title: (18)F-fluoromisonidazole (FMISO) Positron Emission Tomography (PET) Predicts Early Infarct Growth in Patients with Acute Ischemic Stroke.
abstract: OBJECTIVE
  (18) F-fluoromisonidazole (FMISO) positron emission tomography (PET) is used to image metabolically compromised but viable hypoxic tissue. We hypothesized that FMISO PET might predict early infarct growth in acute ischemic stroke patients with perfusion-diffusion mismatch in magnetic resonance imaging (MRI).
  
  
  METHODS
  We prospectively enrolled acute ischemic stroke patients who visited the emergency room within 48 hours after stroke onset and had perfusion-diffusion mismatch (>20%), as shown MRI. Infarct growth was defined as >20% increase of initial infarct volume or >5 mL in follow-up diffusion-weighted image 5 ± 2 days after stroke. The association between FMISO uptake and infarct growth was explored.
  
  
  RESULTS
  Of 19 enrolled patients, 10 (52.6%) showed increased FMISO uptake, with 8 of the latter showing infarct growth. None of the 9 patients who did not show FMISO uptake had infarct growth. FMISO uptake was significantly associated with infarct growth (Fisher's exact test; P < .01). FMISO PET scan had a sensitivity of 100% and a specificity of 82% (AUC = .909) in predicting infarct growth.
  
  
  CONCLUSIONS
  FMISO PET scan can predict early infarct growth in acute ischemic stroke patients with perfusion-diffusion mismatch in MRI.
authors.affiliation: Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea.
authors.forename: Gha-Hyun
authors.initials: GH
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Seung Jun
authors.initials: SJ
authors.lastname: Oh
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Dong-Wha
authors.initials: DW
authors.lastname: Kang
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jong S
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Sun U
authors.initials: SU
authors.lastname: Kwon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D008920:Misonidazole / Q000031:analogs & derivatives*; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology*
chemical_list: D019275:Radiopharmaceuticals; C031843:fluoromisonidazole; D008920:Misonidazole
keywords: Cerebral infarction; diffusion weighted MRI; fluoromisonidazole; positron emission tomography