Abstract 12374: Apparent Diffusion Coefficient Predictors of Outcome in Cardiac Arrest Survivors
Objective: Various methods of quantitative apparent diffusion coefficient (ADC) analysis has been suggested as useful for prognostication of comatose cardiac arrest (CA) patients. We developed a new computerized prognostication method using relative volume of most dominant cluster of low-ADC voxels and tested its performance in multicenter setting.
Method: Adult (>15 years) out-of-hospital CA patients from three different facilities with MRI taken after 12 hours after resuscitation were retrospectively analyzed. Patients with unknown long-term prognosis or poor baseline neurologic function were excluded. Average ADCs (mean and median), LADCV (relative volume of low-ADC voxels) and DC-LADCV (relative volume of most dominant cluster of low-ADC voxels) were extracted using different thresholds from 400 to 800х10–6 mm2/s at 10х10–6 mm2/s intervals. Area under the receiver operating characteristic curve (AUROC) and sensitivity for poor outcome (6-month cerebral performance category score > 2) while maintaining 100% specificity were measured.
Results: 110 patients were analyzed. Average ADCs showed fair performance with AUROC of 0.822 (95% confidence interval [CI], 0.744-0.900) for mean and 0.799 (95% CI, 0.716-0.882) for median ADC. LADCV showed better performance with higher AUROC (maximum, 0.925) in ADC threshold range from 400 to 690х10–6mm2/s. DC-LADCV showed the best performance with higher AUROC (maximum, 0.955) compared to LADCV in ADC threshold range of 600 to 680х10–6 mm2/s. It had high sensitivity for poor outcome (>80%) in wide threshold range from 400 to 580х10–6 mm2/s with maximum of 89.2%.
Interpretation: Computerized quantitative analysis using DC-LADCV showed impressive performance in prognostication of out-of-hospital CA patients in multicenter setting.
Author Disclosures: C. Ha: None. J. Kim: None. K. Kim: None. G. Suh: None. W. Kwon: None. K. Kim: None. J. Shin: None. H. Lee: None.
- © 2015 by American Heart Association, Inc.