The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialists
ABSTRACT Background: The rapid evaluation of non-contrast-enhanced computed tomography (NCCT) brain scans in patients with anterior stroke symptoms saves time and favors optimal and prompt treatment. e-ASPECTS is a tool that automatically calculates the Alberta Stroke Program Early CT Score (ASPEC...
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Thieme Revinter Publicações
2020-12-01
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| Series: | Arquivos de Neuro-Psiquiatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2020001200757&tlng=en |
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| author | Lucas Andrade FERRETI Cleverson Alex LEITAO Bernardo Corrêa de Almeida TEIXEIRA Francisco Diego Negrao LOPES NETO Viviane Flumignan ZÉTOLA Marcos Christiano LANGE |
| author_facet | Lucas Andrade FERRETI Cleverson Alex LEITAO Bernardo Corrêa de Almeida TEIXEIRA Francisco Diego Negrao LOPES NETO Viviane Flumignan ZÉTOLA Marcos Christiano LANGE |
| author_sort | Lucas Andrade FERRETI |
| collection | DOAJ |
| description | ABSTRACT Background: The rapid evaluation of non-contrast-enhanced computed tomography (NCCT) brain scans in patients with anterior stroke symptoms saves time and favors optimal and prompt treatment. e-ASPECTS is a tool that automatically calculates the Alberta Stroke Program Early CT Score (ASPECTS) values, leading to a more accurate and timely image evaluation. Objective: To determine the ability of e-ASPECTS in differentiating images with and without injury. Methods: One-hundred sixteen patients admitted to a stroke unit in a Brazilian tertiary hospital underwent a CT scan at admission and at least one control brain imaging (NCCT or magnetic resonance imaging - MRI) 24 hours after admission. ASPECTS evaluation was performed by three neuroradiologists, three neurologists, and three neurology residents, all blinded to the symptoms and the injury side. The scores were compared to the ground truth, and an ASPECTS score was provided by two independent non blinded evaluators. Sensitivity and specificity were analyzed, and receiver operating characteristic curves, Bland-Altman plots with mean error score, and Matthews correlation coefficients (MCCs) were obtained for ASPECTS scores, assuming values equal to 10 for images without injury and values other than 10 for images with ischemic injury. Results: e-ASPECTS demonstrated similar performance to that of neuroradiologists and neurologists, with an area under the curve of 0.78 and an MCC value of 0.48 in the dichotomous analysis. The sensitivity and specificity of e-ASPECTS were 75% and 73%, respectively. Conclusion: e-ASPECTS is a validated and reliable tool for determining early signs of ischemia in NCCT. |
| format | Article |
| id | doaj-art-52324f18f17842d4af151e7ff312ca73 |
| institution | OA Journals |
| issn | 1678-4227 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | Thieme Revinter Publicações |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj-art-52324f18f17842d4af151e7ff312ca732025-08-20T01:56:24ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272020-12-01781275776110.1590/0004-282x20200072The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialistsLucas Andrade FERRETIhttps://orcid.org/0000-0002-6155-6286Cleverson Alex LEITAOhttps://orcid.org/0000-0003-0463-0643Bernardo Corrêa de Almeida TEIXEIRAhttps://orcid.org/0000-0003-4769-6562Francisco Diego Negrao LOPES NETOhttps://orcid.org/0000-0003-2094-5928Viviane Flumignan ZÉTOLAhttps://orcid.org/0000-0001-8464-9488Marcos Christiano LANGEhttps://orcid.org/0000-0002-0405-7157ABSTRACT Background: The rapid evaluation of non-contrast-enhanced computed tomography (NCCT) brain scans in patients with anterior stroke symptoms saves time and favors optimal and prompt treatment. e-ASPECTS is a tool that automatically calculates the Alberta Stroke Program Early CT Score (ASPECTS) values, leading to a more accurate and timely image evaluation. Objective: To determine the ability of e-ASPECTS in differentiating images with and without injury. Methods: One-hundred sixteen patients admitted to a stroke unit in a Brazilian tertiary hospital underwent a CT scan at admission and at least one control brain imaging (NCCT or magnetic resonance imaging - MRI) 24 hours after admission. ASPECTS evaluation was performed by three neuroradiologists, three neurologists, and three neurology residents, all blinded to the symptoms and the injury side. The scores were compared to the ground truth, and an ASPECTS score was provided by two independent non blinded evaluators. Sensitivity and specificity were analyzed, and receiver operating characteristic curves, Bland-Altman plots with mean error score, and Matthews correlation coefficients (MCCs) were obtained for ASPECTS scores, assuming values equal to 10 for images without injury and values other than 10 for images with ischemic injury. Results: e-ASPECTS demonstrated similar performance to that of neuroradiologists and neurologists, with an area under the curve of 0.78 and an MCC value of 0.48 in the dichotomous analysis. The sensitivity and specificity of e-ASPECTS were 75% and 73%, respectively. Conclusion: e-ASPECTS is a validated and reliable tool for determining early signs of ischemia in NCCT.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2020001200757&tlng=enStrokeInfarction, Anterior Cerebral ArteryTomography, X-Ray ComputedDiagnostic Imaging |
| spellingShingle | Lucas Andrade FERRETI Cleverson Alex LEITAO Bernardo Corrêa de Almeida TEIXEIRA Francisco Diego Negrao LOPES NETO Viviane Flumignan ZÉTOLA Marcos Christiano LANGE The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialists Arquivos de Neuro-Psiquiatria Stroke Infarction, Anterior Cerebral Artery Tomography, X-Ray Computed Diagnostic Imaging |
| title | The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialists |
| title_full | The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialists |
| title_fullStr | The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialists |
| title_full_unstemmed | The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialists |
| title_short | The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialists |
| title_sort | use of e aspects in acute stroke care validation of method performance compared to the performance of specialists |
| topic | Stroke Infarction, Anterior Cerebral Artery Tomography, X-Ray Computed Diagnostic Imaging |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2020001200757&tlng=en |
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