Evidence map›Paper›PMID 34709408›Full record

ArticleClinical neuroradiology2022

Accuracy and Prognostic Role of NCCT-ASPECTS Depend on Time from Acute Stroke Symptom-onset for both Human and Machine-learning Based Evaluation.

A Potreck, C S Weyland, F Seker, U Neuberger, C Herweh, A Hoffmann, S Nagel, M Bendszus, M A Mutke

Erratum issuedOpen access · hybridAbstract read
In one paragraph

Article in Clinical neuroradiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

A PotreckDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
C S WeylandDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
F SekerDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
U NeubergerDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
C HerwehDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
A HoffmannDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
S NagelDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
M BendszusDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
M A MutkeDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany. Matthias.Mutke@med.uni-heidelberg.de.
University Hospital Heidelberg · DEHeidelberg University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe hypothesize that the detectability of early ischemic changes on non-contrast computed tomography (NCCT) is limited in hyperacute stroke for both human and machine-learning based evaluation. In short onset-time-to-imaging (OTI), the CT angiography collateral status may identify fast stroke progressors better than early ischemic changes quantified by ASPECTS.

methodsIn this retrospective, monocenter study, CT angiography collaterals (Tan score) and ASPECTS on acute and follow-up NCCT were evaluated by two raters. Additionally, a machine-learning algorithm evaluated the ASPECTS scale on the NCCT (e-ASPECTS). In this study 136 patients from 03/2015 to 12/2019 with occlusion of the main segment of the middle cerebral artery, with a defined symptom-onset-time and successful mechanical thrombectomy (MT) (modified treatment in cerebral infarction score mTICI = 2c or 3) were evaluated.

resultsAgreement between acute and follow-up ASPECTS were found to depend on OTI for both human (Intraclass correlation coefficient, ICC = 0.43 for OTI < 100 min, ICC = 0.57 for OTI 100-200 min, ICC = 0.81 for OTI ≥ 200 min) and machine-learning based ASPECTS evaluation (ICC = 0.24 for OTI < 100 min, ICC = 0.61 for OTI 100-200 min, ICC = 0.63 for OTI ≥ 200 min). The same applied to the interrater reliability. Collaterals were predictors of a favorable clinical outcome especially in hyperacute stroke with OTI < 100 min (collaterals: OR = 5.67 CI = 2.38-17.8, p < 0.001; ASPECTS: OR = 1.44, CI = 0.91-2.65, p = 0.15) while ASPECTS was in prolonged OTI ≥ 200 min (collaterals OR = 4.21,CI = 1.36-21.9, p = 0.03; ASPECTS: OR = 2.85, CI = 1.46-7.46, p = 0.01).

conclusionThe accuracy and reliability of NCCT-ASPECTS are time dependent for both human and machine-learning based evaluation, indicating reduced detectability of fast stroke progressors by NCCT. In hyperacute stroke, collateral status from CT-angiography may help for a better prognosis on clinical outcome and explain the occurrence of futile recanalization.

Indexed as

Brain IschemiaStrokeCerebral AngiographyComputed Tomography AngiographyHumansMachine LearningPrognosisReproducibility of ResultsRetrospective StudiesTomography, X-Ray ComputedBrainComputed tomographyCT angiographyStrokeThrombectomy

Identifiers

PMID34709408
PMCPMC8894298
OpenAlexW3211203936

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.