Ruling Out Brain CT Contraindications prior to Intravenous Thrombolysis: Diagnostic Equivalence between a Primary...

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Telestroke services rely on accurate and timely interpretation of brain CT scans.
• Diagnostic workstations are standard, but mobile tablet use is increasing.

Purpose of the Study:

• To evaluate the diagnostic equivalence of brain CT interpretations between a diagnostic workstation and a mobile tablet in a telestroke setting.

Main Methods:

• Retrospective analysis of 1452 brain CT interpretations using a factorial design.
• Assessed variables included stroke classification, tPA contraindications, hyperdense intracranial artery sign (HMCA), and Alberta Stroke Program Early CT Score (ASPECTS).

Main Results:

• No statistically significant difference in lesion distribution between reading systems.
• Equivalence demonstrated for hemorrhagic lesions (1.6%), no lesion cases (4.5%), and overall ischemic lesions (5.2%).
• Equivalence achieved for ASPECTS ≤ 6 (2.1%), tPA contraindications (6.5%), and HMCA (7.2%).

Conclusions:

• Diagnostic performance for acute stroke detection is comparable between tablet computers and diagnostic workstations.
• Mobile tablets are a viable tool for telestroke interpretation, ensuring diagnostic accuracy.