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Reliability of the ABC/2 method in determining acute infarct volume
Salvador Pedraza1, Josep Puig, Gerard Blasco
1Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Universitat de Girona, Girona, Spain. sapedraza@gmail.com
Summary
The ABC/2 method for measuring acute infarct volume in stroke trials consistently overestimates actual size. While accurate and reproducible, its clinical use requires careful consideration of this overestimation.
Area of Science:
- Neuroimaging
- Stroke Research
- Medical Technology Assessment
Background:
- Infarct volume is a critical surrogate outcome in acute ischemic stroke clinical trials.
- The ABC/2 method offers a rapid volumetric assessment but requires validation for accuracy.
- Diffusion-weighted imaging (DWI) is a key modality for acute stroke assessment.
Purpose of the Study:
- To evaluate the accuracy and reproducibility of the ABC/2 volumetric method.
- To compare ABC/2 measurements against a manual planimetric method in acute ischemic stroke patients.
- To determine the reliability of ABC/2 in DWI-based infarct volume estimation.
Main Methods:
- Study included 86 consecutive patients diagnosed with acute ischemic stroke.
- Three independent, blinded observers applied the ABC/2 method for volume determination.
- Results from ABC/2 were compared with a gold standard manual planimetric technique.
Main Results:
- The ABC/2 technique demonstrated excellent interrater reliability (intraclass correlation coefficients of .992).
- ABC/2 consistently overestimated infarct volume, with a median false increase of 7.33 cm³ (162.56%).
- The manual planimetric method also showed high interrater reliability (.985).
Conclusions:
- The ABC/2 method is a clinically valuable tool for estimating infarct volume in acute ischemic stroke.
- Despite its utility, ABC/2 systematically overestimates the true infarct volume.
- Further research may be needed to adjust for the overestimation bias of the ABC/2 method.
