2024
Diffusion‐Weighted Imaging Fluid‐Attenuated Inversion Recovery Mismatch on Portable, Low‐Field Magnetic Resonance Imaging Among Acute Stroke Patients
Sorby‐Adams A, Guo J, de Havenon A, Payabvash S, Sze G, Pinter N, Jaikumar V, Siddiqui A, Baldassano S, Garcia‐Guarniz A, Zabinska J, Lalwani D, Peasley E, Goldstein J, Nelson O, Schaefer P, Wira C, Pitts J, Lee V, Muir K, Nimjee S, Kirsch J, Iglesias J, Rosen M, Sheth K, Kimberly W. Diffusion‐Weighted Imaging Fluid‐Attenuated Inversion Recovery Mismatch on Portable, Low‐Field Magnetic Resonance Imaging Among Acute Stroke Patients. Annals Of Neurology 2024, 96: 321-331. PMID: 38738750, PMCID: PMC11293843, DOI: 10.1002/ana.26954.Peer-Reviewed Original ResearchStroke patientsAcute ischemic strokeCut-pointsIschemic strokeStroke patients <Diagnosis of acute ischemic strokeSignal intensity ratioFluid-attenuated inversion recoveryAcute stroke patientsOptimal cut-pointMagnetic resonance imagingDiffusion-weighted imagingDWI-FLAIR mismatchStroke onsetTrained assessorsNational InstituteStrokeThrombolytic interventionNegative predictive valueFLAIR hyperintensitiesPatientsInterobserver agreementHyperacute strokeDiffusion-weightedPredictive value
2022
CT angiographic radiomics signature for risk stratification in anterior large vessel occlusion stroke
Avery EW, Behland J, Mak A, Haider SP, Zeevi T, Sanelli PC, Filippi CG, Malhotra A, Matouk CC, Griessenauer CJ, Zand R, Hendrix P, Abedi V, Falcone GJ, Petersen N, Sansing LH, Sheth KN, Payabvash S. CT angiographic radiomics signature for risk stratification in anterior large vessel occlusion stroke. NeuroImage Clinical 2022, 34: 103034. PMID: 35550243, PMCID: PMC9108990, DOI: 10.1016/j.nicl.2022.103034.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeIndependent cohortPrognostication toolsMechanical thrombectomyRisk stratificationOcclusion strokeExternal cohortAnterior circulation large vessel occlusion strokeOutcome predictionAcute stroke triageAnterior circulation territoryRadiomic featuresTime of admissionGeisinger Medical CenterLVO stroke patientsReliable clinical informationSignificant differencesAdmission CTAStroke patientsPrognostic informationFavorable outcomeStroke triageTreatment decisionsMedical CenterRadiomics signatureImpact of collateral flow on cost-effectiveness of endovascular thrombectomy.
Khunte M, Wu X, Avery EW, Gandhi D, Payabvash S, Matouk C, Heit JJ, Wintermark M, Albers GW, Sanelli P, Malhotra A. Impact of collateral flow on cost-effectiveness of endovascular thrombectomy. Journal Of Neurosurgery 2022, 137: 1801-1810. PMID: 35535841, DOI: 10.3171/2022.2.jns212887.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioEndovascular thrombectomyIschemic stroke patientsCollateral statusPoor collateral statusBetter outcomesPoor collateralsCollateral circulationStroke patientsAcute ischemic stroke patientsModified Rankin Scale scorePoor collateral circulationRankin Scale scoreLarge vessel occlusionCollateral blood flowGood collateral blood flowCost-effectiveness ratioBase-case analysisProbabilistic sensitivity analysesEVT strategyEVT treatmentIschemic strokeMedical therapyMore patientsCollateral flowBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2019
Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients
Malhotra A, Wu X, Payabvash S, Matouk CC, Forman HP, Gandhi D, Sanelli P, Schindler J. Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients. Stroke 2019, 50: 963-969. PMID: 30908156, DOI: 10.1161/strokeaha.119.025031.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIntravenous thrombolysisEndovascular thrombectomyLarge vessel occlusionAge 80 yearsEVT strategyVessel occlusionModified Rankin Scale scorePoststroke functional outcomeAcute ischemic strokeRankin Scale scoreElderly stroke patientsMarkov decision-analytic modelYears of ageDecision analytic modelMultiple sensitivity analysesPurpose- StrokeAcute strokeBaseline disabilityElderly patientsIschemic strokeStroke patientsFunctional outcomeHealthy patientsAdvanced age
2017
Multivariate Prognostic Model of Acute Stroke Combining Admission Infarct Location and Symptom Severity: A Proof-of-Concept Study
Payabvash S, Benson JC, Tyan AE, Taleb S, McKinney AM. Multivariate Prognostic Model of Acute Stroke Combining Admission Infarct Location and Symptom Severity: A Proof-of-Concept Study. Journal Of Stroke And Cerebrovascular Diseases 2017, 27: 936-944. PMID: 29198948, DOI: 10.1016/j.jstrokecerebrovasdis.2017.10.034.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArea Under CurveBrainBrain IschemiaBrain MappingDatabases, FactualDecision Support TechniquesDiffusion Magnetic Resonance ImagingDisability EvaluationFemaleHumansLogistic ModelsMaleMesencephalonMiddle AgedMultivariate AnalysisOdds RatioPatient AdmissionPonsPredictive Value of TestsProof of Concept StudyReproducibility of ResultsRetrospective StudiesRisk FactorsROC CurveSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeConceptsDisability/deathMidbrain/ponsAcute ischemic stroke patientsIschemic stroke patientsAdmission NIHSS scoreStroke patientsNIHSS scoreIndependent predictorsInfarct locationScale scoreHealth Stroke Scale scoreHigher admission NIHSS scoresModified Rankin Scale scoreSymptom severityAdmission stroke severityBaseline functional disabilityLarger infarct volumesStroke Scale scoreRankin Scale scoreHours of onsetAcute ischemic infarctMultivariate prognostic modelMajor arterial occlusionHypothesis-generating studyVoxel-based analysis
2016
The Effects of DWI‐Infarct Lesion Volume on DWI‐FLAIR Mismatch: Is There a Need for Size Stratification?
Payabvash S, Taleb S, Benson JC, Rykken JB, Oswood MC, McKinney AM, Hoffman B. The Effects of DWI‐Infarct Lesion Volume on DWI‐FLAIR Mismatch: Is There a Need for Size Stratification? Journal Of Neuroimaging 2016, 27: 392-396. PMID: 27878926, DOI: 10.1111/jon.12407.Peer-Reviewed Original ResearchConceptsDWI-FLAIR mismatchPositive predictive valueDWI lesion volumeLesion volumeNegative predictive valueStroke onsetAcute infarctsStroke patientsInfarct lesionsPredictive valueFluid-attenuated inversion recovery hyperintensityAcute ischemic stroke patientsInfarct lesion volumeIschemic stroke patientsHours of onsetInversion recovery hyperintensityContralateral normal sideIdentification of strokePotential imaging biomarkerMultivariate regression analysisIdentification of infarctionSymptom onsetTherapy timeNormal sideImaging biomarkersTopographic Assessment of Acute Ischemic Changes for Prognostication of Anterior Circulation Stroke
Payabvash S, Noorbaloochi S, Qureshi AI. Topographic Assessment of Acute Ischemic Changes for Prognostication of Anterior Circulation Stroke. Journal Of Neuroimaging 2016, 27: 227-231. PMID: 27593522, DOI: 10.1111/jon.12383.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreDisability/deathAnterior circulation strokeAcute ischemic changesSymptomatic intracranial hemorrhageIntracranial hemorrhageIschemic changesIndependent predictorsFavorable outcomeIntravenous thrombolytic therapyCT/MRI scansRankin Scale scoreEarly ischemic changesAcute ischemic infarctTopographic assessmentIschemic infarctAdmission CTClinical outcomesStroke patientsThrombolytic therapyCT scoreLentiform nucleusTomography scanImproved outcomesPrognostic toolClinical implications of eye deviation on admission CT examination of acute ischaemic stroke patients
Payabvash S, Qureshi I, Qureshi AI. Clinical implications of eye deviation on admission CT examination of acute ischaemic stroke patients. Clinical Radiology 2016, 71: 1314.e11-1314.e15. PMID: 27592397, DOI: 10.1016/j.crad.2016.08.002.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreAcute ischemic stroke patientsIschemic stroke patientsHigher admission NIHSS scoresAdmission NIHSS scoreEye deviationStroke patientsNIHSS scoreHaemorrhagic transformationCT examinationsLow Alberta Stroke Program Early CT ScoreScale scoreHealth Stroke Scale scoreOlder ageAdmission CT examinationAdmission National InstitutesPatients' older ageStroke Scale scoreHigh rateRankin Scale scoreInfarct volumeMRS scoreAdmission CTCT scorePrognostic valueInterhemispheric Asymmetry in Distribution of Infarct Lesions among Acute Ischemic Stroke Patients Presenting to Hospital
Payabvash S, Taleb S, Benson JC, McKinney AM. Interhemispheric Asymmetry in Distribution of Infarct Lesions among Acute Ischemic Stroke Patients Presenting to Hospital. Journal Of Stroke And Cerebrovascular Diseases 2016, 25: 2464-2469. PMID: 27373730, DOI: 10.1016/j.jstrokecerebrovasdis.2016.06.019.Peer-Reviewed Original ResearchConceptsRight-sided strokeLeft-sided strokeAcute ischemic stroke patientsEarly clinical outcomesIschemic stroke patientsIschemic infarctInfarct lesionsInsular ribbonVoxel-based analysisClinical outcomesStroke patientsLentiform nucleusScale scoreHealth Stroke Scale scoreModified Rankin Scale scoreSymptom severityStroke risk factorsStroke Scale scoreHours of onsetRankin Scale scoreAcute ischemic infarctRate of treatmentAdmission symptomsSymptomatic infarctsRisk factorsClinical diffusion mismatch better discriminates infarct growth than mean transit time–diffusion weighted imaging mismatch in patients with middle cerebral artery–M1 occlusion and limited infarct core
Nogueira RG, Kemmling A, Souza LM, Payabvash S, Hirsch JA, Yoo AJ, Lev MH. Clinical diffusion mismatch better discriminates infarct growth than mean transit time–diffusion weighted imaging mismatch in patients with middle cerebral artery–M1 occlusion and limited infarct core. Journal Of NeuroInterventional Surgery 2016, 9: 127. PMID: 26957483, DOI: 10.1136/neurintsurg-2014-011602.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCerebral AngiographyCerebral InfarctionCerebrovascular CirculationDiffusion Magnetic Resonance ImagingDisease ProgressionFemaleHumansImage Processing, Computer-AssistedInfarction, Middle Cerebral ArteryMalePredictive Value of TestsRetrospective StudiesStrokeTomography, X-Ray ComputedConceptsClinical-diffusion mismatchMCA M1 occlusionAdmission Alberta Stroke Program Early CT scoreSmall infarct coreBaseline NIHSS scoreInfarct growthNIHSS scoreInfarct coreDiffusion mismatchDWI volumeStroke patientsAlberta Stroke Program Early CT ScoreMiddle cerebral artery M1 occlusionProximal middle cerebral artery occlusionMiddle cerebral artery occlusionMTT lesionsUni-/multivariate analysesBaseline National InstitutesHealth Stroke ScaleAdmission NIHSS scoreCerebral artery occlusionConsecutive stroke patientsOnly independent predictorDWI lesionsStroke Scale
2015
Detection of Intraparenchymal Hemorrhage After Endovascular Therapy in Patients with Acute Ischemic Stroke Using Immediate Postprocedural Flat‐Panel Computed Tomography Scan
Payabvash S, Khan AA, Qureshi MH, Saeed O, Suri MF, Qureshi AI. Detection of Intraparenchymal Hemorrhage After Endovascular Therapy in Patients with Acute Ischemic Stroke Using Immediate Postprocedural Flat‐Panel Computed Tomography Scan. Journal Of Neuroimaging 2015, 26: 213-218. PMID: 26282065, DOI: 10.1111/jon.12277.Peer-Reviewed Original ResearchConceptsMultidetector CT studiesNegative predictive valueIschemic stroke patientsIntraparenchymal hemorrhageCT scanEndovascular treatmentHyperdense lesionParenchymal lesionsStroke patientsPredictive valueCT studiesMultidetector CTAcute ischemic stroke patientsAcute ischemic strokeAcute stroke patientsMultidetector CT scanPositive predictive valueEndovascular therapyIschemic strokePost procedureTomography scanSeparate cohortSuch lesionsPatientsDiagnostic valueMiddle Cerebral Artery Residual Contrast Stagnation on Noncontrast CT Scan Following Endovascular Treatment in Acute Ischemic Stroke Patients
Payabvash S, Qureshi MH, Taleb S, Pawar S, Qureshi AI. Middle Cerebral Artery Residual Contrast Stagnation on Noncontrast CT Scan Following Endovascular Treatment in Acute Ischemic Stroke Patients. Journal Of Neuroimaging 2015, 25: 946-951. PMID: 25684437, DOI: 10.1111/jon.12211.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke patientsMCA M1 occlusionIschemic stroke patientsIntraparenchymal hemorrhageEndovascular treatmentContrast stagnationCT scanPostprocedural CT scanNoncontrast CT scanStroke patientsM1 occlusionContralateral arteryHounsfield unitsAverage HU valueM1 segmentRelative riskNoncontrast CTPatientsScansArteryTreatmentAttenuation differenceHU valuesOcclusionRisk
2014
Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment
Payabvash S, Qureshi MH, Khan SM, Khan M, Majidi S, Pawar S, Qureshi AI. Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment. Neuroradiology 2014, 56: 737-744. PMID: 24925217, DOI: 10.1007/s00234-014-1381-8.Peer-Reviewed Original ResearchConceptsPost-procedural CT scanAcute ischemic stroke patientsIschemic stroke patientsContrast extravasationIntraparenchymal hemorrhageEndovascular treatmentStroke patientsCT scanNoncontrast CT scanHyperdense lesionHounsfield unitsParenchymal lesionsImaging recordsIntroductionThis studyHemorrhagePatientsExtravasationLesionsScansHyperdensityHyperdenseTreatmentAverage attenuationCharacteristic analysisResultsOf
2013
Variable Selection and Prediction Using a Nested, Matched Case-Control Study: Application to Hospital Acquired Pneumonia in Stroke Patients
Qian J, Payabvash S, Kemmling A, Lev MH, Schwamm LH, Betensky RA. Variable Selection and Prediction Using a Nested, Matched Case-Control Study: Application to Hospital Acquired Pneumonia in Stroke Patients. Biometrics 2013, 70: 153-163. PMID: 24320930, PMCID: PMC3954429, DOI: 10.1111/biom.12113.Peer-Reviewed Original ResearchConceptsMassachusetts General HospitalCase-control studyStroke patientsAcute ischemic stroke patientsBrain regionsMatched Case-Control StudyHospital-Acquired PneumoniaIschemic stroke patientsLarge prospective studiesUnconditional logistic regressionCase-control designSpecific brain regionsAcquired PneumoniaAcute infarctionClinical featuresProspective studyClinical variablesGeneral HospitalEpidemiologic studiesPatientsModern imagingLarger studyLogistic regressionAppropriate statistical analysisHAP studiesHospital Acquired Pneumonia Is Linked to Right Hemispheric Peri-Insular Stroke
Kemmling A, Lev MH, Payabvash S, Betensky RA, Qian J, Masrur S, Schwamm LH. Hospital Acquired Pneumonia Is Linked to Right Hemispheric Peri-Insular Stroke. PLOS ONE 2013, 8: e71141. PMID: 23951094, PMCID: PMC3737185, DOI: 10.1371/journal.pone.0071141.Peer-Reviewed Original ResearchConceptsHemispheric infarctsBrain regionsConsecutive acute stroke patientsConditional logistic regression modelsHospital-Acquired PneumoniaRight hemispheric infarctAcute stroke patientsInsular cortex volumeVolume-based variablesSpecific brain regionsLogistic regression modelsAcquired PneumoniaControl patientsMajor complicationsBrainstem strokeImmune suppressionInfarct sizeStroke patientsAutonomic modulationClinical variablesAdmission imagingInfarct locationUnivariate analysisImmune mechanismsCortex volume
2012
Location-weighted CTP analysis predicts early motor improvement in stroke
Payabvash S, Souza LC, Kamalian S, Wang Y, Passanese J, Kamalian S, Fung SH, Halpern EF, Schaefer PW, Gonzalez RG, Furie KL, Lev MH. Location-weighted CTP analysis predicts early motor improvement in stroke. Neurology 2012, 78: 1853-1859. PMID: 22573641, PMCID: PMC3369521, DOI: 10.1212/wnl.0b013e318258f799.Peer-Reviewed Original ResearchConceptsAcute stroke patientsAdmission NIHSSMotor improvementStroke patientsCT perfusionPredictive valueOnly independent clinical predictorMultivariate binary logistic regressionFrontal lobe white matterMultivariate modelIndependent clinical predictorsMotor functional improvementMotor function improvementNegative predictive valuePositive predictive valueSuperior temporal gyrusBinary logistic regressionExtremity paresisAcute strokeSymptom onsetClinical predictorsConsecutive patientsIndependent predictorsClinical outcomesImaging predictors
2011
CT Perfusion Mean Transit Time Maps Optimally Distinguish Benign Oligemia from True “At-Risk” Ischemic Penumbra, but Thresholds Vary by Postprocessing Technique
Kamalian S, Kamalian S, Konstas AA, Maas MB, Payabvash S, Pomerantz SR, Schaefer PW, Furie KL, González RG, Lev MH. CT Perfusion Mean Transit Time Maps Optimally Distinguish Benign Oligemia from True “At-Risk” Ischemic Penumbra, but Thresholds Vary by Postprocessing Technique. American Journal Of Neuroradiology 2011, 33: 545-549. PMID: 22194372, PMCID: PMC3746025, DOI: 10.3174/ajnr.a2809.Peer-Reviewed Original ResearchConceptsAcute stroke patientsLarge vessel occlusionBenign oligemiaStroke patientsIschemic penumbraCTP parametersRelative cerebral blood flowConsecutive stroke patientsHours of onsetCerebral blood flowMean transit time mapsCharacteristic curve analysisTransit time mapsUninvolved hemisphereRadiographic evidenceThrombolytic therapyFinal infarctVessel occlusionRelative MTTBlood flowCTP mapsPerfusion parametersOligemiaReperfusionPatientsAdmission CT Perfusion Is an Independent Predictor of Hemorrhagic Transformation in Acute Stroke with Similar Accuracy to DWI
Souza LC, Payabvash S, Wang Y, Kamalian S, Schaefer P, Gonzalez RG, Furie KL, Lev MH. Admission CT Perfusion Is an Independent Predictor of Hemorrhagic Transformation in Acute Stroke with Similar Accuracy to DWI. Cerebrovascular Diseases 2011, 33: 8-15. PMID: 22143195, PMCID: PMC3250646, DOI: 10.1159/000331914.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBostonCerebrovascular CirculationChi-Square DistributionDiffusion Magnetic Resonance ImagingFemaleHumansIntracranial HemorrhagesLogistic ModelsMaleMiddle AgedMultivariate AnalysisPatient AdmissionPerfusion ImagingPredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentRisk FactorsROC CurveStrokeTomography, X-Ray ComputedConceptsRelative mean transit timeAdmission CT perfusionDiffusion-weighted imagingPredictors of HTRelative cerebral blood flowHemorrhagic transformationCT perfusionAcute strokeIndependent predictorsTissue volumeAdmission diffusion-weighted imagingConsecutive stroke patientsOnly independent predictorCerebral blood flowIschemic hemisphereMechanical thrombectomyStroke patientsInfarct coreMean transit timeBlood flowTest characteristicsCurve analysisDWI scansLesionsStrokeRegional Ischemic Vulnerability of the Brain to Hypoperfusion
Payabvash S, Souza LC, Wang Y, Schaefer PW, Furie KL, Halpern EF, Gonzalez RG, Lev MH. Regional Ischemic Vulnerability of the Brain to Hypoperfusion. Stroke 2011, 42: 1255-1260. PMID: 21493917, PMCID: PMC3090217, DOI: 10.1161/strokeaha.110.600940.Peer-Reviewed Original ResearchConceptsIschemic vulnerabilityStroke patientsInfarct coreRCBF thresholdAdmission diffusion-weighted imagingCerebral blood flow reductionAcute stroke patientsIschemic stroke onsetBlood flow reductionAdmission CT perfusionDiffusion-weighted imagingCT perfusion mapsStroke onsetRCBF reductionCT perfusionBrain lesionsInferior frontal gyrusParacentral lobuleCaudate bodyInsular ribbonPerfusion parameter mapsHypoperfusionSubcortical regionsPatientsRCBF