Assessing response to XXXX thrombolysis: validation of 24-hour multimodal magnetic resonance imaging.

@entity1 @entity64 @entity1188
BACKGROUND: Imaging is used as a surrogate for clinical outcome in early-phase @entity64 trials. Assessment of @entity1188 growth earlier than the standard 90 days used for clinical end points may be equally accurate and more practical. OBJECTIVE: To compare assessment of the effect of reperfusion therapies using 24-hour vs day 90 magnetic resonance imaging. DESIGN: @entity1188 volume was assessed on diffusion-weighted imaging (DWI) at baseline and 24 hours after @entity64 onset and on fluid-attenuated inversion recovery images at day 90. The DWI and fluid-attenuated inversion recovery lesions were manually outlined by 2 independent raters, and the volumes were averaged. Interrater consistency was assessed using the median difference in lesion volume between raters. SETTING: Referral center. @entity1   Imaging data were available for 83 @entity1 ; 77 of these @entity1 received thrombolysis. MAIN OUTCOME MEASURES: @entity1188 volume at 24 hours and 90 days. RESULTS: The 24-hour DWI @entity1188 volume had a strong linear correlation with day 90 fluid-attenuated inversion recovery @entity1188 volume (r  =  0.98, 95% confidence interval, 0.97-0.99). Recanalization had a significant effect on @entity1188 evolution between baseline and 24 hours but not between 24 hours and day 90. @entity1188 growth from baseline was significantly reduced by recanalization, whether assessed at 24 hours or day 90. @entity1188 volume at either time point predicted functional outcome independent of age and baseline @entity64 severity. Interrater agreement was better for DWI than fluid-attenuated inversion recovery (1.4 mL [8%] vs 1.8 mL [17%]; P  =  .002). CONCLUSIONS: Assessment of final @entity1188 volume using DWI at 24 hours captures the effect of reperfusion therapies on @entity1188 growth and predicts functional outcome similarly to imaging at day 90. This has the potential to reduce loss to follow-up in trials and may add early prognostic information in clinical practice.
