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Stroke. 2016 May;47(5):1389-98. doi: 10.1161/STROKEAHA.115.012364. Epub 2016 Apr 12.

Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials: Consensus Recommendations and Further Research Priorities.

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From the Department of Neurology, Dell Medical School, University of Texas at Austin (S.J.W.); Stroke Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD (M.L.); Department of Neurology (G.W.A., M.G.L.), Department of Radiology (R.B.), Neuroradiology Section, Department of Radiology (J.J.H., M.P.M., M.W.), Stanford University School of Medicine, CA; Department of Neurology, John Hunter Hospital, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia (A.B., M.W.P.); Departments of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia (B.C.V.C.); Department of Radiology, University of Iowa Hospitals and Clinics Iowa City (C.D.); Departments of Neurology (P.K.) and Neuroadiology (A.V.), University of Cincinnati, OH; Neurovascular Imaging Research Core and UCLA Stroke Center, Department of Neurology, University of California, Los Angeles (D.S.L.); Department of Radiology, AMC, Amsterdam, The Netherlands (C.B.L.M.M.); Calgary Stroke Program, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (B.K.M.); Institute of Neurosciences and Psychology, University of Glasgow, Southern General Hospital, Glasgow, Scotland, United Kingdom (K.W.M.); Texas Stroke Institute, Plano (A.J.Y.); Department of Neurology, The University of Tennessee Health Science Center, Memphis (A.V.A.); INSERM U894, Centre Hospitalier Sainte-Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom (J.-C.B.); Department of Neurosurgery, State University of New York at Stony Brook (D.J.F.); Department of Neurology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, OH (A.J.F.); Department of Radiology, Hospital Josep Tru



The Stroke Imaging Research (STIR) group, the Imaging Working Group of StrokeNet, the American Society of Neuroradiology, and the Foundation of the American Society of Neuroradiology sponsored an imaging session and workshop during the Stroke Treatment Academy Industry Roundtable (STAIR) IX on October 5 to 6, 2015 in Washington, DC. The purpose of this roadmap was to focus on the role of imaging in future research and clinical trials.


This forum brought together stroke neurologists, neuroradiologists, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), industry representatives, and members of the US Food and Drug Administration to discuss STIR priorities in the light of an unprecedented series of positive acute stroke endovascular therapy clinical trials.


The imaging session summarized and compared the imaging components of the recent positive endovascular trials and proposed opportunities for pooled analyses. The imaging workshop developed consensus recommendations for optimal imaging methods for the acquisition and analysis of core, mismatch, and collaterals across multiple modalities, and also a standardized approach for measuring the final infarct volume in prospective clinical trials.


Recent positive acute stroke endovascular clinical trials have demonstrated the added value of neurovascular imaging. The optimal imaging profile for endovascular treatment includes large vessel occlusion, smaller core, good collaterals, and large penumbra. However, equivalent definitions for the imaging profile parameters across modalities are needed, and a standardization effort is warranted, potentially leveraging the pooled data resulting from the recent positive endovascular trials.


angiography; clinical trial; ischemia; reperfusion; stroke

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