Published Online
on April 10, 2008

A more recent version of this article appeared on May 1, 2008

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Submitted on December 13, 2007
Revised on February 4, 2008
Accepted on March 11, 2008

Acute Stroke Imaging Research Roadmap

Max Wintermark MD^*; Gregory W. Albers MD; Andrei V. Alexandrov MD; Jeffry R. Alger PhD; Roland Bammer PhD; Jean-Claude Baron MD; Stephen Davis MD, FRCP, Edin FRACP; Bart M. Demaerschalk MD, MSc, FRCP(C); Colin P. Derdeyn MD; Geoffrey A. Donnan MD, FRACP; James D. Eastwood MD; Jochen B. Fiebach MD; Marc Fisher MD; Karen L. Furie MD, MPH; Gregory V. Goldmakher MD, PhD; Werner Hacke MD, PhD; Chelsea S. Kidwell MD; Stephan P. Kloska MD; Martin Köhrmann MD; Walter Koroshetz MD; Ting-Yim Lee PhD; Kennedy R. Lees MD; Michael H. Lev MD; David S. Liebeskind MD; Leif Ostergaard MD, MSc, PhD, DMSc; William J. Powers MD; James Provenzale MD; Peter Schellinger MD, PhD; Robert Silbergleit MD; Alma Gregory Sorensen MD; Joanna Wardlaw MD; Ona Wu PhD; and Steven Warach MD, PhD

From the University of California, San Francisco (M.W.); Stanford University (G.W.A., R.B.), Palo Alto, Calif; University of Alabama Comprehensive Stroke Center (A.V.A.), Birmingham, Ala; University of California, Los Angeles (J.R.A.); Addenbrooke's Hospital Hills Road (J.-C.B.), Department of Neurology, Cambridge, UK; Department of Neurology (S.D.), Royal Melbourne Hospital, University of Melbourne, Australia; Mayo Clinic (B.M.D.), Phoenix, Arizona; Washington University (C.P.D.), St Louis, Mo; National Stroke Research Institute (G.A.D.), Austin Health, University of Melbourne; Department of Radiology (J.D.E., J.P.), Duke University Medical Center, Durham, NC; Charité University Hospital and Berlin NeuroImaging Center (BNIC) (J.B.F.), Berlin, Germany; University of Massachusetts Medical School (M.F.), Worchester, Mass; Massachusetts General Hospital (K.L.F., G.V.G., M.H.L., A.G.S., O.W.), Boston, Mass; Heidelberg University (W.H.), Germany; Georgetown University, Washington Hospital Center (C.S.K.), Washington, DC; Department of Clinical Radiology (S.P.K.), University of Muenster, Germany; Department of Neurology (M.K.), University Clinic at Erlangen, Germany; National Institute of Neurological Disorders and Stroke (W.K., S.W.), Bethesda, Md; Lawson Health Research Institute (T.-Y.L.), Canada; University Department of Medicine & Therapeutics (K.R.L.), Western Infirmary, University of Glasgow, UK; University of California, Los Angeles Stroke Center (D.S.L.); Center for Functionally Integrative Neuroscience (L.O.), Department of Neuroradiology, Aarhus, Denmark; Department of Neurology (W.J.P.), University of North Carolina at Chapel Hill; Department of Neurology (P.S.), University Clinic at Erlangen, Germany; University of Michigan (R.S.), Ann Arbor; and Western General Hospital (J.W.), Edinburgh, UK.

^* To whom correspondence should be addressed. E-mail: Max.Wintermark{at}radiology.ucsf.edu.

Abstract—The recent "Advanced Neuroimaging for Acute Stroke Treatment" meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Biomedical Imaging and Bioengineering (NIBIB), industry representatives, and members of the US Food and Drug Administration (FDA) to discuss the role of advanced neuroimaging in acute stroke treatment. The goals of the meeting were to assess state-of-the-art practice in terms of acute stroke imaging research and to propose specific recommendations regarding: (1) the standardization of perfusion and penumbral imaging techniques, (2) the validation of the accuracy and clinical utility of imaging markers of the ischemic penumbra, (3) the validation of imaging biomarkers relevant to clinical outcomes, and (4) the creation of a central repository to achieve these goals. The present article summarizes these recommendations and examines practical steps to achieve them.

Key words: acute stroke • CT • magnetic resonance • outcomes • thrombolysis • perfusion imaging

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