e-ASPECTS software is non-inferior to neuroradiologists in applying the ASPECT score to computed tomography scans of acute ischemic stroke patients
BackgroundThe Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is an established 10-point quantitative topographic computed tomography scan score to assess early ischemic changes. We performed a non-inferiority trial between the e-ASPECTS software and neuroradiologists in scoring ASP...
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| Main Author: | |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2017
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| In: |
International journal of stroke
Year: 2016, Volume: 12, Issue: 6, Pages: 615-622 |
| ISSN: | 1747-4949 |
| DOI: | 10.1177/1747493016681020 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1177/1747493016681020 Verlag, Volltext: https://doi.org/10.1177/1747493016681020 
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| Author Notes: | Simon Nagel, Devesh Sinha, Diana Day, Wolfgang Reith, René Chapot, Panagiotis Papanagiotou, Elizabeth A Warburton, Paul Guyler, Sharon Tysoe, Klaus Fassbender, Silke Walter, Marco Essig, Jens Heidenrich, Angelos A Konstas, Michael Harrison, Michalis Papadakis, Eric Greveson, Olivier Joly, Stephen Gerry, Holly Maguire, Christine Roffe, James Hampton-Till, Alastair M Buchan and Iris Q Grunwald |
| Summary: | BackgroundThe Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is an established 10-point quantitative topographic computed tomography scan score to assess early ischemic changes. We performed a non-inferiority trial between the e-ASPECTS software and neuroradiologists in scoring ASPECTS on non-contrast enhanced computed tomography images of acute ischemic stroke patients.MethodsIn this multicenter study, e-ASPECTS and three independent neuroradiologists retrospectively and blindly assessed baseline non-contrast enhanced computed tomography images of 132 patients with acute anterior circulation ischemic stroke. Follow-up scans served as ground truth to determine the definite area of infarction. Sensitivity, specificity, and accuracy for region- and score-based analysis, receiver-operating characteristic curves, Bland-Altman plots and Matthews correlation coefficients relative to the ground truth were calculated and comparisons were made between neuroradiologists and different pre-specified e-ASPECTS operating points. The non-inferiority margin was set to 10% for both sensitivity and specificity on region-based analysis.ResultsIn total 2640 (132 patients???20 regions per patient) ASPECTS regions were scored. Mean time from onset to baseline computed tomography was 146?±?124?min and median NIH Stroke Scale (NIHSS) was 11 (6?17, interquartile range). Median ASPECTS for ground truth on follow-up imaging was 8 (6.5?9, interquartile range). In the region-based analysis, two e-ASPECTS operating points (sensitivity, specificity, and accuracy of 44%, 93%, 87% and 44%, 91%, 85%) were statistically non-inferior to all three neuroradiologists (all p-values <0.003). Both Matthews correlation coefficients for e-ASPECTS were higher (0.36 and 0.34) than those of all neuroradiologists (0.32, 0.31, and 0.3).Conclusionse-ASPECTS was non-inferior to three neuroradiologists in scoring ASPECTS on non-contrast enhanced computed tomography images of acute stroke patients. |
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| Item Description: | First published: December 1, 2016 Gesehen am 04.09.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1747-4949 |
| DOI: | 10.1177/1747493016681020 |