Apparent diffusion coefficient (ADC) values identifying cerebral infarct core in pre and post-thrombectomy

Muda, Ahmad Sobri and Ahmad Shukri, Amirun Safwan and Tharek, Anas and Yusof Khan, Abdul Hanif Khan and Shamsuddin Perisamy, Rajeev and Amran, Mohd Hanif and Mahmood, Mohamad Khairi (2025) Apparent diffusion coefficient (ADC) values identifying cerebral infarct core in pre and post-thrombectomy. In: Asia Pacific Stroke Conference 2025 (APSC), 11th September 2025, Kobe, Japan.

PDF (Abstract) - Published Version Download (416kB)

Abstract

Introduction: In acute ischemic stroke (AIS), timely identification of the infarct core is essential for optimizing patient selection for reperfusion therapies such as mechanical thrombectomy. The Apparent Diffusion Coefficient (ADC), derived from diffusion-weighted MRI, is a promising quantitative biomarker for delineating irreversibly infarcted brain tissue. However, its behavior postthrombectomy remains inadequately understood, and no universally accepted threshold exists. Method: This retrospective observational study involved 33 AIS patients with large vessel occlusion who underwent brain MRI on Day 1 (≤24 hours) and Day 5 - 7 post-thrombectomy at Hospital Sultan Abdul Aziz Shah (HSAAS), Universiti Putra Malaysia. ADC values were extracted from infarct core, penumbra, and normal parenchyma based on regions defined on Day 5 - 7 MRI. Statistical analyses included paired t-tests, Mann-Whitney U tests, and ROC curve analysis. Result: Significant ADC increases were observed in all regions from Day 1 to Day 5 - 7 (p < 0.001), with the greatest change in the infarct core (mean ADC from 0.369 to 0.472 × 10-3 mm2 /s). ROC analysis showed that an ADC threshold of 0.400 × 10-3 mm2/s provided high diagnostic accuracy for infarct core on Day 1 (AUC = 0.92). The conventional threshold of 0.600 × 10-3 mm2 /s remained highly accurate post- thrombectomy (sensitivity 0.97, specificity 1.00). Conclusion: An ADC threshold of 0.400 × 10-3 mm2/s is highly indicative of infarct core in the acute phase. Post-thrombectomy ADC values evolve significantly, suggesting that fixed thresholds may not reliably define infarcted tissue over time. These findings support integrating time-adaptive ADC metrics into post-stroke imaging protocols and clinical decision-making.

Item Type:	Proceeding Paper (Other)
Additional Information:	7722/123323
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine R Medicine > RZ Other systems of medicine
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Radiology
Depositing User:	Dr Rajeev Shamsuddin Perisamy
Date Deposited:	26 Sep 2025 09:13
Last Modified:	26 Sep 2025 10:40
URI:	http://irep.iium.edu.my/id/eprint/123323

Actions (login required)

View Item