Trial Imaging for Stroke

1. What is cerebral stroke?

  Cerebral stroke is cerebrovascular disease that causes intracranial hemorrhage or ischemia.

  The proportion of ischemic stroke is 70-80 % in cerebral stroke.

  Temporal evolution of ischemic strokes are typically categorized into hyperacute (0-6 hours),
    acute (6-24 hours), subacute (24 hours to 2 weeks), chronic stroke ( > 2 weeks old).

2. Role of neuroimaging in acute ischemic stroke

  Acute ischemic stroke is diagnosed based on clinical symptoms and neuroimaging.

  Neuroimaging plays an essential role in the managements of the acute ischemic stroke.

  Neuroimaging is used to detect acute ischemic stroke and guide options of treatments.

  Representative neuroimaging for the evaluation of acute ischemic stroke are computed tomography (CT)
    such as noncontrast brain CT, CT angiography (CTA), CT perfusion (CTP) and magnetic resonance imaging
    (MRI) such as diffusion-weighted imaging (DWI), MR angiography (MRA), MR perfusion (MRP) using dynamic
    susceptibility contrast (DSC) technique, fluid attenuated inversion recovery (FLAIR), T2* gradient echo imaging
    (GRE), and digital subtraction angiography (DSA).

3. Requirements for neuroimaging in clinical trials for acute ischemic stroke

  Speed

  Standardization

  Quality control

  Reproducibility

  Centralization

4. Representative outcomes based on neuroimaging in clinical trials for acute ischemic stroke

  Infarct core volume

  Hemorrhage or hemorrhagic transformation

  Revascularization, recanalization, or reperfusion

5. References

  급성 뇌졸중 임상시험 영상의 글로벌 동향 조사 보고서  

  뇌졸중·치매 질환의 영상 진단 동향 정보집 

  급성 뇌졸중 영상촬영 프로토콜 표준화 및 팬텀 품질평가를 위한 기준안  

  뇌졸중 영상 바이오마커 분석 프로그램 표준작업지침서  

  뇌졸중 신약 후보물질의 비임상 유효성 평가를 위한 바이오이미징 활용 현황 및 기준안  

Does the Apparent Diffusion Coefficient Value Predict Permanent Cerebral Ischemia/Reperfusion
Injury in Rats?

Kwon JI, Woo CW, Kim KW, Choi Y, Kim ST, Kim YJ, Kang J, Lee DW, Tak E, Kim JK, Jung SC, Kim
TH, Woo DC. Acad Radiol. 2019 Jan 17.  
 Full Text

Perfusion CT for prediction of hemorrhagic transformation in acute ischemic stroke: a systematic
review and meta-analysis

Suh CH, Jung SC, Cho SJ, Kim D, Lee JB, Woo DC, Oh WY, Lee JG, Kim KW. Eur Radiol.
2019 Aug;29(8):4077-4087.  
 Full Text

Multicenter Clinical Imaging Management System: Critical Success Factor for Multidisciplinary
Brain Research

Lee K, Sung YS, Suh CH, Woo DC, Oh WY, Lee JG, Jung SC, Kim KW. Journal of the Korean Society of Imaging Informatics in Medicine 2018;24:1-9.   Full Text

6. 뇌졸중 임상시험을 위한 영상바이오마커 활용에 대한 강의

  2019 7th International Congress of Magnetic resonance imaging & 24th annual scientific meeting of
    KSMRM 

  2019 대한신경두경부영상의학회 춘계학술대회 (수용자 만족도 포함) 

  2019 서울아산병원 영상의학과 리서치 컨퍼런스 

  2019 제7회 난치성 뇌질환 중개연구실 연구세미나 (충북대학교병원) 

  2019 삼성서울병원 뇌졸중 심포지움 

  2019 임상시험 현장전문인력 교육 세미나 (수용자 만족도 포함)