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P59 OBJECTIVE: To show that the lesion defined by  ISODATA (Iterative Self Organizing Data Analysis Technique) has a  greater correlation with the deficit on perfusion weighted image (PWI)  and National Institute of Health Stroke Scale (NIHSS) compared to the  lesion defined by diffusion weighted image (DWI) or T2 weighted image  (T2WI).BACKGROUND: Early in the course of acute ischemic  stroke, the PWI lesion area is usually larger than the DWI or T2WI  lesion areas, and correlates best with clinical neurological deficit.  The computer segmentation algorithm ISODATA integrates different MRI  parameters (DWI, T2WI, T1WI) and provides complimentary information  about status of the tissue.METHODS: We obtained MRI  parameters of DWI, T2WI and T1WI from 11 patients at two time points  after stroke, the acute (&lt;12 hrs) and chronic (3 months). The clinical  neurological deficit was graded by the NIHSS at each time point. PWI  was obtained at the acute time point. Relative mean transit time images  (rMTT) were used to define the perfusion deficit. We compared PWI  deficit area with DWI, ISODATA and T2WI lesion of the same location.  The lesion areas were also correlated with NIHSS at acute time point.  At chronic time point T2WI and ISODATA lesion volumes were compared  with NIHSS.RESULTS: In acute phase PWI lesion area  correlated best with NIHSS (r=0.72, p&lt;0.05), followed by ISODATA  (r=0.62, p&lt;0.05), DWI (r =0.51, p&lt;0.05) &amp; T2WI (r=0.21, p&lt;0.05)  lesion areas. ISODATA correlated best with PWI lesion (r=0.90,  p&lt;0.05), and outperformed DWI (r=0.63, p&lt;0.05) and T2WI (r= 0.48,  p&lt;0.05). We also noticed at chronic time point that there is a good  correlation between ISODATA and T2WI(r= 0.97, p&lt;0.05), ISODATA and  NIHSS (r= 0.70, p&lt;0.0.5), T2WI and NIHSS (r=0.68, p&lt;0.05).CONCLUSION: This preliminary study shows that the integrated  ISODATA approach to tissue segmentation discriminates abnormal from  normal tissue at each time point after stroke. The area of the ISODATA  defined lesion correlates well with PWI at the acute and T2WI at the  chronic time point and the clinical neurological status of the  patient.

Lesion defined by Multiparametric MRI ISODATA correlates well with neurological deficit and PWI