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Abstract #2185

The Influence of Clinical Confounders on Imaging Biomarkers of Lesion Age in Acute Stroke

Vince I Madai 1 , Carla N Wood 1 , Ivana Galinovic 1 , Ulrike Grittner 1 , Gajanan S Revankar 1 , Steve Z Martin 1 , Olivier Zaro Weber 2 , Walter Mller-Hartmann 3 , Federico C von Samson-Himmelstjerna 1,4 , Wolf-Dieter Heiss 2 , Martin Ebinger 5 , Jochen B Fiebach 1 , and Jan Sobesky 1

1 Center for Stroke Research Berlin, Charit Universittsmedizin Berlin, Berlin, Berlin, Germany, 2 Max Planck Institute for Metabolism Research, Cologne, Germany, 3 Department of Radiology, Ludmillenstift Meppen, Meppen, Germany, 4 Fraunhofer MEVIS, Bremen, Germany, 5 Centre for Stroke Research Berlin, Charit Universittsmedizin Berlin, Berlin, Germany

In acute stroke of unknown onset, the DWI-FLAIR mismatch allows for the identification of patients presenting within the thrombolysis time window (<4.5h). FLAIR lesions, however, are difficult to analyze visually. Relative-signal-intensity (rSI) biomarkers derived from MRI sequences, namely DWI or FLAIR, constitute an increasingly investigated observer-independent alternative. In the present work we demonstrate that clinical confounders (e.g. age, NIHSS) significantly influence performance of FLAIR imaging biomarkers in contrast to DWI biomarkers, which are independent of this influence and offer high performance. These results might partly explain heteregenous results for FLAIR biomarkers in the past and support the use of DWI biomarkers.

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