Validation of automated Alberta Stroke Program Early CT Score (ASPECTS) software for detection of early ischemic changes on non-contrast brain CT scans.

Purpose: In ASPECTS, 10 brain regions are scored visually for presence of acute ischemic stroke damage. We evaluated automated ASPECTS in comparison to expert readers. Methods: Consecutive, baseline non-contrast CT-scans (5-mm slice thickness) from the prospective MR CLEAN trial (n = 459, MR CLEAN N...

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Publicado en:Neuroradiology Vol. 63; no. 4; pp. 491 - 499
Autores principales: Wolff, Lennard, Berkhemer, Olvert A., van Es, Adriaan C. G. M., van Zwam, Wim H., Dippel, Diederik W. J., Majoie, Charles B. L. M., van Walsum, Theo, van der Lugt, Aad
Formato: research tables/charts Journal Article
Publicado: Springer Nature Apr2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2021
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-020-02533-6
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        atl: Validation of automated Alberta Stroke Program Early CT Score (ASPECTS) software for detection of early ischemic changes on non-contrast brain CT scans.
      aug:
        au:
          Wolff, Lennard
          Berkhemer, Olvert A.
          van Es, Adriaan C. G. M.
          van Zwam, Wim H.
          Dippel, Diederik W. J.
          Majoie, Charles B. L. M.
          van Walsum, Theo
          van der Lugt, Aad
        affil: Department of Radiology & Nuclear Medicine, Erasmus MC, P. van Andel & L. Wolff, room Ne-515, Postbus 2040, 3000, Rotterdam, CA, the Netherlands
      sug:
        subj:
          Software Design Evaluation
          Brain Radiography
          Cerebral Ischemia Physiopathology
          Tomography, X-Ray Computed
          Ischemic Stroke
          Instrument Validation
          Clinical Assessment Tools
          Human
          Female
          Male
          Validation Studies
          Consensus
          Sensitivity and Specificity
          ROC Curve
          Intraclass Correlation Coefficient
          Descriptive Statistics
          Image Processing, Computer Assisted
          Female
          Male
      ab: Purpose: In ASPECTS, 10 brain regions are scored visually for presence of acute ischemic stroke damage. We evaluated automated ASPECTS in comparison to expert readers. Methods: Consecutive, baseline non-contrast CT-scans (5-mm slice thickness) from the prospective MR CLEAN trial (n = 459, MR CLEAN Netherlands Trial Registry number: NTR1804) were evaluated. A two-observer consensus for ASPECTS regions (normal/abnormal) was used as reference standard for training and testing (0.2/0.8 division). Two other observers provided individual ASPECTS-region scores. The Automated ASPECTS software was applied. A region score specificity of ≥ 90% was used to determine the software threshold for detection of an affected region based on relative density difference between affected and contralateral region. Sensitivity, specificity, and receiver-operating characteristic curves were calculated. Additionally, we assessed intraclass correlation coefficients (ICCs) for automated ASPECTS and observers in comparison to the reference standard in the test set. Results: In the training set (n = 104), with software thresholds for a specificity of ≥ 90%, we found a sensitivity of 33–49% and an area under the curve (AUC) of 0.741–0.785 for detection of an affected ASPECTS region. In the test set (n = 355), the results for the found software thresholds were 89–89% (specificity), 41–57% (sensitivity), and 0.750–0.795 (AUC). Comparison of automated ASPECTS with the reference standard resulted in an ICC of 0.526. Comparison of observers with the reference standard resulted in an ICC of 0.383–0.464. Conclusion: The performance of automated ASPECTS is comparable to expert readers and could support readers in the detection of early ischemic changes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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