Saim TURKOGLU, Huseyin AKDENIZ, Ertug GUNSOY, Ferhat KURT
The Atlantic Journal of Medical Science and Research - 2026;6(1):30-37
Aim: This study aimed to evaluate the prognostic value of absolute interhemispheric ADC differences (DeltaADC) in patients with AIS due to large vessel occlusion (LVO) who underwent endovascular therapy (EVT). Materials and Methods: In this retrospective observational study, 100 patients with acute LVO stroke who underwent endovascular treatment and pre-treatment diffusion-weighted MRI were included. A total of 100 patients (mean age:66.6 years, 95% CI:64.0-69.2; 46% male) with acute ischemic stroke due to large vessel occlusion were retrospectively analyzed. ADC values were measured from infarcted regions and their contralateral homologous areas to calculate DeltaADC. Functional outcome at discharge was assessed using the modified Rankin Scale (mRS), and receiver operating characteristic (ROC) analysis was performed to evaluate the predictive performance of DeltaADC for poor outcomes (mRS>=5). Results: The mean DeltaADC was 295.7+/-150.4x10-6 mm²/s. Patients with better functional outcomes (mRS 0-4) exhibited consistently higher mean ADC differences (e.g., mRS 4:374.2x10-6 mm²/s), whereas those with poor outcomes had notably lower values (mRS 5:211.0; mRS 6:42.0x10-6 mm²/s). A significant negative correlation was found between DeltaADC and mRS score (r=-0.29, p=0.003). ROC analysis yielded an AUC of 0.75 (p<0.001), with an optimal DeltaADC threshold of <=318x10-6 mm²/s (sensitivity: 0.88, specificity: 0.57). Conclusion: In patients undergoing EVT for acute large vessel occlusion, DeltaADC is a simple, reproducible, and treatment-independent imaging biomarker that correlates with short-term functional outcomes. Its integration into clinical stroke imaging protocols may aid early risk stratification.
