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<meta name="DC.Title" content="Quantification of Collateral Supply with Local-AIF Dynamic Susceptibility Contrast MRI Predicts Infarct Growth" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8441" />
<meta name="DC.Date" content="2024-08-12" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: In ischemic stroke, leptomeningeal collaterals can provide delayed and dispersed compensatory blood flow to tissue-at-risk despite an occlusion and can impact treatment response and infarct growth. The purpose of this work is to test the hypothesis that inclusion of this delayed and dispersed flow with an appropriately calculated Local Arterial Input Function (Local-AIF) is needed to quantify the degree of collateral blood supply in tissue distal to an occlusion.

MATERIALS AND METHODS: Seven experiments were conducted in a pre-clinical middle cerebral artery occlusion model. Dynamic susceptibility contrast MRI was imaged and post-processed to yield quantitative cerebral blood flow (qCBF) maps with both a traditionally chosen single arterial input function applied globally to the whole brain (i.e. “Global-AIF”) and a delay and dispersion corrected AIF (i.e. “Local-AIF”) that is sensitive to retrograde flow. Leptomeningeal collateral arterial recruitment was quantified with a pial collateral score from x-ray angiograms, and infarct growth calculated from serially acquired diffusion weighted MRI scans.

RESULTS: The degree of collateralization at x-ray correlated more strongly with qCBF using the Local-AIF in the ischemic penumbra (R2=0.81) than traditionally chosen Global-AIF (R2=0.05). qCBF using a Local-AIF was negatively correlated (less infarct progression as perfusion increased) with infarct growth (R2 = 0.79) more strongly than a Global-AIF (R2=0.02).

CONCLUSIONS: In acute stroke, qCBF calculated with a Local-AIF is more accurate for assessing tissue status and collateral supply than traditionally chosen Global-AIFs. These findings support use of a Local-AIF that corrects for delayed and dispersed retrograde flow in determining quantitative tissue perfusion with collateral supply in occlusive disease.

ABBREVIATIONS: MRI = magnetic resonance imaging; DSC = dynamic susceptibility contrast; PCS = pial collateral score; MCAO = middle cerebral artery occlusion; MCA = middle cerebral artery; AIF = arterial input function; rCBF = relative cerebral blood flow; qCBF = quantitative cerebral blood flow" />
<meta name="DC.Contributor" content="Mira M. Liu" />
<meta name="DC.Contributor" content="Niloufar Saadat" />
<meta name="DC.Contributor" content="Steven P. Roth" />
<meta name="DC.Contributor" content="Marek A. Niekrasz" />
<meta name="DC.Contributor" content="Mihai Giurcanu" />
<meta name="DC.Contributor" content="Timothy J. Carroll" />
<meta name="DC.Contributor" content="Gregory A. Christoforidis" />
<meta name="article:published_time" content="2024-08-12" />
<meta name="article:section" content="ORIGINAL RESEARCH" />
<meta name="citation_title" content="Quantification of Collateral Supply with Local-AIF Dynamic Susceptibility Contrast MRI Predicts Infarct Growth" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;ABSTRACT&lt;/h3&gt;
&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;In ischemic stroke, leptomeningeal collaterals can provide delayed and dispersed compensatory blood flow to tissue-at-risk despite an occlusion and can impact treatment response and infarct growth. The purpose of this work is to test the hypothesis that inclusion of this delayed and dispersed flow with an appropriately calculated Local Arterial Input Function (Local-AIF) is needed to quantify the degree of collateral blood supply in tissue distal to an occlusion.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Seven experiments were conducted in a pre-clinical middle cerebral artery occlusion model. Dynamic susceptibility contrast MRI was imaged and post-processed to yield quantitative cerebral blood flow (qCBF) maps with both a traditionally chosen single arterial input function applied globally to the whole brain (i.e. “Global-AIF”) and a delay and dispersion corrected AIF (i.e. “Local-AIF”) that is sensitive to retrograde flow. Leptomeningeal collateral arterial recruitment was quantified with a pial collateral score from x-ray angiograms, and infarct growth calculated from serially acquired diffusion weighted MRI scans.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The degree of collateralization at x-ray correlated more strongly with qCBF using the Local-AIF in the ischemic penumbra (R&lt;sup&gt;2&lt;/sup&gt;=0.81) than traditionally chosen Global-AIF (R&lt;sup&gt;2&lt;/sup&gt;=0.05). qCBF using a Local-AIF was negatively correlated (less infarct progression as perfusion increased) with infarct growth (R&lt;sup&gt;2&lt;/sup&gt; = 0.79) more strongly than a Global-AIF (R&lt;sup&gt;2&lt;/sup&gt;=0.02).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In acute stroke, qCBF calculated with a Local-AIF is more accurate for assessing tissue status and collateral supply than traditionally chosen Global-AIFs. These findings support use of a Local-AIF that corrects for delayed and dispersed retrograde flow in determining quantitative tissue perfusion with collateral supply in occlusive disease.&lt;/p&gt;&lt;p&gt;ABBREVIATIONS: MRI = magnetic resonance imaging; DSC = dynamic susceptibility contrast; PCS = pial collateral score; MCAO = middle cerebral artery occlusion; MCA = middle cerebral artery; AIF = arterial input function; rCBF = relative cerebral blood flow; qCBF = quantitative cerebral blood flow&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2024/08/12" />
<meta name="citation_mjid" content="ajnr;ajnr.A8441v1" />
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<meta name="citation_section" content="ORIGINAL RESEARCH" />
<meta name="citation_author" content="Mira M. Liu" />
<meta name="citation_author_institution" content="From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA" />
<meta name="citation_author" content="Niloufar Saadat" />
<meta name="citation_author_institution" content="From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA" />
<meta name="citation_author" content="Steven P. Roth" />
<meta name="citation_author_institution" content="From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA" />
<meta name="citation_author" content="Marek A. Niekrasz" />
<meta name="citation_author_institution" content="From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA" />
<meta name="citation_author" content="Mihai Giurcanu" />
<meta name="citation_author_institution" content="From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA" />
<meta name="citation_author" content="Timothy J. Carroll" />
<meta name="citation_author_institution" content="From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA" />
<meta name="citation_author" content="Gregory A. Christoforidis" />
<meta name="citation_author_institution" content="From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA" />
<meta name="twitter:title" content="Quantification of Collateral Supply with Local-AIF Dynamic Susceptibility Contrast MRI Predicts Infarct Growth" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: In ischemic stroke, leptomeningeal collaterals can provide delayed and dispersed compensatory blood flow to tissue-at-risk despite an occlusion and can impact treatment response and infarct growth. The purpose of this work is to test the hypothesis that inclusion of this delayed and dispersed flow with an appropriately calculated Local Arterial Input Function (Local-AIF) is needed to quantify the degree of collateral blood supply in tissue distal to an occlusion.

MATERIALS AND METHODS: Seven experiments were conducted in a pre-clinical middle cerebral artery occlusion model. Dynamic susceptibility contrast MRI was imaged and post-processed to yield quantitative cerebral blood flow (qCBF) maps with both a traditionally chosen single arterial input function applied globally to the whole brain (i.e. “Global-AIF”) and a delay and dispersion corrected AIF (i.e. “Local-AIF”) that is sensitive to retrograde flow. Leptomeningeal collateral arterial recruitment was quantified with a pial collateral score from x-ray angiograms, and infarct growth calculated from serially acquired diffusion weighted MRI scans.

RESULTS: The degree of collateralization at x-ray correlated more strongly with qCBF using the Local-AIF in the ischemic penumbra (R2=0.81) than traditionally chosen Global-AIF (R2=0.05). qCBF using a Local-AIF was negatively correlated (less infarct progression as perfusion increased) with infarct growth (R2 = 0.79) more strongly than a Global-AIF (R2=0.02).

CONCLUSIONS: In acute stroke, qCBF calculated with a Local-AIF is more accurate for assessing tissue status and collateral supply than traditionally chosen Global-AIFs. These findings support use of a Local-AIF that corrects for delayed and dispersed retrograde flow in determining quantitative tissue perfusion with collateral supply in occlusive disease.

ABBREVIATIONS: MRI = magnetic resonance imaging; DSC = dynamic susceptibility contrast; PCS = pial collateral score; MCAO = middle cerebral artery occlusion; MCA = middle cerebral artery; AIF = arterial input function; rCBF = relative cerebral blood flow; qCBF = quantitative cerebral blood flow" />
<meta name="og-title" property="og:title" content="Quantification of Collateral Supply with Local-AIF Dynamic Susceptibility Contrast MRI Predicts Infarct Growth" />
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<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: In ischemic stroke, leptomeningeal collaterals can provide delayed and dispersed compensatory blood flow to tissue-at-risk despite an occlusion and can impact treatment response and infarct growth. The purpose of this work is to test the hypothesis that inclusion of this delayed and dispersed flow with an appropriately calculated Local Arterial Input Function (Local-AIF) is needed to quantify the degree of collateral blood supply in tissue distal to an occlusion.

MATERIALS AND METHODS: Seven experiments were conducted in a pre-clinical middle cerebral artery occlusion model. Dynamic susceptibility contrast MRI was imaged and post-processed to yield quantitative cerebral blood flow (qCBF) maps with both a traditionally chosen single arterial input function applied globally to the whole brain (i.e. “Global-AIF”) and a delay and dispersion corrected AIF (i.e. “Local-AIF”) that is sensitive to retrograde flow. Leptomeningeal collateral arterial recruitment was quantified with a pial collateral score from x-ray angiograms, and infarct growth calculated from serially acquired diffusion weighted MRI scans.

RESULTS: The degree of collateralization at x-ray correlated more strongly with qCBF using the Local-AIF in the ischemic penumbra (R2=0.81) than traditionally chosen Global-AIF (R2=0.05). qCBF using a Local-AIF was negatively correlated (less infarct progression as perfusion increased) with infarct growth (R2 = 0.79) more strongly than a Global-AIF (R2=0.02).

CONCLUSIONS: In acute stroke, qCBF calculated with a Local-AIF is more accurate for assessing tissue status and collateral supply than traditionally chosen Global-AIFs. These findings support use of a Local-AIF that corrects for delayed and dispersed retrograde flow in determining quantitative tissue perfusion with collateral supply in occlusive disease.

ABBREVIATIONS: MRI = magnetic resonance imaging; DSC = dynamic susceptibility contrast; PCS = pial collateral score; MCAO = middle cerebral artery occlusion; MCA = middle cerebral artery; AIF = arterial input function; rCBF = relative cerebral blood flow; qCBF = quantitative cerebral blood flow" />
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      <h1 class="highwire-cite-title" id="page-title">Quantification of Collateral Supply with Local-AIF Dynamic Susceptibility Contrast MRI Predicts Infarct Growth</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Mira M. Liu</span>, <span class="highwire-citation-author" data-delta="1">Niloufar Saadat</span>, <span class="highwire-citation-author" data-delta="2">Steven P. Roth</span>, <span class="highwire-citation-author" data-delta="3">Marek A. Niekrasz</span>, <span class="highwire-citation-author" data-delta="4">Mihai Giurcanu</span>, <span class="highwire-citation-author" data-delta="5">Timothy J. Carroll</span> and <span class="highwire-citation-author" data-delta="6">Gregory A. Christoforidis</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2024,  </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">ajnr.A8441; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8441 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-109821--61269706541" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Mira M. Liu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Mira%2BM.%2BLiu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Liu%20MM&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AMira%2BM.%2BLiu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Niloufar Saadat </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Niloufar%2BSaadat%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Saadat%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ANiloufar%2BSaadat%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Steven P. Roth </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Steven%2BP.%2BRoth%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Roth%20SP&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ASteven%2BP.%2BRoth%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Marek A. Niekrasz </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Marek%2BA.%2BNiekrasz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Niekrasz%20MA&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AMarek%2BA.%2BNiekrasz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Mihai Giurcanu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology, Medical Physics (MML, TJC), Department of Interventional Radiology (NS, GAC), Department of Surgery and Large Animal Studies (MAN), and the Department of Statistics (MG), University of Chicago, Chicago, IL, USA; Department of Anesthesiology (SPR), University of Illinois, Chicago, IL, USA; Department of Radiology, Biomedical Engineering and Imaging Institute (Current affiliation MML), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Carmel Health Systems (Current affiliation GAC), Columbus, OH, USA</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Mihai%2BGiurcanu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Giurcanu%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AMihai%2BGiurcanu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Timothy J. 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