ArticleEuropean radiology2020
Detection of emergent large vessel occlusion stroke with CT angiography is high across all levels of radiology training and grayscale viewing methods.
Article in European radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 16 citations in OpenAlex.
- CT perfusion enhances accuracy of intracranial occlusion detection in acute stroke: effect of specialty and experience level.Neuroradiology · 2025Article
- Perfusion patterns as a tool for emergency stroke diagnosis: differentiating proximal and distal MCA occlusions.BMJ neurology open · 2025Article
- Diagnostic accuracy of large and medium vessel occlusions in acute stroke imaging by neurology residents and stroke fellows: A comparison of CT angiography alone and CT angiography with CT perfusion.European stroke journal · 2024Article
- Value of CT-based radiomics in evaluating the response of bone metastases to systemic drug therapy in breast cancer patients.Thoracic cancer · 2024Article
- Automated detection of intracranial large vessel occlusions using Viz.ai software: Experience in a large, integrated stroke network.Brain and behavior · 2023Article
- Diagnostic performance of an algorithm for automated large vessel occlusion detection on CT angiography.Journal of neurointerventional surgery · 2022Article
- Accuracy of CTA evaluations in daily clinical practice for large and medium vessel occlusion detection in suspected stroke patients.European stroke journal · 2021Article
- Effects of multiphase versus single-phase CT angiography for the detection of distal cerebral vessel occlusion.Emergency radiology · 2021Article
- Comparison of Prehospital Scales for Predicting Large Anterior Vessel Occlusion in the Ambulance Setting.JAMA neurology · 2021Observational
- Emerging Detection Techniques for Large Vessel Occlusion Stroke: A Scoping Review.Frontiers in neurology · 2021Article
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Authors and funding
12 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesCT angiography (CTA) is essential in acute stroke to detect emergent large vessel occlusions (ELVO) and must be interpreted by radiologists with and without subspecialized training. Additionally, grayscale inversion has been suggested to improve diagnostic accuracy in other radiology applications. This study examines diagnostic performance in ELVO detection between neuroradiologists, non-neuroradiologists, and radiology residents using standard and grayscale inversion viewing methods.
methodsA random, counterbalanced experimental design was used, where 18 radiologists with varying experiences interpreted the same patient images with and without grayscale inversion. Confirmed positive and negative ELVO cases were randomly ordered using a balanced design. Sensitivity, specificity, positive and negative predictive values as well as confidence, subjective assessment of image quality, time to ELVO detection, and overall interpretation time were examined between grayscale inversion (on/off) by experience level using generalized mixed modeling assuming a binary, negative binomial, and binomial distributions, respectively.
resultsAll groups of radiologists had high sensitivity and specificity for ELVO detection (all > .94). Neuroradiologists were faster than non-neuroradiologists and residents in interpretation time, with a mean of 47 s to detect ELVO, as compared with 59 and 74 s, respectively. Residents were subjectively less confident than attending physicians. With respect to grayscale inversion, no differences were observed between groups with grayscale inversion vs. standard viewing for diagnostic performance (p = 0.30), detection time (p = .45), overall interpretation time (p = .97), and confidence (p = .20).
conclusionsDiagnostic performance in ELVO detection with CTA was high across all levels of radiologist training level. Grayscale inversion offered no significant detection advantage. KEY POINTS: • Stroke is an acute vascular syndrome that requires acute vascular imaging. • Proximal large vessel occlusions can be identified quickly and accurately by radiologists across all training levels. • Grayscale inversion demonstrated minimal detectable benefit in the detection of proximal large vessel occlusions.
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