Abstract TP245: Smartphone App Can Precisely Share Neuroimaging for Stroke Team

Abstract

Background and Objectives: Bland new smartphone application (JOIN) can provide sharing text, neuroimagings, photos, and videos among stroke team with high security. Our aim is to investigate the diagnostic accuracy and agreement of DWI-ASPECTS between JOIN and conventional PC monitor. Methods: This study used the MRI images of consecutive acute stroke patients having main artery blockage (ICA and/or MCA). After concealing patient backgrounds, two vascular neurologist independently graded ischemic change on DWI-ASPECT by using JOIN and conventional PC monitor, respectively. All patients were estimated DWI-ASPECT≥6 or <6 (DWI cut-line) according to AHA/ASA GUIDELINE for endovascular treatment. Then, we analyzed inter-device (JOIN and PC monitor) and inter-rater (vascular neurologist 1 and 2) agreements of DWI cut-line. Additionally, detection rates of JOIN were compared for each DWI-ASPECTS region between vascular neurologist 1and 2. Results: We analyzed the cases of 50 subject patients (67% male, average age 66 ± 11, median NIHSS score 7). Between JOIN and PC monitor, the inter-device agreement of DWI cut-line was significantly excellent (vascular neurologist 1;κ=0.80, p<0.001, vascular neurologist 2; κ=0.77, p<0.001) .The inter-rater agreements between vascular neurologist 1 and 2 were also satisfactory by using JOIN (κ=0.68, p<0.001), and PC monitor (κ=0.60, p<0.001). The average interpretation duration (from recognizing image to finishing interpretation) of JOIN and PC monitor were similar (vascular neurologist 1; 1.7 min of JOIN vs. 1.6 min of PC monitor (p=0.64) and vascular neurologist 2; 2.4 min vs. 2.0 min (p=0.14). Between vascular neurologist 1 and 2, DWI-ASPECTS lesion of JOIN were detected in the M1 (32% vs. 34%, p=0.83), M2 (30% vs.38%, p=0.39), M3 (30% vs.34%, p=0.67), M4 (38% vs.24%, p=0.13), M5 (76% vs.44%, p<0.001), M6 (38% vs.36%, p=0.84), caudate head (14% vs.12%, p=0.77), insular cortex (48% vs.50%, p=0.84), lentiform nucleus (18% vs.34%, p=0.06), and internal capsule (16% vs.10%, p=0.37), respectively. Conclusion: By using smartphone App, stroke neurologists are able to estimate DWI-ASPECTS precisely and quickly. Outstanding App “JOIN” should yield a profit of acute stroke care.