935/ https://www.ncbi.nlm.nih.gov/pubmed/34350507 http://dx.doi.org/10.1007/s00330-021-08211-2 |
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author | Pistocchi, Silvia Strambo, Davide Bartolini, Bruno Maeder, Philippe Meuli, Reto Michel, Patrik Dunet, Vincent |
author_facet | Pistocchi, Silvia Strambo, Davide Bartolini, Bruno Maeder, Philippe Meuli, Reto Michel, Patrik Dunet, Vincent |
author_sort | Pistocchi, Silvia |
collection | PubMed |
description | OBJECTIVE: Impact of different MR perfusion software on selection and outcome of patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO) treated by endovascular thrombectomy (EVT) is unclear. We aimed at comparing two commercial MRI software, semi-automated with unadjusted (method A) and adjusted mask (method B), and fully automated (method C) in this setting. METHODS: MRI from 144 consecutive AIS patients with anterior circulation LVO was retrospectively analysed. All diffusion- and perfusion-weighted images (DWI-PWI) were post-processed with the three methods using standard thresholds. Concordance for core and hypoperfusion volumes was assessed with Lin’s test. Clinical outcome was compared between groups in patients who underwent successful EVT in the early and late time window. RESULTS: Mean core volume was higher and mean hypoperfusion volume was lower in method C than in methods A and B. In the early time window, methods A and B found fewer patients with a mismatch ratio ≤ 1.2 than method C (1/67 [1.5%] vs. 12/67 [17.9%], p = 0.0013). In the late time window, methods A and B found fewer patients with a mismatch ratio < 1.8 than method C (3/46 [6.5%] and 2/46 [4.3%] vs. 18/46 [39.1%], p ≤ 0.0002). More patients with functional independence at 3 months would not have been treated using method C versus methods A and B in the early (p = 0.0063) and late (p ≤ 0.011) time window. CONCLUSIONS: MRI software for DWI-PWI analysis may influence patients’ selection before EVT and clinical outcome. KEY POINTS: • Method C detects fewer patients with favourable mismatch profile. • Method C might underselect more patients with functional independence at 3 months. • Software used before thrombectomy may influence patients’ outcome. |
format | Online Article Text |
id | pubmed-8794935 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-87949352022-02-02 MRI software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome Pistocchi, Silvia Strambo, Davide Bartolini, Bruno Maeder, Philippe Meuli, Reto Michel, Patrik Dunet, Vincent Eur Radiol Neuro OBJECTIVE: Impact of different MR perfusion software on selection and outcome of patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO) treated by endovascular thrombectomy (EVT) is unclear. We aimed at comparing two commercial MRI software, semi-automated with unadjusted (method A) and adjusted mask (method B), and fully automated (method C) in this setting. METHODS: MRI from 144 consecutive AIS patients with anterior circulation LVO was retrospectively analysed. All diffusion- and perfusion-weighted images (DWI-PWI) were post-processed with the three methods using standard thresholds. Concordance for core and hypoperfusion volumes was assessed with Lin’s test. Clinical outcome was compared between groups in patients who underwent successful EVT in the early and late time window. RESULTS: Mean core volume was higher and mean hypoperfusion volume was lower in method C than in methods A and B. In the early time window, methods A and B found fewer patients with a mismatch ratio ≤ 1.2 than method C (1/67 [1.5%] vs. 12/67 [17.9%], p = 0.0013). In the late time window, methods A and B found fewer patients with a mismatch ratio < 1.8 than method C (3/46 [6.5%] and 2/46 [4.3%] vs. 18/46 [39.1%], p ≤ 0.0002). More patients with functional independence at 3 months would not have been treated using method C versus methods A and B in the early (p = 0.0063) and late (p ≤ 0.011) time window. CONCLUSIONS: MRI software for DWI-PWI analysis may influence patients’ selection before EVT and clinical outcome. KEY POINTS: • Method C detects fewer patients with favourable mismatch profile. • Method C might underselect more patients with functional independence at 3 months. • Software used before thrombectomy may influence patients’ outcome. Springer Berlin Heidelberg 2021-08-05 2022 /pmc/articles/PMC8794935/ /pubmed/34350507 http://dx.doi.org/10.1007/s00330-021-08211-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Neuro Pistocchi, Silvia Strambo, Davide Bartolini, Bruno Maeder, Philippe Meuli, Reto Michel, Patrik Dunet, Vincent MRI software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome |
title | MRI software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome |
title_full | MRI software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome |
title_fullStr | MRI software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome |
title_full_unstemmed | MRI software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome |
title_short | MRI software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome |
title_sort | mri software for diffusion-perfusion mismatch analysis may impact on patients’ selection and clinical outcome |
topic | Neuro |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794935/ https://www.ncbi.nlm.nih.gov/pubmed/34350507 http://dx.doi.org/10.1007/s00330-021-08211-2 |
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