To examine the predictive value of a voxel-based ADC threshold for DWI-R (diffusion-weighted imaging reversal) in patients achieving rapid and successful recanalization by EVT (endovascular therapy).
Key Findings:
A single ADC threshold may not reliably distinguish salvageable from unsalvageable tissue due to physiological variations, which could impact treatment decisions.
Lower ADC values correlate with more severe ischaemic injury, but a universal threshold is complicated by individual patient variability, necessitating personalized approaches.
Over-reliance on a single ADC threshold may misclassify salvageable tissue as irreversibly damaged, potentially leading to missed treatment opportunities.
Interpretation:
A nuanced understanding of ADC thresholds is essential for accurate stroke imaging interpretation and guiding clinical decisions regarding reperfusion therapies, emphasizing the need for individualized patient assessments.
Limitations:
Variability in ADC measurements across different brain regions and imaging platforms may lead to inconsistent clinical outcomes.
Potential misclassification of salvageable tissue due to reliance on a single ADC threshold highlights the need for more robust diagnostic criteria.
Conclusion:
Further research is needed to establish more reliable ADC thresholds for predicting lesion reversal in acute ischaemia, ensuring appropriate patient management and exploring alternative imaging techniques.
by Thor Håkon Skattør, Atle Bjørnerud, Terje Nome, Kine Mari Bakke, Brian Anthony Enriquez, Ingrid Digernes, Cecilie Mørck Offersen, Mona Kristiansen Beyer, Geir Ringstad, Anne Hege Aamodt
