ArticleClinical neuroradiology2023
Location-specific ASPECTS does not improve Outcome Prediction in Large Vessel Occlusion compared to Cumulative ASPECTS.
Article in Clinical neuroradiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Role of high-density area score in predicting outcomes of large-vessel occlusion stroke after endovascular treatment.European radiology · 2026Article
- Neuroimaging-clinical phenotypes are associated with functional outcomes in acute ischemic stroke: a latent class analysis of multidimensional biomarkers.Neuroradiology · 2026Article
- Relationship of ASPECTS Lesion Topography with Clinical Outcomes in Acute Ischemic Stroke Treated with Endovascular Thrombectomy: A Single-Center Cohort Study.Diagnostics (Basel, Switzerland) · 2026Article
- Location-Specific Net Water Uptake and Malignant Cerebral Edema in Acute Anterior Circulation Occlusion Ischemic Stroke.AJNR. American journal of neuroradiology · 2025Article
- Association of clinical outcome and imaging endpoints in extensive ischemic stroke-comparing measures of cerebral edema.European radiology · 2024Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIndividual regions of the Alberta Stroke Programme Early CT Score (ASPECTS) may contribute differently to the clinical symptoms in large vessel occlusion (LVO). Here, we investigated whether the predictive performance on clinical outcome can be increased by considering specific ASPECTS subregions.
methodsA consecutive series of patients with LVO affecting the middle cerebral artery territory and subsequent endovascular treatment (EVT) between January 2015 and July 2020 was analyzed, including affected ASPECTS regions. A multivariate logistic regression was performed to assess the individual impact of ASPECTS regions on good clinical outcome (defined as modified Rankin scale after 90 days of 0-2). Machine-learning-driven logistic regression models were trained (training = 70%, testing = 30%) to predict good clinical outcome using i) cumulative ASPECTS and ii) location-specific ASPECTS, and their performance compared using deLong's test. Furthermore, additional analyses using binarized as well as linear clinical outcomes using regression and machine-learning techniques were applied to thoroughly assess the potential predictive properties of individual ASPECTS regions and their combinations.
resultsOf 1109 patients (77.3 years ± 11.6, 43.8% male), 419 achieved a good clinical outcome and a median NIHSS after 24 h of 12 (interquartile range, IQR 4-21). Individual ASPECTS regions showed different impact on good clinical outcome in the multivariate logistic regression, with strongest effects for insula (odds ratio, OR 0.56, 95% confidence interval, CI 0.42-0.75) and M5 (OR 0.53, 95% CI 0.29-0.97) regions. Accuracy (ACC) in predicting good clinical outcome of the test set did not differ between when considering i) cumulative ASPECTS and ii) location-specific ASPECTS (ACC = 0.619, 95% CI 0.58-0.64 vs. ACC = 0.629, 95% CI 0.60-0.65; p = 0.933).
conclusionCumulative ASPECTS assessment in LVO remains a stable and reliable predictor for clinical outcome and is not inferior to a weighted (location-specific) ASPECTS assessment.
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