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Research ArticleBrain
Open Access

Stroke Mismatch Volume with the Use of ABC/2 Is Equivalent to Planimetric Stroke Mismatch Volume

M. Luby, J. Hong, J.G. Merino, J.K. Lynch, A.W. Hsia, A. Magadán, S.S. Song, L.L. Latour and S. Warach
American Journal of Neuroradiology October 2013, 34 (10) 1901-1907; DOI: https://doi.org/10.3174/ajnr.A3476
M. Luby
aFrom the National Institute of Neurological Disorders and Stroke (M.L., J.H., J.G.M., J.K.L., A.W.H., A.M., L.L.L., S.W.); Bethesda, Maryland
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J. Hong
aFrom the National Institute of Neurological Disorders and Stroke (M.L., J.H., J.G.M., J.K.L., A.W.H., A.M., L.L.L., S.W.); Bethesda, Maryland
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J.G. Merino
aFrom the National Institute of Neurological Disorders and Stroke (M.L., J.H., J.G.M., J.K.L., A.W.H., A.M., L.L.L., S.W.); Bethesda, Maryland
bJohns Hopkins Community Physicians (J.G.M.), Bethesda, Maryland
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J.K. Lynch
aFrom the National Institute of Neurological Disorders and Stroke (M.L., J.H., J.G.M., J.K.L., A.W.H., A.M., L.L.L., S.W.); Bethesda, Maryland
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A.W. Hsia
aFrom the National Institute of Neurological Disorders and Stroke (M.L., J.H., J.G.M., J.K.L., A.W.H., A.M., L.L.L., S.W.); Bethesda, Maryland
bJohns Hopkins Community Physicians (J.G.M.), Bethesda, Maryland
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A. Magadán
aFrom the National Institute of Neurological Disorders and Stroke (M.L., J.H., J.G.M., J.K.L., A.W.H., A.M., L.L.L., S.W.); Bethesda, Maryland
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S.S. Song
dCedars Sinai Medical Center (S.S.S.), Los Angeles, California
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L.L. Latour
aFrom the National Institute of Neurological Disorders and Stroke (M.L., J.H., J.G.M., J.K.L., A.W.H., A.M., L.L.L., S.W.); Bethesda, Maryland
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S. Warach
aFrom the National Institute of Neurological Disorders and Stroke (M.L., J.H., J.G.M., J.K.L., A.W.H., A.M., L.L.L., S.W.); Bethesda, Maryland
eNINDS Natural History of Stroke Investigators (S.W.), Bethesda, Maryland.
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    Fig 1.

    Corresponding measurements for the ABC/2 method (A, DWI = 116.1 mL; B, MTT = 194.7 mL) and planimetric method (C, DWI = 116.2 mL; D, MTT = 248.4 mL) on paired sections placed independently by 2 different readers.

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    Fig 2.

    Linear regression plots of ABC/2 with planimetric measurements displaying the respective regression lines with R2 and slope values for DWI (A), MTT (B), and mismatch (C). Plots are on the logarithmic scale.

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    Fig 3.

    Bland-Altman plots of the ABC/2 and planimetric volume measurements demonstrate the difference between the log volume of the planimetric measurement and the log volume of the ABC/2 measurement over the mean for DWI (A), MTT (B), and mismatch (C). Threshold lines above and below plots represent values that are 2 SD from the mean difference. Plots are on the logarithmic scale.

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    Fig 4.

    Bland-Altman plots of the 2 independent ABC/2 volume measurements demonstrate the difference between the log volume of the measurements over the average for DWI (A), MTT (B), and mismatch (C). Threshold lines above and below plots represent values that are 2 SD from the mean difference. Plots are on the logarithmic scale.

Tables

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    Table 1:

    Comparison of volume statistics between patients classified as mismatch versus no mismatch by use of the 50-mL mismatch definition for the ABC/2 and planimetric methods

    Volume StatisticsABC/2 Mismatch Yes (n = 94)ABC/2 Mismatch No (n = 56)Planimetric Mismatch Yes (n = 92)Planimetric Mismatch No (n = 62)
    Median DWI volume (IQR, 25–75), mL26.1 (8.9–69.4)10.2 (1.97–24.98)26.4 (6.2–71.0)8.7 (2.4–18.0)
    Median MTT volume (IQR 25–75), mL198.4 (134.3–287.2)28.26 (11.58–59.35)191.2 (137.6–276.8)28.4 (11.4–44.3)
    Median mismatch volume (IQR 25–75), mL151.5 (86.1–225.5)15.85 (5.78–30.3)149.6 (89.8–208.9)15.14 (3.2–30.5)
    Median mismatch percentage (IQR 25–75), %81% (62.8–95%)57.5% (29.3–80.5%)84% (59–96.8%)53% (25.3–80%)
    • View popup
    Table 2:

    Volume statistics for discrepant patients (n = 17, nine false-positives and eight false-negatives) on the basis of the ABC/2 method compared with the planimetric method by use of the mismatch definition ≥50 mL

    Case No.ABC/2 DWI (mL)ABC/2 MTT (mL)ABC/2 Mismatch (mL)ABC/2 Mismatch PercentagePlanimetric DWI (mL)Planimetric MTT (mL)Planimetric Mismatch (mL)Planimetric Mismatch Percentage
    FP 13.954.250.392.83.838.434.690.2
    FP 232.386.854.562.813.540.426.966.7
    FP 326.583.256.668.117.322.45.122.8
    FP 420.497.376.979.09.045.036.080.0
    FP 514.197.783.785.620.351.130.860.2
    FP 623.0110.687.679.226.161.335.257.5
    FP 74.6133.7129.196.65.641.536.086.6
    FP 8357.9513.3155.430.3436.5474.337.98.00
    FP 916.7318.1301.494.815.142.627.564.6
    FN 1111.3121.410.18.372.2122.550.341.1
    FN 244.260.616.427.026.8105.879.174.7
    FN 391.7119.728.123.471.1133.762.646.8
    FN 4266.3298.432.110.7223.5344.8121.335.2
    FN 5207.5247.239.616.0180.5254.674.129.1
    FN 62.30.0N/AN/A3.1186.5183.398.3
    FN 7311.0291.0N/AN/A279.2354.174.921.2
    FN 8243.5240.5N/AN/A170.3261.090.734.8
    • Note:—FP indicates false-positive; FN = false-negative.

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    Table 3:

    Summary of functional outcome (modified Rankin Scale) at follow-up of all patients on the basis of mismatch definition of ≥50 mL by use of the ABC/2 and planimetric methods

    Functional Outcome (Modified Rankin Scale) at Follow-UpPositive ABC/2 Quantitative Mismatch (n = 94)Positive Planimetric Quantitative Mismatch (n = 92)
    Favorable outcome (0,1): all patients with positive mismatch28%27%
    Favorable outcome (0,1): patients ≤80 years of age with positive mismatch39%38%
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American Journal of Neuroradiology: 34 (10)
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M. Luby, J. Hong, J.G. Merino, J.K. Lynch, A.W. Hsia, A. Magadán, S.S. Song, L.L. Latour, S. Warach
Stroke Mismatch Volume with the Use of ABC/2 Is Equivalent to Planimetric Stroke Mismatch Volume
American Journal of Neuroradiology Oct 2013, 34 (10) 1901-1907; DOI: 10.3174/ajnr.A3476

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Stroke Mismatch Volume with the Use of ABC/2 Is Equivalent to Planimetric Stroke Mismatch Volume
M. Luby, J. Hong, J.G. Merino, J.K. Lynch, A.W. Hsia, A. Magadán, S.S. Song, L.L. Latour, S. Warach
American Journal of Neuroradiology Oct 2013, 34 (10) 1901-1907; DOI: 10.3174/ajnr.A3476
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