Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
DWI/FLAIR mismatch assessment for ischemic stroke patients shows promising results in determining if patients are eligible for recombinant tissue-type plasminogen activator (r-tPA) treatment. However, the mismatch criteria suffer from two major issues: binary classification of a non-binary problem and the subjectiveness of the assessor. In this article, we present a simple automatic method for segmenting stroke-related parenchymal hyperintensities on FLAIR, allowing for an automatic and continuous DWI/FLAIR mismatch assessment. We further show that our method's segmentations have comparable inter-rater agreement (DICE 0.820, SD 0.12) compared to that of two neuro-radiologists (DICE 0.856, SD 0.07), that our method appears robust to hyper-parameter choices (suggesting good generalizability), and lastly, that our methods continuous DWI/FLAIR mismatch assessment correlates to mismatch assessments made for a cohort of wake-up stroke patients at hospital submission. The proposed method shows promising results in automating the segmentation of parenchymal hyperintensity within ischemic stroke lesions and could help reduce inter-observer variability of DWI/FLAIR mismatch assessment performed in clinical environments as well as offer a continuous assessment instead of the current binary one.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10802848 | PMC |
| http://dx.doi.org/10.3390/diagnostics14010069 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Associations between Fluid-Attenuated Inversion Recovery vessel hyperintensities and Alberta Stroke Programme Early CT Score and clinical outcomes in stroke patients with unknown time of onset: a sub-analysis from a randomized controlled trial.
Int J Stroke
August 2025
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
Background and AimsFLAIR vessel hyperintensities (FVH)-Alberta Stroke Program Early CT Score (ASPECTS) is an imaging marker but its clinical implications remain unclear. We estimated the correlation between FVH-ASPECTS and clinical outcomes in patients with wake-up stroke or unknown time of stroke onset.MethodsThe THrombolysis for Acute Wake-up and Unclear-onset Strokes with Alteplase at 0.
View Article and Find Full Text PDFAutomated DWI-FLAIR mismatch assessment in stroke using DWI only.
Eur Stroke J
August 2025
Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.
Introduction: In Acute Ischemic Stroke (AIS), mismatch between Diffusion-Weighted Imaging (DWI) and Fluid-Attenuated Inversion-Recovery (FLAIR) helps identify patients who can benefit from thrombolysis when stroke onset time is unknown (15% of AIS). However, visual assessment has suboptimal observer agreement. Our study aims to develop and validate a Deep-Learning model for predicting DWI-FLAIR mismatch using solely DWI data.
View Article and Find Full Text PDFDeep learning to identify stroke within 4.5 h using DWI and FLAIR in a prospective multicenter study.
Sci Rep
July 2025
Nunaps Inc., Seoul, South Korea.
To enhance thrombolysis eligibility in acute ischemic stroke, we developed a deep learning model to estimate stroke onset within 4.5 h using diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) images. Given the variability in human interpretation, our multimodal Res-U-Net (mRUNet) model integrates a modified U-Net and ResNet-34 to classify stroke onset as < 4.
View Article and Find Full Text PDFMore than half of patients with wake-up stroke have slept through their stroke onset.
J Stroke Cerebrovasc Dis
August 2025
Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA. Electronic address:
Background: Conventional time-from-onset decision-making for use of reperfusion therapies in acute ischemic stroke is challenged by patients with wake-up strokes (WUS) in whom onset time is uncertain. Management of these patients, including use of advanced imaging to make "tissue-clock" rather than "time-clock" treatment decisions, and development of wearable technologies to detect stroke onset during sleep, would be aided by delineation of how often WUS patients had onset long before or shortly before awakening.
Methods: We performed a meta-analysis of studies comparing diffusion weighted imaging-fluid-attenuated inversion recovery (DWI-FLAIR) mismatch frequencies in patients with WUS compared with patients with clear onset time stroke (COS).
Utilization of DWI-FLAIR Mismatch for Intravenous Thrombolysis in an Elderly Patient With Stroke.
Neurohospitalist
May 2025
Department of Neurology, Duke University School of Medicine, Durham, NC, USA.
Objectives: To discuss utility of using DWI-FLAIR mismatch in select patients not included in the original WAKE-UP trial for administration of IV thrombolytics.
Methods: We identified a female over 100 years old who presented with stroke symptoms upon waking up. This case is selected due to its unique management.