Oxygen extraction fraction changes in ischemic tissue from 24–72 hours to 12 months after successful reperfusion

Oxygen Extraction Fraction (OEF) is a critical measure of a tissue's metabolic state post-ischemic stroke. This study investigated OEF changes in stroke-affected tissue compared to healthy tissue, post-reperfusion. OEF maps generated from gradient echo MRI images of 87 ischemic stroke patients at three time points after successful Endovascular Thrombectomy (EVT) were analysed in a prospective longitudinal multicentre study. Regions of interest (ROIs) delineating the infarct areas and corresponding mirror regions were drawn. The MR-derived OEF index values were obtained from the ROIs and compared using Wilcoxon signed rank tests. The cross-sectional comparison of OEF index values revealed lower values in the infarct areas than the corresponding contralateral areas at all three time points after successful EVT, presented as median (interquartile range) [24-72 hours: 20.84 (17.56-26.82)% vs 27.56 (23.22-31.87)%; 3 months: 27.37 (23.28-30.35)% vs 32.55 (28.00-35.81)%; 12 months: 24.38 (22.35-29.77)% vs 29.39 (25.86-34.04)%, p < 0.001 for all three time points]. Longitudinally, relative OEF index values increased gradually over time [24-72 hours: 0.81 (0.67-0.87); 3 months: 0.86 (0.79-0.95); 12 months: 0.88 (0.75-0.95)]. The findings revealed that following successful EVT, OEF in infarct tissue improves over time, indicating potential tissue recovery.Trial registration name and URL: Post-Reperfusion Pathophysiology in Acute Ischemic Stroke https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12624000629538.