Abstract
Background: Aim of the study was to test the accuracy of AI-based software for detection of large vessel occlusion (LVO) with computed tomography angiography (CTA) in stroke patients using an experienced neuroradiologist’s evaluation as the reference. Methods: Consecutive patients who underwent multimodal brain CT for suspected acute ischemic stroke were retrospectively identified. The presence and site (classified as proximal and distal) of LVO were assessed in CTA by an experienced neuroradiologist as a reference and compared to readings of three medical students and AI-based software, the e-CTA. Results: One-hundred-eight participants with a mean age of 70 years (±12.6); 55 (50.9%) females were included. Neuroradiologist found LVO in 70 (64.8%) cases: 45 (41.7%) proximal, and 25 (23.1%) distal. The overall sensitivity for e-CTA was 0.67 (95%CI 0.55–0.78); 0.84 (95%CI 0.71–0.94) for proximal, and 0.36 (95%CI 0.18–0.57) for distal LVOs. Overall specificity and accuracy for e-CTA were 0.95 (95%CI 0.82–0.99) and 0.77 (95%CI 0.68–0.84), respectively. The student’s performance was similar to e-CTA. Conclusions: The tested software’s performance is acceptable for the detection of proximal LVOs, while it appears to be not accurate enough for distal LVOs.
Highlights
Mechanical thrombectomy (MT) is the current standard of care in patients with acute stroke and large vessel occlusion (LVO) [1,2]
This therapy became the standard of care in patients with occlusion of major arteries supplying the brain, termed large vessel occlusion (LVO)
As they are usually accessible in comprehensive stroke centers performing MT, the majority of stroke patients primarily are transported to the nearest stroke unit without a neuroradiologist present
Summary
Mechanical thrombectomy (MT) is the current standard of care in patients with acute stroke and large vessel occlusion (LVO) [1,2]. The presence or absence of an LVO is a prerequisite in patient selection for MT. For this purpose, computed tomography angiography (CTA) is the most frequently used modality. It demonstrates the site of cerebral artery occlusion and yields noninvasive information on the extra- and intracranial vasculature before endovascular treatment. Several artificial intelligence (AI) based automated analysis platforms for detecting LVO on CTA images have been introduced and are increasingly used. They are supposed to allow faster review of CTA data for therapy decisions. One of the vendors of automated analysis platforms claims a very high accuracy of their software for detecting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
