{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:07:09Z","timestamp":1790690829231,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,1,18]],"date-time":"2016-01-18T00:00:00Z","timestamp":1453075200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infarct growth (IG) is used as surrogate end-point in therapeutic trials. For practical reasons, infarct growth is commonly assessed using simple subtraction of acute from follow-up diffusion-weighted imaging (DWI) lesion volumes. However, the volume subtraction method will underestimate true infarct growth in case of diffusion-weighted imaging lesion reversal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To measure the size of the difference between true infarct growth on voxel-based coregistration and infarct growth approximated with simple volume subtraction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 322 consecutive stroke patients (median (IQR) age: 70 years (57\u201380), National Institute of Health Stroke Score at admission 14 (8\u201319)), who underwent a magnetic resonance imaging before (DWI\n                      <jats:sub>1<\/jats:sub>\n                      ) and \u224824\u2009h (DWI\n                      <jats:sub>2<\/jats:sub>\n                      ) after IV-thrombolysis. IG\n                      <jats:sub>voxel-based<\/jats:sub>\n                      was defined as the volume of signal changes on DWI\n                      <jats:sub>2<\/jats:sub>\n                      that did not overlap with that on coregistered DWI\n                      <jats:sub>1<\/jats:sub>\n                      . This was compared with simply subtracting DWI\n                      <jats:sub>1<\/jats:sub>\n                      from DWI\n                      <jats:sub>2<\/jats:sub>\n                      lesion volume (IG\n                      <jats:sub>subtracted<\/jats:sub>\n                      ). We also compared these two metrics for the prediction of three-month unfavorable outcome (mRS\u2009\u2265\u20092) using c-statistics of multivariable models, adjusted for age, and National Institute of Health Stroke Score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Infarct growth volume metrics were strongly correlated (\u03c1\u2009=\u20090.94), but IG\n                      <jats:sub>subtracted<\/jats:sub>\n                      substantially underestimated IG\n                      <jats:sub>voxel-based<\/jats:sub>\n                      (median (IQR): 9.52 (0.23\u201338.9) vs. 16.98 (4.4\u201345.4) mL). Of the 75 patients with shrinking or stable diffusion-weighted imaging lesion using volume subtraction, IG\n                      <jats:sub>voxel-based<\/jats:sub>\n                      was \u22655\u2009mL in 20 (27% of the subset, 6.2% of the whole population). Moreover, IG\n                      <jats:sub>voxel-based<\/jats:sub>\n                      better predicted unfavorable outcome than IG\n                      <jats:sub>subtracted<\/jats:sub>\n                      (c-statistics\u2009=\u20090.86 (95% CI, 0.82\u20130.90) vs. 0.82 (0.78\u20130.87), P\u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At early post-thrombolysis time points, the simple subtraction of lesion volumes masked substantial diffusion-weighted imaging lesion growth in 6.2% of patients. Although more time-consuming, the voxel-based method may impact results of trials that use infarct growth attenuation as an end-point.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493015616636","type":"journal-article","created":{"date-parts":[[2016,1,18]],"date-time":"2016-01-18T11:12:16Z","timestamp":1453115536000},"page":"221-228","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Comparison between voxel-based and subtraction methods for measuring diffusion-weighted imaging lesion growth after thrombolysis"],"prefix":"10.1177","volume":"11","author":[{"given":"Wajih Ben","family":"Hassen","sequence":"first","affiliation":[{"name":"Department of Radiology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"},{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Tisserand","sequence":"additional","affiliation":[{"name":"Department of Radiology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"},{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Turc","sequence":"additional","affiliation":[{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"},{"name":"Department of Neurology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Charron","sequence":"additional","affiliation":[{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Seners","sequence":"additional","affiliation":[{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"},{"name":"Department of Neurology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Edjlali","sequence":"additional","affiliation":[{"name":"Department of Radiology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"},{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Legrand","sequence":"additional","affiliation":[{"name":"Department of Radiology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"},{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Lion","sequence":"additional","affiliation":[{"name":"Department of Radiology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Calvet","sequence":"additional","affiliation":[{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"},{"name":"Department of Neurology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Naggara","sequence":"additional","affiliation":[{"name":"Department of Radiology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"},{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Mas","sequence":"additional","affiliation":[{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"},{"name":"Department of Neurology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Meder","sequence":"additional","affiliation":[{"name":"Department of Radiology, Centre Hospitalier Sainte-Anne, Universit\u00e9 Paris Descartes, Paris, France"},{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Claude","family":"Baron","sequence":"additional","affiliation":[{"name":"Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Paris, France"},{"name":"Department of Neurology, Centre Hospitalier Sainte-Anne, Universit\u00e9 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