Abstract 1901: Perfusion Augmentation with the NeuroFlo Device in the SENTIS Trial: Cerebral Blood Volume Gradients Improve on Serial MRI
Bibliographic record
Abstract
Background: Partial aortic occlusion may increase global cerebral blood volume (CBV) to enhance collateral perfusion in acute ischemic stroke. Therapeutic CBV changes in the ischemic territory may be difficult to detect with standard techniques if superimposed on global CBV alterations. We used CBV gradient maps to evaluate perfusion augmentation in the ischemic territory on serial MRI from baseline to 6 hours follow-up in subjects randomized to medical therapy with or without NeuroFlo treatment in the SENTIS trial. Methods: Perfusion MRI datasets in 54 subjects acquired at both baseline and 6 hours were prospectively collected at the core lab. Post-processing yielded CBV images and corresponding CBV gradient maps that depict regional variation of this perfusion parameter. Blinded imaging expert review was conducted to document presence, location, and other features of CBV gradients, with description of serial changes. Serial changes in CBV gradient maps were analyzed with respect to baseline demographics, medical history, treatment arm, and clinical outcomes (modified Rankin Scale, mRS) at day 90. Results: CBV gradient maps could be generated in 51 subjects with paired perfusion MRIs. CBV gradients were evident in 33/51 subjects (64.7%) at baseline, predominantly involving peripheral regions of the MCA territory. The presence of CBV gradients at baseline did not differ based on demographics, medical history, or treatment allocation. Overall, 12.1% revealed unchanged CBV gradients from baseline to 6 hours, with worsening in 18.2% and improvements in 69.7%. Alterations of CBV gradients on serial MRI were not related to baseline demographics or medical history in this cohort. Device therapy, however, was significantly associated with improvement of CBV gradients (p=0.005). Such early improvement in perfusion immediately post-procedure did not translate into statistically improved clinical outcomes (mRS 0-2) at day 90. Conclusions: CBV gradient maps can depict evolution of ischemia in acute stroke and therapeutic interventions such as perfusion augmentation. Treatment with the NeuroFlo device may improve perfusion in acute stroke, although other factors may subsequently influence clinical outcomes at day 90.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".