Review ArticlesDiffusion and Perfusion MR Imaging in Acute Stroke Clinical Utility and Potential Limitations for Treatment SelectionBateman, Mathew MBChB, FRANZCR; Slater, Lee-Anne MBBS, FRANZCR; Leslie-Mazwi, Thabele MD; Simonsen, Claus Z. MD, PhD; Stuckey, Stephen MBBS, MD, FRANZCR; Chandra, Ronil V. MBBS, FRANZCRAuthor Information *Neuroradiology Service, Monash Imaging, Monash Health †School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia ‡NeuroEndovascular Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA §Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. Address correspondence to Ronil V. Chandra, MBBS, MMed, FRANZCR, Diagnostic and Interventional Neuroradiology, Monash Health, Monash University, Melbourne, VIC 3168, Australia. (e-mail: firstname.lastname@example.org;email@example.com). The authors report no conflicts of interest. Topics in Magnetic Resonance Imaging: April 2017 - Volume 26 - Issue 2 - p 77–82 doi: 10.1097/RMR.0000000000000124 Buy Metrics Abstract Magnetic resonance (MR) diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) offer unique insight into acute ischemic stroke pathophysiology. These techniques may offer the ability to apply pathophysiology to accurately individualize acute stroke reperfusion treatment, including extending the opportunity of reperfusion treatment to well beyond the current time-based treatment windows. This review examines the use of DWI and PWI in the major stroke trials, their current clinical utility, and potential limitations for reperfusion treatment selection. DWI and PWI continue to be investigated in ongoing randomized controlled trials, and continued research into these techniques will help achieve the goal of tissue-based decision making and individualized acute stroke treatment. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.