{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:47:04Z","timestamp":1788911224961,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000070","name":"National Institute of Biomedical Imaging and Bioengineering","doi-asserted-by":"publisher","award":["1R01EB017230"],"award-info":[{"award-number":["1R01EB017230"]}],"id":[{"id":"10.13039\/100000070","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Susceptibility\u2010induced geometric distortions and non\u2010physiologic hyperintensities confound acute ischemic stroke diagnosis on diffusion weighted imaging (DWI). Reverse phase\u2010encoded imaging needed for artifact correction is rarely acquired acutely. Structural imaging\u2010based correction is validated in healthy subjects, but its efficacy in acute stroke remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate whether structural imaging\u2010based artifact correction reduces DWI distortions and non\u2010physiologic hyperintensities in clinical acute stroke imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Retrospective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>214 patients with acute ischemic stroke and clinical MRI from two centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Field Strength\/Sequences<\/jats:title>\n                    <jats:p>1.5\u2009T\/3\u2009T; single\u2010shot echo planar DWI; 3D MP\u2010RAGE and 2D spin echo, gradient echo, turbo spin echo, and turbo inversion recovery T1\u2010weighted sequences; 2D turbo spin echo and BLADE FLAIR sequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Assessment<\/jats:title>\n                    <jats:p>DWI distortions were corrected using the Synb0\u2010DisCo and TOPUP algorithms with b0 and T1\u2010weighted images. Mutual information evaluated geometric agreement against FLAIR and T1\u2010weighted images before and after correction. The diagnostic value of hyperintense DWI lesions for apparent diffusion coefficient (ADC)\u2010defined reference infarct was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Tests<\/jats:title>\n                    <jats:p>\n                      Wilcoxon sign rank or rank sum tests of mutual information, sensitivity, specificity, and positive and negative predictive value; Bland\u2013Altman plots; and linear regression with coefficients of determination (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) in linear and log space. Bonferroni\u2010adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 was significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After correction, DWI demonstrated significantly increased mutual information against FLAIR images [0.31 (IQR, 0.25\u20130.38) versus 0.30 (0.24\u20130.35)] and T1\u2010weighted images [0.32 (IQR, 0.29\u20130.36) versus 0.29 (0.24\u20130.33)]. ADC\u2010defined infarct volumes before and after correction correlated strongly (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      0.998, log 0.541) with a negative bias of 0.51 (95% CI, 0.18\u20130.85) mL. DWI hyperintensities before and after correction correlated strongly (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      0.996, log 0.360) but demonstrated a negative bias of 2.47 (95% CI, 1.95\u20133.00) mL. After correction, DWI hyperintensities demonstrated significantly improved specificity [0.998 (IQR, 0.994\u20131.000) versus 0.997 (0.992\u20130.999)] and positive predictive value [0.53 (IQR, 0.31\u20130.77) versus 0.39 (0.16\u20130.63)] for ADC\u2010defined infarct.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Conclusion<\/jats:title>\n                    <jats:p>Structural imaging\u2010based distortion correction of routinely acquired clinical DWI in acute ischemic stroke improves anatomic geometry and reduces false positive hyperintensities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Level<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Stage of Technical Efficacy<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmri.70519","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:56:32Z","timestamp":1788868592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Artifact Correction of Clinical Diffusion Weighted Imaging in Acute Ischemic Stroke"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5812-5397","authenticated-orcid":false,"given":"Leon Y.","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Neurology Johns Hopkins Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanzhang","family":"Lu","sequence":"additional","affiliation":[{"name":"Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7297-2015","authenticated-orcid":false,"given":"Hye\u2010Young","family":"Heo","sequence":"additional","affiliation":[{"name":"Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5733-2127","authenticated-orcid":false,"given":"Bennett A.","family":"Landman","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering Vanderbilt University  Nashville Tennessee USA"},{"name":"Department of Radiology and Radiological Sciences Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3686-7645","authenticated-orcid":false,"given":"Kurt G.","family":"Schilling","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek S.","family":"Yedavalli","sequence":"additional","affiliation":[{"name":"Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000513"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.036204"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012794"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2019.05.008"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0236418"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.28678"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1053\u20108119(03)00336\u20107"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010025\u201012033\u2010x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.09.015"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2004.07.051"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2022.103097"},{"key":"e_1_2_9_13_1","doi-asserted-by":"crossref","unstructured":"A.Garma\u2010Oehmichen K. 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