Journal: Stroke

Article Title: Blood-Brain Barrier Leakage in the Penumbra Is Associated With Infarction on Follow-Up Imaging in Acute Ischemic Stroke

doi: 10.1161/STROKEAHA.124.050171

Figure Lengend Snippet: Methodological overview of the imaging pipeline. A , First, ischemic cores were segmented semiautomatically on baseline apparent diffusion coefficient (ADC≤620 mm²/s) and follow-up fluid-attenuated inversion recovery (FLAIR) images using the SONIA software. Then, pharmacokinetic modeling was performed in 2 different software suites ( B ). (1) NordicIce was used to estimate extraction fraction (EF) as a marker of blood-brain barrier (BBB) leakage, based on delay-insensitive singular value deconvolution and residue function–based leakage correction using an automatically defined arterial input function. (2) RAPID was used for current state-of-the-art estimation of time to maximum of the tissue residue function (T max ) maps and perfusion deficit masks. C , After coregistration, different tissue types of interest were defined using the perfusion deficit, baseline, and follow-up ischemic core masks. D , Different analytical approaches. We performed both tissue type of interest analyses using averaged EF/T max values and voxel-wise analyses. For simplicity, only the salvaged vs infarcted penumbra contrast is shown here.

Article Snippet: BBB leakage was estimated as extraction fraction (EF) using NordicICE, version 4.2.0 (Nordic-NeuroLab, Bergen, Norway) via delay-insensitive singular value deconvolution and residue function–based leakage correction using an automatically defined arterial input function (Figure B).

Techniques: Imaging, Diffusion-based Assay, Software, Extraction, Marker, Residue