{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:45:54Z","timestamp":1790948754738,"version":"4.1.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>In patients with acute ischemic stroke, infarct growth occurs despite successful reperfusion. Oxygen extraction fraction (OEF) has shown promising results in evaluating ischemic tissue viability and can now be quantified from routinely performed dynamic susceptibility contrast perfusion. We aimed to determine the association of OEF alterations within the ischemic tissue on pretreatment magnetic resonance imaging and infarct growth in patients who underwent successful reperfusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      In this retrospective cohort study from the University of California, Los Angeles, between 2015 and 2020, patients were included if they had anterior circulation large vessel occlusion, achieved successful reperfusion (Thrombolysis in Cerebral Infarction \u22652b), had pretreatment dynamic susceptibility contrast perfusion and posttreatment magnetic resonance imaging within 48 hours from reperfusion. Dynamic susceptibility contrast-derived OEF values were quantified from the segmented ischemic core (apparent diffusion coefficient \u2264620\u00d710\n                      <jats:sup>\u22126<\/jats:sup>\n                      mm\n                      <jats:sup>2<\/jats:sup>\n                      \/s) and penumbra tissue (time-to-maximum [Tmax] &gt;6 s) on pretreatment magnetic resonance imaging and normalized to contralateral hemisphere (relative oxygen extraction fraction [OEF\n                      <jats:sub>r<\/jats:sub>\n                      ]). Primary outcome was substantial infarct growth \u226510 mL, and secondary outcomes were continuous measures of infarct growth volume and penumbra-to-infarct conversion ratio. The associations between baseline clinical and imaging variables, including OEF\n                      <jats:sub>r<\/jats:sub>\n                      and outcome measures, were tested by multivariate and regression analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 89 patients who met inclusion criteria, 33 (37%) patients had infarct growth \u226510 mL. Patients with infarct growth had significantly (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001) lower penumbra-OEF\n                      <jats:sub>r<\/jats:sub>\n                      values compared with those without infarct growth. There was significant association between penumbra OEF\n                      <jats:sub>r<\/jats:sub>\n                      and infarct growth (\u03b2=\u22122.9 [95% CI, \u22125.0 to \u22120.8];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.007) and similarly for penumbra-to-infarct conversion ratio (\u03b2=\u221210.4 [95% CI, \u221219.6 to \u22121.2];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      Our results showed penumbra-OEF\n                      <jats:sub>r<\/jats:sub>\n                      is a promising imaging biomarker for predicting infarct growth in acute ischemic stroke following successful reperfusion. Although elevation of penumbra-OEF\n                      <jats:sub>r<\/jats:sub>\n                      is protective, patients with lower penumbra-OEF\n                      <jats:sub>r<\/jats:sub>\n                      values sustained further ischemic injury and infarct growth.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.125.051270","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T09:00:06Z","timestamp":1754298006000},"page":"3024-3033","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Oxygen Extraction Fraction on Baseline MRI Predicts Infarction Growth in Successfully Reperfused Patients"],"prefix":"10.1161","volume":"56","author":[{"given":"Mona","family":"Asghariahmadabad","sequence":"first","affiliation":[{"name":"Department of Radiology and Biomedical Imaging (M.A., P.M., D.S., D.L.C., S.W.H., M.R.A., K.H.N., C.P.H., K.N.), University of California, San Francisco."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameera","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences (A.I., E.T., K.N.), David Geffen School of Medicine at University of California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2905-4080","authenticated-orcid":true,"given":"Pouya","family":"Metanat","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging (M.A., P.M., D.S., D.L.C., S.W.H., M.R.A., K.H.N., C.P.H., K.N.), University of California, San Francisco."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2869-8087","authenticated-orcid":true,"given":"Elham","family":"Tavakkol","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences (A.I., E.T., K.N.), David Geffen School of Medicine at University of California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3049-4542","authenticated-orcid":true,"given":"Mersedeh","family":"Bahr-Hosseini","sequence":"additional","affiliation":[{"name":"Department of Neurology (M.B.-H., V.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0703-8258","authenticated-orcid":true,"given":"Viktor","family":"Szeder","sequence":"additional","affiliation":[{"name":"Department of Neurology (M.B.-H., V.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3376-0933","authenticated-orcid":true,"given":"Geoffrey P.","family":"Colby","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (G.P.C.), David Geffen School of Medicine at University of California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9141-2251","authenticated-orcid":true,"given":"Jeffrey L.","family":"Saver","sequence":"additional","affiliation":[{"name":"Department of Neurology (M.B.-H., V.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2450-4014","authenticated-orcid":true,"given":"Vivek S.","family":"Yedavalli","sequence":"additional","affiliation":[{"name":"The Russell H. 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