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Performance of Automated ASPECTS Software and Value as a Computer-Aided Detection Tool.

J Lambert1,2,3, J Demeestere4,5, B Dewachter6,2

  • 1From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.) julie.lambert@uzleuven.be.

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Summary
This summary is machine-generated.

Automated ASPECTS software improves interrater agreement for early ischemic changes in stroke patients undergoing thrombectomy. This computer-aided detection enhances scoring consistency in clinical practice.

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Area of Science:

  • Neuroradiology
  • Stroke Imaging
  • Quantitative Analysis

Background:

  • The Alberta Stroke Program Early CT Score (ASPECTS) assesses early ischemic changes on non-contrast CT (NCCT) in anterior circulation stroke.
  • Interrater variability in conventional ASPECTS scoring can impact clinical decision-making, particularly for thrombectomy eligibility.

Purpose of the Study:

  • To evaluate the agreement of automated ASPECTS software compared to conventional scoring by multiple raters.
  • To assess the impact of computer-aided detection on improving scoring accuracy and consistency in acute ischemic stroke.

Main Methods:

  • Retrospective analysis of NCCT scans from 175 acute ischemic stroke patients with large-vessel occlusion undergoing thrombectomy.
  • Five raters independently scored conventional ASPECTS; automated ASPECTS was generated using RAPID software.
  • Agreement was assessed against a criterion standard, both for full ASPECTS and dichotomized scores (0-5 vs. 6-10) relevant to thrombectomy guidelines.

Main Results:

  • Automated ASPECTS showed moderate agreement (weighted κ = 0.59) with the criterion standard, comparable to individual raters.
  • Software assistance significantly improved both individual rater agreement with the criterion standard and interrater agreement (Fleiss κ increased).
  • Improved agreement was observed for both full and dichotomized ASPECTS scoring when using automated outputs.

Conclusions:

  • Automated ASPECTS provides a level of agreement with the criterion standard similar to conventional scoring.
  • Integrating automated ASPECTS into the NCCT evaluation process enhances agreement and reduces interrater variability.
  • This computer-aided approach holds potential for more standardized and reliable ASPECTS scoring in acute stroke management.