Automated ASPECTS for multi-modality CT predict infarct extent and outcome in large-vessel occlusion stroke

•CTA-venous-ASPECTS is a reliable tool to predict the infarct extent and outcome.•CTA-venous-ASPECTS facilitates treatment decisions after large vessel occlusion.•Best sensitivity of mismatch-ASPECTS to predict good outcomes after treatment. This study aimed to use the automated Alberta Stroke Progr...

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Veröffentlicht in:European journal of radiology 2021-10, Vol.143, p.109899-109899, Article 109899
Hauptverfasser: Cheng, XiaoQing, Shi, JiaQian, Wu, Hang, Dong, Zheng, Liu, Jia, Lu, MengJie, Zhou, ChangSheng, Liu, QuanHui, Su, XiaoQin, Shi, Zhao, Li, YingLe, Zhu, WuSheng, Lu, GuangMing
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container_title European journal of radiology
container_volume 143
creator Cheng, XiaoQing
Shi, JiaQian
Wu, Hang
Dong, Zheng
Liu, Jia
Lu, MengJie
Zhou, ChangSheng
Liu, QuanHui
Su, XiaoQin
Shi, Zhao
Li, YingLe
Zhu, WuSheng
Lu, GuangMing
description •CTA-venous-ASPECTS is a reliable tool to predict the infarct extent and outcome.•CTA-venous-ASPECTS facilitates treatment decisions after large vessel occlusion.•Best sensitivity of mismatch-ASPECTS to predict good outcomes after treatment. This study aimed to use the automated Alberta Stroke Program Early CT Score (ASPECTS) software to assess the value of different CT modalities (non-contrast CT, CT angiography [CTA]-arterial, CTA-venous, and arterial- and venous-phase mismatch-ASPECTS) in predicting the final infarct extent and clinical outcome in large-vessel occlusion stroke. This retrospective study included patients with large-vessel occlusion stroke who underwent reperfusion therapy during 2015 to 2019. Correlations between different CT-ASPECTS modalities and follow-up CT-ASPECTS and outcome were determined using Spearman rank correlation coefficient. Receiver operating characteristic curve analysis was used to assess the ability of different CT-ASPECTS modalities to identify patients with good outcomes. One hundred and thirty-five patients were included. We found almost-perfect correlation between CTA-venous-ASPECTS and follow-up CT-ASPECTS (r = 0.92; 95% CI: 0.89–0.95), better than that in other CT modalities. The 90-day modified Rankin scale (mRS) score substantially correlated with CTA-venous-ASPECTS (r = -0.64; 95% CI: −0.73 to −0.52). The ROC curve analysis showed CTA-venous-ASPECTS had the highest area under the curve (AUC: 0.82; 95% CI: 0.75–0.89; P 
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This study aimed to use the automated Alberta Stroke Program Early CT Score (ASPECTS) software to assess the value of different CT modalities (non-contrast CT, CT angiography [CTA]-arterial, CTA-venous, and arterial- and venous-phase mismatch-ASPECTS) in predicting the final infarct extent and clinical outcome in large-vessel occlusion stroke. This retrospective study included patients with large-vessel occlusion stroke who underwent reperfusion therapy during 2015 to 2019. Correlations between different CT-ASPECTS modalities and follow-up CT-ASPECTS and outcome were determined using Spearman rank correlation coefficient. Receiver operating characteristic curve analysis was used to assess the ability of different CT-ASPECTS modalities to identify patients with good outcomes. One hundred and thirty-five patients were included. We found almost-perfect correlation between CTA-venous-ASPECTS and follow-up CT-ASPECTS (r = 0.92; 95% CI: 0.89–0.95), better than that in other CT modalities. The 90-day modified Rankin scale (mRS) score substantially correlated with CTA-venous-ASPECTS (r = -0.64; 95% CI: −0.73 to −0.52). The ROC curve analysis showed CTA-venous-ASPECTS had the highest area under the curve (AUC: 0.82; 95% CI: 0.75–0.89; P &lt; 0.001), followed by mismatch-ASPECTS (AUC: 0.75; 95% CI: 0.65–0.85; P &lt; 0.001). When emphasizing the sensitivity for identifying patients with good outcomes, the best cut-off point of mismatch-ASPECTS was −3 with the highest sensitivity (91.30%). CTA-venous-ASPECTS is a reliable tool to predict the infarct extent and outcome. Furthermore, mismatch-ASPECTS may represent images in different angiographic phases and was sensitive for prognosis prediction.</description><identifier>ISSN: 0720-048X</identifier><identifier>EISSN: 1872-7727</identifier><identifier>DOI: 10.1016/j.ejrad.2021.109899</identifier><language>eng</language><publisher>Elsevier B.V</publisher><subject>Angiography ; Artificial intelligence ; Computed tomography ; Middle cerebral artery occlusion ; Stroke</subject><ispartof>European journal of radiology, 2021-10, Vol.143, p.109899-109899, Article 109899</ispartof><rights>2021 Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c336t-8f3817b430df7572066aab7d13a134d1a2ec7e8d0f9bb6f2d1873635f23653923</citedby><cites>FETCH-LOGICAL-c336t-8f3817b430df7572066aab7d13a134d1a2ec7e8d0f9bb6f2d1873635f23653923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejrad.2021.109899$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids></links><search><creatorcontrib>Cheng, XiaoQing</creatorcontrib><creatorcontrib>Shi, JiaQian</creatorcontrib><creatorcontrib>Wu, Hang</creatorcontrib><creatorcontrib>Dong, Zheng</creatorcontrib><creatorcontrib>Liu, Jia</creatorcontrib><creatorcontrib>Lu, MengJie</creatorcontrib><creatorcontrib>Zhou, ChangSheng</creatorcontrib><creatorcontrib>Liu, QuanHui</creatorcontrib><creatorcontrib>Su, XiaoQin</creatorcontrib><creatorcontrib>Shi, Zhao</creatorcontrib><creatorcontrib>Li, YingLe</creatorcontrib><creatorcontrib>Zhu, WuSheng</creatorcontrib><creatorcontrib>Lu, GuangMing</creatorcontrib><title>Automated ASPECTS for multi-modality CT predict infarct extent and outcome in large-vessel occlusion stroke</title><title>European journal of radiology</title><description>•CTA-venous-ASPECTS is a reliable tool to predict the infarct extent and outcome.•CTA-venous-ASPECTS facilitates treatment decisions after large vessel occlusion.•Best sensitivity of mismatch-ASPECTS to predict good outcomes after treatment. This study aimed to use the automated Alberta Stroke Program Early CT Score (ASPECTS) software to assess the value of different CT modalities (non-contrast CT, CT angiography [CTA]-arterial, CTA-venous, and arterial- and venous-phase mismatch-ASPECTS) in predicting the final infarct extent and clinical outcome in large-vessel occlusion stroke. This retrospective study included patients with large-vessel occlusion stroke who underwent reperfusion therapy during 2015 to 2019. Correlations between different CT-ASPECTS modalities and follow-up CT-ASPECTS and outcome were determined using Spearman rank correlation coefficient. Receiver operating characteristic curve analysis was used to assess the ability of different CT-ASPECTS modalities to identify patients with good outcomes. One hundred and thirty-five patients were included. We found almost-perfect correlation between CTA-venous-ASPECTS and follow-up CT-ASPECTS (r = 0.92; 95% CI: 0.89–0.95), better than that in other CT modalities. The 90-day modified Rankin scale (mRS) score substantially correlated with CTA-venous-ASPECTS (r = -0.64; 95% CI: −0.73 to −0.52). The ROC curve analysis showed CTA-venous-ASPECTS had the highest area under the curve (AUC: 0.82; 95% CI: 0.75–0.89; P &lt; 0.001), followed by mismatch-ASPECTS (AUC: 0.75; 95% CI: 0.65–0.85; P &lt; 0.001). When emphasizing the sensitivity for identifying patients with good outcomes, the best cut-off point of mismatch-ASPECTS was −3 with the highest sensitivity (91.30%). CTA-venous-ASPECTS is a reliable tool to predict the infarct extent and outcome. 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This study aimed to use the automated Alberta Stroke Program Early CT Score (ASPECTS) software to assess the value of different CT modalities (non-contrast CT, CT angiography [CTA]-arterial, CTA-venous, and arterial- and venous-phase mismatch-ASPECTS) in predicting the final infarct extent and clinical outcome in large-vessel occlusion stroke. This retrospective study included patients with large-vessel occlusion stroke who underwent reperfusion therapy during 2015 to 2019. Correlations between different CT-ASPECTS modalities and follow-up CT-ASPECTS and outcome were determined using Spearman rank correlation coefficient. Receiver operating characteristic curve analysis was used to assess the ability of different CT-ASPECTS modalities to identify patients with good outcomes. One hundred and thirty-five patients were included. We found almost-perfect correlation between CTA-venous-ASPECTS and follow-up CT-ASPECTS (r = 0.92; 95% CI: 0.89–0.95), better than that in other CT modalities. The 90-day modified Rankin scale (mRS) score substantially correlated with CTA-venous-ASPECTS (r = -0.64; 95% CI: −0.73 to −0.52). The ROC curve analysis showed CTA-venous-ASPECTS had the highest area under the curve (AUC: 0.82; 95% CI: 0.75–0.89; P &lt; 0.001), followed by mismatch-ASPECTS (AUC: 0.75; 95% CI: 0.65–0.85; P &lt; 0.001). When emphasizing the sensitivity for identifying patients with good outcomes, the best cut-off point of mismatch-ASPECTS was −3 with the highest sensitivity (91.30%). CTA-venous-ASPECTS is a reliable tool to predict the infarct extent and outcome. Furthermore, mismatch-ASPECTS may represent images in different angiographic phases and was sensitive for prognosis prediction.</abstract><pub>Elsevier B.V</pub><doi>10.1016/j.ejrad.2021.109899</doi><tpages>1</tpages></addata></record>
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subjects Angiography
Artificial intelligence
Computed tomography
Middle cerebral artery occlusion
Stroke
title Automated ASPECTS for multi-modality CT predict infarct extent and outcome in large-vessel occlusion stroke
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