title: Magnetic resonance imaging biomarkers of ischemic stroke: criteria for the validation of primary imaging biomarkers.
abstract: Ischemic stroke is associated with a high rate of disability and death. Establishing valid biomarkers could help accelerate the approval of promising new therapies for stroke. Whereas many serum biomarkers have been evaluated, possible imaging biomarkers of stroke lack validation. Magnetic resonance imaging (MRI) is a very sensitive technique to study acute stroke and MRI parameters have been established to assess the outcome of acute stroke. This review reassesses the criteria for the validation of MRI biomarkers of acute ischemic stroke (MRI-BAS). Seven criteria were used to review the validity of the main MRI-BAS: vascular status, lesion volume, reversibility on diffusion-weighted imaging, perfusion alteration, penumbra studied with diffusion-perfusion mismatch, clinical-diffusion mismatch, diffusion-angiography mismatch and hemorrhagic transformation. We analyzed the definitions of these biomarkers and the extent to which each fulfills the criteria for validation and found that few MRI-BAS have been fully validated. Further studies should help to improve the validation of current MRI-BAS and develop new biomarkers.
authors.affiliation: MRI Center, Institute of Diagnostic Imaging (IDI), Radiology Department, University Hospital Dr. Josep Trueta, Girona, Spain. sapedraza@gmail.com
authors.forename: Salvador
authors.initials: S
authors.lastname: Pedraza
authors.forename: Josep
authors.initials: J
authors.lastname: Puig
authors.forename: Gerard
authors.initials: G
authors.lastname: Blasco
authors.forename: Josep
authors.initials: J
authors.lastname: Daunis-i-Estadella
authors.forename: Imma
authors.initials: I
authors.lastname: Boada
authors.forename: Anton
authors.initials: A
authors.lastname: Bardera
authors.forename: Alberto
authors.initials: A
authors.lastname: Prats
authors.forename: Mar
authors.initials: M
authors.lastname: Castellanos
authors.forename: Joaquin
authors.initials: J
authors.lastname: Serena
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002545:Brain Ischemia / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology; D054928:Validation Studies as Topic
chemical_list: D015415:Biomarkers