Computed tomography perfusion (CTP) and diffusion or perfusion magnetic resonance imaging (MRI) is widely used in the evaluation of acute ischemic stroke patients for endovascular thrombectomy (EVT) and can be used to quantify the perfusion status of the brain. In the later (6-24h) time window, patient selection based on perfusion imaging is recommended after the added value of EVT was shown in patients with small core volumes. In the earlier (0-6h) time window, patient selection for EVT based on perfusion imaging is currently not recommended.
Perfusion imaging allows for differentiating brain tissue which is severely hypoperfused (called the ‘penumbra’) from brain tissue which is irreversibly injured and likely to become infarcted (commonly named the ‘ischemic core’). Despite the increased implementation of perfusion imaging, differences among CTP acquisition protocols, scanners, and post-processing software vendors. Regarding MRI, implementing acute (perfusion) MRI in emergency departments which are not yet equipped with MRI scanners may logistically be challenging. Furthermore, it remains unclear if EVT is favorable for patients with larger core volumes and whether perfusion imaging can reliably estimate the ischemic core, especially in the earlier time window. Perfusion imaging has the potential to improve diagnostic accuracy, treatment decision making, and outcome prediction in acute ischemic stroke. However, there are still various challenges in the harmonization and implementation of perfusion imaging in routine acute stroke care.
In this Research Topic, we aim to investigate various issues related to the harmonization and improved implementation of perfusion imaging in acute ischemic stroke. We will explore the:
- Accuracy of commercially available CTP and perfusion MRI software packages
- Possibilities to improve the harmonization of perfusion imaging
- Added value of perfusion imaging in posterior circulation stroke
- Value of CTP beyond 24 h and in wake-up stroke
- Validity of surrogates for perfusion-based core volume determination
- Outcome prediction in acute ischemic stroke based on perfusion parameters
Thus, this Research Topic welcomes any types of manuscripts supported by the Journal pertaining, but not limited to the following potential areas of interest:
- Cost-effectiveness of CTP and perfusion MRI
- AI-focused solutions using CTP and perfusion MRI
- Perfusion imaging in lacunar stroke
- Effect of perfusion parameters on IV thrombolysis in acute ischemic stroke
- Robustness and effect of perfusion imaging – especially CTP – in the early (0-6h) time window
Computed tomography perfusion (CTP) and diffusion or perfusion magnetic resonance imaging (MRI) is widely used in the evaluation of acute ischemic stroke patients for endovascular thrombectomy (EVT) and can be used to quantify the perfusion status of the brain. In the later (6-24h) time window, patient selection based on perfusion imaging is recommended after the added value of EVT was shown in patients with small core volumes. In the earlier (0-6h) time window, patient selection for EVT based on perfusion imaging is currently not recommended.
Perfusion imaging allows for differentiating brain tissue which is severely hypoperfused (called the ‘penumbra’) from brain tissue which is irreversibly injured and likely to become infarcted (commonly named the ‘ischemic core’). Despite the increased implementation of perfusion imaging, differences among CTP acquisition protocols, scanners, and post-processing software vendors. Regarding MRI, implementing acute (perfusion) MRI in emergency departments which are not yet equipped with MRI scanners may logistically be challenging. Furthermore, it remains unclear if EVT is favorable for patients with larger core volumes and whether perfusion imaging can reliably estimate the ischemic core, especially in the earlier time window. Perfusion imaging has the potential to improve diagnostic accuracy, treatment decision making, and outcome prediction in acute ischemic stroke. However, there are still various challenges in the harmonization and implementation of perfusion imaging in routine acute stroke care.
In this Research Topic, we aim to investigate various issues related to the harmonization and improved implementation of perfusion imaging in acute ischemic stroke. We will explore the:
- Accuracy of commercially available CTP and perfusion MRI software packages
- Possibilities to improve the harmonization of perfusion imaging
- Added value of perfusion imaging in posterior circulation stroke
- Value of CTP beyond 24 h and in wake-up stroke
- Validity of surrogates for perfusion-based core volume determination
- Outcome prediction in acute ischemic stroke based on perfusion parameters
Thus, this Research Topic welcomes any types of manuscripts supported by the Journal pertaining, but not limited to the following potential areas of interest:
- Cost-effectiveness of CTP and perfusion MRI
- AI-focused solutions using CTP and perfusion MRI
- Perfusion imaging in lacunar stroke
- Effect of perfusion parameters on IV thrombolysis in acute ischemic stroke
- Robustness and effect of perfusion imaging – especially CTP – in the early (0-6h) time window
