Abstract
The rapid evaluation of non-contrast-enhanced computed tomography (NCCT) brain scans in patients with anterior stroke symptoms saves time and favors optimal and prompt treatment. e-ASPECTS is a tool that automatically calculates the Alberta Stroke Program Early CT Score (ASPECTS) values, leading to a more accurate and timely image evaluation. To determine the ability of e-ASPECTS in differentiating images with and without injury. One-hundred sixteen patients admitted to a stroke unit in a Brazilian tertiary hospital underwent a CT scan at admission and at least one control brain imaging (NCCT or magnetic resonance imaging - MRI) 24 hours after admission. ASPECTS evaluation was performed by three neuroradiologists, three neurologists, and three neurology residents, all blinded to the symptoms and the injury side. The scores were compared to the ground truth, and an ASPECTS score was provided by two independent non blinded evaluators. Sensitivity and specificity were analyzed, and receiver operating characteristic curves, Bland-Altman plots with mean error score, and Matthews correlation coefficients (MCCs) were obtained for ASPECTS scores, assuming values equal to 10 for images without injury and values other than 10 for images with ischemic injury. e-ASPECTS demonstrated similar performance to that of neuroradiologists and neurologists, with an area under the curve of 0.78 and an MCC value of 0.48 in the dichotomous analysis. The sensitivity and specificity of e-ASPECTS were 75% and 73%, respectively. e-ASPECTS is a validated and reliable tool for determining early signs of ischemia in NCCT.
Highlights
Acute ischemic stroke management has advanced in the last three decades, from the introduction of intravenous thrombolysis to the validation of mechanical thrombectomy[1]
A software-based machine learning algorithm (e-Alberta Stroke Program Early CT Score (ASPECTS), Brainomix®, Oxford, UK; www. brainomix.com) has been developed based on the Alberta Stroke Program Early Computed Tomography Score (ASPECTS), a simple and reliable method for assessing early ischemic stroke signs in non-contrast-enhanced computed tomography (NCCT) brain scan. e-ASPECTS is a 10-point quantitative score used in patients with symptoms suggestive of middle cerebral artery (MCA) ischemic stroke
The scores range from 10 to 08. e-ASPECTS has demonstrated a good correlation compared to assessments by neuroradiologists, stroke neurologists, and residents in neurology, but current analyses have been performed only in high-income countries
Summary
Acute ischemic stroke management has advanced in the last three decades, from the introduction of intravenous thrombolysis to the validation of mechanical thrombectomy[1]. Brainomix.com) has been developed based on the Alberta Stroke Program Early Computed Tomography Score (ASPECTS), a simple and reliable method for assessing early ischemic stroke signs in non-contrast-enhanced computed tomography (NCCT) brain scan. E-ASPECTS has demonstrated a good correlation compared to assessments by neuroradiologists, stroke neurologists, and residents in neurology, but current analyses have been performed only in high-income countries. The rapid evaluation of non-contrast-enhanced computed tomography (NCCT) brain scans in patients with anterior stroke symptoms saves time and favors optimal and prompt treatment. E-ASPECTS is a tool that automatically calculates the Alberta Stroke Program Early CT Score (ASPECTS) values, leading to a more accurate and timely image evaluation. ASPECTS evaluation was performed by three neuroradiologists, three neurologists, and three neurology residents, all blinded to the symptoms and the injury side. Conclusion: e-ASPECTS is a validated and reliable tool for determining early signs of ischemia in NCCT
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