Advances in Ischemic Stroke: The Role of Imaging Biomarkers in Improving Diagnosis, Prognosis, and Therapeutic Decision-making

In summary, MRI and CT are excellent diagnostic tools in the acute phase of stroke, providing valuable information that is crucial for understanding individual stroke pathology. The discussed studies highlight the potential of various imaging biomarkers, including thrombus characteristics on CT, FLAIR hyperintense vessels, vessel size determined on VSI, and underlying small vessel disease, all of which provide imaging-based physiological information to assess the patientspecific risk-benefit profile. There is still a strong need for the definitions of these imaging biomarkers to be standardized across centers and sites. Only in this way can the true diagnostic and prognostic value of these biomarkers be tested in a multicenter, controlled setting and the actual clinical utility be sufficiently assessed. Nonetheless, the multitude of information gained through different acute imaging modalities can be explored in smaller cohort studies like ours. These findings contribute to both our pathophysiological understanding of ischemic stroke and move us towards a more imaging-based and targeted treatment concept in all-around stroke care.