Title | Oxygen extraction fraction and stroke risk in patients with carotid stenosis or occlusion: a systematic review and meta-analysis. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Gupta A, Baradaran H, Schweitzer AD, Kamel H, Pandya A, Delgado D, Wright D, Hurtado-Rua S, Wang Y, Sanelli PC |
Journal | AJNR Am J Neuroradiol |
Volume | 35 |
Issue | 2 |
Pagination | 250-5 |
Date Published | 2014 Feb |
ISSN | 1936-959X |
Keywords | Aged, Biomarkers, Brain, Carotid Stenosis, Causality, Comorbidity, Female, Humans, Male, Middle Aged, Oxygen, Oxygen Radioisotopes, Positron-Emission Tomography, Prevalence, Radiopharmaceuticals, Reproducibility of Results, Risk Assessment, Risk Factors, Sensitivity and Specificity, Stroke |
Abstract | BACKGROUND AND PURPOSE: Increased oxygen extraction fraction on PET has been considered a risk factor for stroke in patients with carotid stenosis or occlusion, though the strength of this association has recently been questioned. We performed a systematic review and meta-analysis to summarize the association between increased oxygen extraction fraction and ipsilateral stroke risk. MATERIALS AND METHODS: A comprehensive literature search was performed. We included studies with baseline PET oxygen extraction fraction testing, ipsilateral stroke as the primary outcome, and at least 1 year of follow-up. A meta-analysis was performed by use of a random-effects model. RESULTS: After screening 2158 studies, 7 studies with 430 total patients with mean 30-month follow-up met inclusion criteria. We found that 6 of 7 studies were amenable to meta-analysis. Although 4 of the 6 studies independently did not reach statistical significance, meta-analysis revealed a significant positive relationship between abnormal oxygen extraction fraction and future ipsilateral stroke, with a pooled OR of 6.04 (95% CI, 2.58-14.12). There was no statistically significant difference in OR in the subgroup analyses according to testing method or disease site. CONCLUSIONS: Abnormal oxygen extraction fraction remains a powerful predictor of stroke in carotid stenosis or occlusion and is a valuable reference standard to compare and validate MR imaging-based measures of brain oxygen metabolism. However, there is a need for further evaluation of oxygen extraction fraction testing in patients with high-grade but asymptomatic carotid disease. |
DOI | 10.3174/ajnr.A3668 |
Alternate Journal | AJNR Am J Neuroradiol |
PubMed ID | 23945227 |
PubMed Central ID | PMC7965748 |
Grant List | R01 EB013443 / EB / NIBIB NIH HHS / United States R01EB013443 / EB / NIBIB NIH HHS / United States |
Related Institute:
MRI Research Institute (MRIRI)