Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials

Author:

Warach Steven J.1,Luby Marie1,Albers Gregory W.1,Bammer Roland1,Bivard Andrew1,Campbell Bruce C.V.1,Derdeyn Colin1,Heit Jeremy J.1,Khatri Pooja1,Lansberg Maarten G.1,Liebeskind David S.1,Majoie Charles B.L.M.1,Marks Michael P.1,Menon Bijoy K.1,Muir Keith W.1,Parsons Mark W.1,Vagal Achala1,Yoo Albert J.1,Alexandrov Andrei V.1,Baron Jean-Claude1,Fiorella David J.1,Furlan Anthony J.1,Puig Josep1,Schellinger Peter D.1,Wintermark Max1,Ansari Sameer A.2,Aviv Richard I.3,Barreto Andrew D.4,Broderick Joseph P.5,Christensen Søren6,Davis Stephen M.7,Demchuk Andrew M.8,Dippel Diederik W.9,Donnan Geoffrey A.10,Fiebach Jochen B.11,Fiehler Jens12,Houser Gary13,Grotta James C.14,Hacke Werner15,Hill Michael D.16,Hsia Amie W.17,Jovin Tudor G.18,Köhrmann Martin19,Latour Lawrence L.17,Leigh Richard20,Lees Kennedy R.17,Lev Michael D.21,Marshall Randolph S.22,Mocco J23,Nadareishvili Zurab17,Nogueira Raul G.24,Olivot Jean Marc25,Palesch Yuko26,Pedraza Salvador27,Sasaki Makoto28,Saver Jeffrey L.29,Savitz Sean I.30,Schwamm Lee H.31,Simpkins Alexis17,Smith Wade S.32,Thijs Vincent33,Thomalla Götz34,Wechsler Lawrence R.35,Wu Ona36,Zaharchuk Greg37,Zaidat Osama O.38,

Affiliation:

1. From the Department of Neurology, Dell Medical School, University of Texas at Austin (S.J.W.); Stroke Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD (M.L.); Department of Neurology (G.W.A., M.G.L.), Department of Radiology (R.B.), Neuroradiology Section, Department of Radiology (J.J.H., M.P.M., M.W.), Stanford University School of Medicine, CA; Department of Neurology, John Hunter Hospital, Hunter Medical Research Institute,...

2. Departments of Radiology, Neurology, and Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

3. Department of Medical Imaging, University of Toronto and Sunnybrook Health Science Centre, Toronto, Canada

4. Department of Neurology, University of Texas Health Science Center at Houston, Houston, TX, USA

5. Department of Neurology, University of Cincinnati Neuroscience Institute, Cincinnati, OH, USA

6. Stanford University School of Medicine, Stanford, CA, USA

7. The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia

8. Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada

9. Erasmus MC University Medical Center, Rotterdam, The Netherlands

10. The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia

11. Academic Neuroradiology, Center for Stroke Research Berlin, Charité – Universitätsmedizin, Berlin, Germany

12. Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

13. The Stroke Group, Centennial, CO, USA

14. Department of Neurology, Memorial Hermann Hospital - TMC, Houston, TX, USA

15. Department of Neurology, University of Heidelberg, Heidelberg, Germany

16. Departments of Clinical Neurosciences, Radiology Medicine, Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada

17. National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA

18. Department of Neurology, University of Pittsburgh Medical Center, Stroke Institute and UPMC Center for Neuroendovascular Therapy, Pittsburgh, PA, USA

19. Department of Neurology, Universitätsklinik Erlangen, Erlangen, Germany

20. Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK

21. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

22. Department of Neurology, Columbia Presbyterian Medical Center, New York, NY, USA

23. Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA

24. Neuroendovascular Service, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA

25. Department of Neurology, UMR 825, CHU de Toulouse, Université Toulouse III – Paul Sabatier, Toulouse, France

26. Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA

27. Servicio de Radiología, Hospital Josep Trueta, Girona, Spain

28. Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan

29. Department of Neurology, Geffen School of Medicine at UCLA, Los Angeles, CA, USA

30. Department of Neurology, University of Texas Medical School at Houston, Houston, TX, USA

31. Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

32. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA

33. Department of Neurology, Austin Health and Melbourne Brain Center, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia

34. Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

35. Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

36. Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

37. Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA

38. Department of Neurology, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, WI, USA

Abstract

Background and Purpose— The Stroke Imaging Research (STIR) group, the Imaging Working Group of StrokeNet, the American Society of Neuroradiology, and the Foundation of the American Society of Neuroradiology sponsored an imaging session and workshop during the Stroke Treatment Academy Industry Roundtable (STAIR) IX on October 5 to 6, 2015 in Washington, DC. The purpose of this roadmap was to focus on the role of imaging in future research and clinical trials. Methods— This forum brought together stroke neurologists, neuroradiologists, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), industry representatives, and members of the US Food and Drug Administration to discuss STIR priorities in the light of an unprecedented series of positive acute stroke endovascular therapy clinical trials. Results— The imaging session summarized and compared the imaging components of the recent positive endovascular trials and proposed opportunities for pooled analyses. The imaging workshop developed consensus recommendations for optimal imaging methods for the acquisition and analysis of core, mismatch, and collaterals across multiple modalities, and also a standardized approach for measuring the final infarct volume in prospective clinical trials. Conclusions— Recent positive acute stroke endovascular clinical trials have demonstrated the added value of neurovascular imaging. The optimal imaging profile for endovascular treatment includes large vessel occlusion, smaller core, good collaterals, and large penumbra. However, equivalent definitions for the imaging profile parameters across modalities are needed, and a standardization effort is warranted, potentially leveraging the pooled data resulting from the recent positive endovascular trials.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

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