title: The role of bolus delay and dispersion in predictor models for stroke.
abstract: OBJECTIVE
  In combination with diffusion-weighted imaging, perfusion-weighted imaging parameters are hypothesized to detect tissue at risk of infarction in patients with acute stroke. Recent studies have suggested that in addition to perfusion deficits, vascular flow parameters indicating bolus delay and/or dispersion may also contain important predictive information. This work investigates the infarct risk associated with delay/dispersion using multiparametric predictor models.
  
  
  METHODS
  Predictor models were developed using specific combinations of perfusion parameters calculated using global arterial input function deconvolution (where perfusion is biased by dispersion), local arterial input function deconvolution (where perfusion has minimal dispersion bias), and parameters approximating bolus delay/dispersion. We also compare predictor models formed using summary parameters (which primarily reflect delay/dispersion). The models were trained on 15 patients with acute stroke imaged at 3 to 6 hours.
  
  
  RESULTS
  The global arterial input function models performed significantly better than their local arterial input function counterparts. Furthermore, in a paired comparison, the models including the delay/dispersion parameter performed significantly better than those without. There was no significant difference between the best deconvolution model and the best summary parameter model.
  
  
  CONCLUSIONS
  Delay and dispersion information is important to achieve accurate infarct prediction in the acute time window.
authors.affiliation: Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria, 3084, Australia. l.willats@brain.org.au
authors.forename: Lisa
authors.initials: L
authors.lastname: Willats
authors.forename: Alan
authors.initials: A
authors.lastname: Connelly
authors.forename: Soren
authors.initials: S
authors.lastname: Christensen
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Donnan
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Davis
authors.forename: Fernando
authors.initials: F
authors.lastname: Calamante
mesh_terms: D001783:Blood Flow Velocity; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D018810:Magnetic Resonance Angiography; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D011859:Radiography; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors