Abstract #2526

MRI OEF and CMRO₂ in Predicting Ischemic Lesion Survival in Acute Stroke: New insight on Diffusion Reversibility

Mona Asghariahmadabad¹, Pouya Metanat¹, Elham Tavakol², Ameera F Ismail², Mersedeh Bahr-Hosseini³, Viktor Szeder², Geoffrey P Colby⁴, Jeffrey L Saver³, David S Liebeskind³, Vivek Yedavalli⁵, Wade S Smith⁶, Anthony Kim⁶, Cathra Halabi⁶, Nerissa Ko⁶, Anirudh Sreekrishnan⁶, S Andrew Josephson⁶, Kazim Narsinh¹, Luis E Savastano⁷, Steven Hetts¹, Christopher P Hess¹, and Kambiz Nael¹

¹Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States, ²Radiology, University of California Los Angeles, Los Angeles, CA, United States, ³Neurology, University of California Los Angeles, Los Angeles, CA, United States, ⁴Nuerosurgery, University of California Los Angeles, Los Angeles, CA, United States, ⁵Radiology, Johns Hopkins University, Baltimore, MD, United States, ⁶Neurology, University of California San Francisco, San Francisco, CA, United States, ⁷Neurosurgery, University of California San Francisco, San Francisco, CA, United States

Synopsis

Keywords: Stroke, DSC & DCE Perfusion, Stroke, Ghost core, OEF, CMRO2

Motivation: Our study examines OEF and CMRO₂ as markers of tissue viability in AIS cases with "ghost core," where ischemic core is overestimated on MRI.

Goal(s): This study aims to determine if elevated pretreatment OEF and CMRO₂ predict DWI lesion reversibility in acute ischemic stroke, aiding treatment decisions.

Approach: This study used a retrospective voxel-based analysis of pretreatment OEF and CMRO₂ maps and posttreatment MRI to assess metabolic markers associated with DWI lesion reversibility after reperfusion.

Results: Our findings show that recovered ischemic tissue depicted by reversal of reduced diffusion have significantly higher OEF and CMRO₂ values in comparison to tissue which remained infarcted.

Impact: Pretreatment MR OEF and CMRO₂ markers in AIS patients can predict diffusion reversibility within the estimated ischemic core. This approach can refine the ischemic core assessment for reperfusion therapy selection and potentially improving clinical outcomes through tailored treatment strategies.

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