Acute stroke imaging research roadmap II and international survey of acute stroke imaging capabilities: we need your help!

Beyond the scientific method: model-based inquiry as a new paradigm of preference for school science investigations. P erforming neuroimaging in the setting of a clinical trial, across multiple sites, is challenging because it involves standardizing acquisition and processing imaging protocols on multiple types of scanners by using multiple different platforms. The challenge is even more pronounced for cutting-edge imaging techniques such as arterial spin-labeling or diffusion tensor imaging. Mechanisms are therefore needed to translate and test advanced imaging methods across centers, to encourage the use of advanced imaging in acute settings, to stimulate closer academic-industry collaborations , and to promote the retrospective and prospective collection and pooling of imaging data while keeping in mind practical considerations such as clinical feasibility. This daunting task has been tackled by the Stroke Imaging Research (STIR) group, a consortium of neuroradiologists, neu-rologists, imaging scientists, and emergency physicians with an interest in stroke imaging. STIR had a series of meetings in 2012 and 2013, where heated debates led to consensus recommendations as part of a stroke imaging research roadmap. This roadmap was published in Stroke 1 and should be read by all radiologists interested in stroke research because it contains some very important recommendations in terms of standardization of image acquisition and processing for stroke and how imaging should be incorporated in stroke clinical trials. To view the paper use the link in this issue's table of contents, or go directly to: STIR proposes a specific, standardized terminology for acute stroke imaging, aligned with the National Institute of Neurologi-cal Disorders and Stroke Common Data Elements, 2 including a modified TICI scale to assess reperfusion on cerebral conventional angiography. STIR also introduces the concept of " Treatment Relevant Acute Imaging Targets " (TRAIT), which is meant to capture imaging elements needed for inclusion (or exclusion) into specific treatment protocols. TRAIT acts as a shorthand term to describe the collection of specific imaging metrics used in protocols and simultaneously reminds trial designers to ensure that imaging is directed to the key anatomic or physiologic targets of their specific intervention. STIR proposes the establishment of a calibration process for measuring ischemic core and penumbral software, as well as the population of the STIR clinical and imaging data repository to facilitate this calibration process. STIR recognizes that imaging techniques continuously evolve and that there will always be a newer, better ischemic core or penumbral imaging technique or processing software. …