Abstract TP8: Apparent Diffusion Coefficientvalue Could Be The New Perspective To Ascertain Effectiveness Of Mechanical Thrombectomy In Large Ischemic Regions
Bibliographic record
Abstract
Introduction: Recently, we reported that apparent diffusion coefficient (ADC) values are independently associated with diffusion-weighted imaging (DWI) reversal, and DWI lesions with mean ADC ≥ 520 х 10 -6 mm 2 /s are salvageable by mechanical thrombectomy. These areas regain neurological function. This study aimed to determine the effectiveness of mechanical thrombectomy in especially large ischemic regions with mean ADC ≥ 520 х 10 -6 mm 2 /s. Materials and Methods: We conducted a retrospective cohort study including patients with acute ischemic stroke who underwent endovascular mechanical thrombectomy with successful recanalization between April 2017 and March 2021. DWI reversal was assessed through follow-up magnetic resonance imaging 24 h after treatment. Cases with Alberta stroke program early CT score (ASPECTS)-DWI values 3-5 were enrolled in this study. They were classified as DWI lesions with mean ADC ≥ 520 х 10 -6 mm 2 /s and mean ADC < 520 х 10 -6 mm 2 /s. The primary outcome was modified Rankin scale (mRS) score 0-3 (on a scale of 0-6) at 3 months. Results: In total, ASPECTS-DWI values 3-5 were confirmed in 20 patients. Six patients had DWI lesions with mean ADC ≥ 520 х 10 -6 mm 2 /s, and the remaining 14 patients had DWI lesions with mean ADC < 520 х 10 -6 mm 2 /s. DWI reversals were significantly larger in cases with mean ADC ≥ 520 х 10 -6 mm 2 /s than in those with mean ADC < 520 х 10 -6 mm 2 /s (p=.049). The mRS scores at 3 months in cases with mean ADC ≥ 520 х 10 -6 mm 2 /s and ADC < 520 х 10 -6 mm 2 /s were 3 (0.75-3.75) and 5 (4-6), respectively. mRS score was significantly improved in cases with mean ADC ≥ 520 х 10 -6 mm 2 /s than in cases with mean ADC < 520 х 10 -6 mm 2 /s (p=.011). Conclusions: In large ischemic regions (ASPECTS-DWI: 3-5), DWI lesions with mean ADC ≥ 520 х 10 -6 mm 2 /s are associated with preferable outcomes. The ADC value is easily assessed and a useful tool to predict viable lesions. Therefore, the ADC value could be a new perspective to ascertain the effectiveness of mechanical thrombectomy in large ischemic regions. ABBREVIATIONS: ASPECTS = Alberta stroke program early CT score; ADC = apparent diffusion coefficient; DWI = diffusion-weighted imaging; mRS = modified Rankin scale
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".