ArticleNeuroradiology2026
Visual versus automated collateral scoring on CT angiography for predicting outcome after endovascular therapy for large-vessel occlusion stroke: a prospective multicentre study.
Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeCollateral circulation (CC) is a key determinant of tissue viability and clinical outcome in large-vessel occlusion (LVO) stroke. Whether automated collateral scoring on single-phase CT angiography (sCTA) provides prognostic information comparable to traditional visual assessment remains uncertain. This study aimed to compare the predictive performance of visual versus automated collateral evaluation for functional outcome after endovascular therapy (EVT).
methodsWe conducted a prospective multicentre cohort study including consecutive patients with anterior circulation LVO treated with EVT between 2020 and 2022. Collateral status on baseline sCTA was graded visually (Tan and ASITN/SIR scores) and automatically using Brainomix
resultsA total of 332 patients (mean age 72.6 ± 12.7 years; 48.5% female) were analysed. Good collateral status was independently associated with favourable outcome for both visual (Tan aOR 2.41, 95% CI 1.09-5.30; p = 0.029) and automated (aOR 2.45, 95% CI 1.11-5.24; p = 0.027) methods. Predictive performance was nearly identical (0.865 for visual and 0.867 for automated assessment; p = 0.777). Good collaterals were also associated with lower mortality and lower risk of symptomatic intracerebral haemorrhage.
conclusionAutomated collateral scoring on baseline sCTA achieves equivalent predictive performance to expert visual assessment for functional outcome after EVT. Their added consistency and reproducibility support the integration of automated methods to standardise collateral evaluation across centres, particularly where immediate expert neuroradiological assessment is not available.
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