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The authors explored the effect of multimodal imaging (CT perfusion and/or CT angiography) versus noncontrast CT alone on time to treatment and outcomes in the IMS III trial. Of 656 subjects enrolled in the trial, 90 (13.7%) received CTP and CTA, 216 (32.9%) received CTA (without CTP), and 342 (52.1%) received NCCT alone. Median times from stroke onset to IV tPA in the CTP+CTA, CTA, and NCCT groups were 120.5 vs 117.5 vs 120 minutes, respectively. They conclude that the use of CTA (with or without CTP) did not delay IV tPA or endovascular therapy compared with NCCT in the IMS III trial.