ArticleAJNR. American journal of neuroradiology2022
Interrater Agreement and Detection Accuracy for Medium-Vessel Occlusions Using Single-Phase and Multiphase CT Angiography.
Article in AJNR. American journal of neuroradiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- European Stroke Organisation (ESO) guidelines on Primary Angiitis of the Central Nervous System (PACNS).European stroke journal · 2023Guideline
- Angiographic Systems for Classifying Distal Arterial Occlusions.Cerebrovascular diseases (Basel, Switzerland) · 2023Pooled it
- (Holo-PACS): use of holograms to improve provider acumen when reading clinical radiographic scans.Neurological research · 2026Article
- A Comparative Study of CT Perfusion Postprocessing Tools in Medium/Distal Vessel Occlusion Stroke.AJNR. American journal of neuroradiology · 2025Article
- CT perfusion enhances accuracy of intracranial occlusion detection in acute stroke: effect of specialty and experience level.Neuroradiology · 2025Article
- (Holo-Stroke-CTA): Stroke Hologram Teleportation for CTA Large Vessel Occlusion Assessments.Stroke (Hoboken, N.J.) · 2025Article
- Utility of automated CT perfusion software in acute ischemic stroke with large and medium vessel occlusion.Annals of clinical and translational neurology · 2024Article
- 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
- Development of machine learning models for predicting outcome in patients with distal medium vessel occlusions: a retrospective study.Quantitative imaging in medicine and surgery · 2023Article
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Authors and funding
8 authors at 4 institutions in 5 countries.
Funding
Abstract
background and purposeAccurate and reliable detection of medium-vessel occlusions is important to establish the diagnosis of acute ischemic stroke and initiate appropriate treatment with intravenous thrombolysis or endovascular thrombectomy. However, medium-vessel occlusions are often challenging to detect, especially for unexperienced readers. We aimed to evaluate the accuracy and interrater agreement of the detection of medium-vessel occlusions using single-phase and multiphase CTA. MATERIALS AND
methodsSingle-phase and multiphase CTA of 120 patients with acute ischemic stroke (20 with no occlusion, 44 with large-vessel occlusion, and 56 with medium-vessel occlusion in the anterior and posterior circulation) were assessed by 3 readers with varying levels of experience (session 1: single-phase CTA; session 2: multiphase CTA). Interrater agreement for occlusion type (large-vessel occlusion versus medium-vessel occlusion versus no occlusion) and for detailed occlusion sites was calculated using the Fleiss κ with 95% confidence intervals. Accuracy for the detection of medium-vessel occlusions was calculated for each reader using classification tables.
resultsInterrater agreement for occlusion type was moderate for single-phase CTA (κ = 0.58; 95% CI, 0.56-0.62) and almost perfect for multiphase CTA (κ = 0.81; 95% CI, 0.78-0.83). Interrater agreement for detailed occlusion sites was moderate for single-phase CTA (κ = 0.55; 95% CI, 0.53-0.56) and substantial for multiphase CTA (κ = 0.71; 95% CI, 0.67-0.74). On single-phase CTA, readers 1, 2, and 3 classified 33/56 (59%), 34/56 (61%), and 32/56 (57%) correctly as medium-vessel occlusions. On multiphase CTA, 48/56 (86%), 50/56 (89%), and 50/56 (89%) medium-vessel occlusions were classified correctly.
conclusionsInterrater agreement for medium-vessel occlusions is moderate when using single-phase CTA and almost perfect with multiphase CTA. Detection accuracy is substantially higher with multiphase CTA compared with single-phase CTA, suggesting that multiphase CTA might be a valuable tool for assessment of medium-vessel occlusion stroke.
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