e-ASPECTS Correlates with and Is Predictive of Outcome after Mechanical Thrombectomy

Area of Science:

• Neurology
• Medical Imaging
• Artificial Intelligence in Medicine

Background:

• Mechanical thrombectomy is a key treatment for acute ischemic stroke.
• Accurate assessment of early ischemic changes on CT is crucial for treatment decisions.
• The ASPECTS (Alberta Stroke Program Early CT Score) is a standard scoring system.

Purpose of the Study:

• To evaluate the correlation between automated ASPECTS (e-ASPECTS) scores and clinical outcomes.
• To determine if e-ASPECTS can predict functional outcome after mechanical thrombectomy.

Main Methods:

• Retrospective analysis of 220 patients with anterior circulation ischemic stroke treated with mechanical thrombectomy.
• Baseline CT scans were scored using both e-ASPECTS software and three expert raters.
• Correlation with functional outcome (modified Rankin Scale) at 3 months was assessed.

Main Results:

• e-ASPECTS demonstrated good inter-rater reliability with expert scores.
• Lower e-ASPECTS scores were significantly associated with unfavorable functional outcomes at 3 months.
• e-ASPECTS was an independent predictor of unfavorable outcomes, alongside factors like blood sugar and NIHSS.

Conclusions:

• The e-ASPECTS software provides a reliable and automated method for ASPECTS scoring.
• e-ASPECTS is a valuable tool for predicting functional outcomes in patients undergoing mechanical thrombectomy.
• Further research is warranted for patients with poor baseline scans (low e-ASPECTS).