ArticleEuropean stroke journal2026
Validity of intracerebral haemorrhage volume assessment: comparison of fully automated segmentation analysis with manual ABC/2 and semi-automated measurement.
Article in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- The "brush sign": a novel and accessible CT marker for hematoma expansion in hypertensive intracerebral hemorrhage.Frontiers in neurologyArticle
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13 authors.
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Abstract
introductionIn patients with spontaneous Intracerebral haemorrhage (ICH), ICH volume is associated with neurological and functional outcome and it is an important factor in neurosurgical decision-making. This study aims to assess the agreement between automated ICH volume measurement, the ABC/2 method and semi-automatic segmentation. PATIENTS AND
methodsWe retrospectively collected data from 300 consecutive adult patients (November 2018-June 2023) with spontaneous, supratentorial ICH, with a symptom onset-to-CT time ≤ 24 hours. We measured ICH volumes with automated StrokeViewer software, the manual ABC/2 method and semi-automated Brainlab software (reference standard). We performed a Bland-Altman analysis to compare measurements, considering a deviation of 10% or less from the reference standard as clinically acceptable.
resultsThe median age was 69 years (IQR, 57-76), 124 (41.3%) were women and the median NIHSS was 18 (IQR, 11-23). Median ICH volume was 26.0 mL (IQR, 9.3-59.2) (Brainlab). StrokeViewer also segmented hyperdense structures other than ICH, but occasionally, it only segmented part of the ICH accurately. The mean absolute differences were 11.2 mL (limits of agreement [LoA] -34.3 to 56.7) between StrokeViewer and Brainlab, -0.42 mL (LoA -65.0 to 64.9) between StrokeViewer and ABC/2 and 10.1 mL (LoA -36.2 to 56.4) between ABC/2 and Brainlab.
conclusionThere is substantial disagreement between the 3 methods for the measurement of ICH volume. Considering a clinical limit of acceptance of 10% or less, neither StrokeViewer nor ABC/2 agreed with our reference standard. Therefore, StrokeViewer results should not be used for volume-based clinical decisions without visual confirmation of adequate segmentation.
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