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Abstract #1012

A 4D Spatio-Temporal Model to Estimate Stroke Lesion Evolution on MR Perfusion-Diffusion Imaging Following Acute Ischemic Stroke

Islem Rekik1, 2, Stphanie Allassonnire2, Stanley Durrleman3, Trevor Carpenter1, Joanna Wardlaw1

1Clinical Neurosciences, Edinburgh University, Edinburgh, United Kingdom; 2CMAP, Ecole Polytechnique, Paris, France; 3INRIA, Paris, France

The 4D dynamic simulation of perfusion and diffusion lesion evolutions in acute-subacute ischemic stroke has considerable prognostic potential. We applied a current-based, 4D, dense, diffeomorphic regression model to perfusion and diffusion MR images acquired at three successive timepoints after stroke. The evaluation of the 4D patient-specific perfusion-diffusion evolution scenarios of 8 representative patients was promising as it fitted the reference standard manually-delineated lesion boundaries. Meanwhile, the dynamic spatio-temporal and kinetic contraction/expansion stroke lesion behavior did not fit with the expected lesion evolution as expected from the perfusion-diffusion mismatch hypothesis commonly used in stroke treatment.