MRI software for diffusion-perfusion mismatch analysis may impact on patients' selection and clinical outcome.

Details

Serval ID
serval:BIB_3EB793463DD7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
MRI software for diffusion-perfusion mismatch analysis may impact on patients' selection and clinical outcome.
Journal
European radiology
Author(s)
Pistocchi S., Strambo D., Bartolini B., Maeder P., Meuli R., Michel P., Dunet V.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
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.
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.
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.
MRI software for DWI-PWI analysis may influence patients' selection before EVT and clinical outcome.
• 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.
Keywords
Diffusion, Perfusion, Software, Stroke, Thrombectomy
Pubmed
Web of science
Open Access
Yes
Create date
20/08/2021 16:33
Last modification date
15/09/2021 6:42
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