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1. Automated Quantification of Stroke Damage on Brain Computed Tomography Scans: e-ASPECTS

Author

James Hampton-Till, Michael Harrison, Anna Luisa Kühn, Oliver Anderson, Devesh Sinha, Sharon Tysoe, Eric Greveson, Michalis Papadakis, and Iris Q. Grunwald

Subjects
Alberta Stroke Program Early CT Score (ASPECTS), automated, computed tomography, e-ASPECTS, ischaemic, Ischaemic stroke, patient selection, Neurology. Diseases of the nervous system, RC346-429
Abstract

Emergency radiological diagnosis of acute ischaemic stroke requires the accurate detection and appropriate interpretation of relevant imaging findings. Non-contrast computed tomography (CT) provides fast and low-cost assessment of the early signs of ischaemia and is the most widely used diagnostic modality for acute stroke. The Alberta Stroke Program Early CT Score (ASPECTS) is a quantitative and clinically validated method to measure the extent of ischaemic signs on brain CT scans. The CE-marked electronic-ASPECTS (e-ASPECTS) software automates the ASPECTS score. Anglia Ruskin Clinical Trials Unit (ARCTU) independently carried out a clinical investigation of the e-ASPECTS software, an automated scoring system which can be integrated into the diagnostic pathway of an acute ischaemic stroke patient, thereby assisting the physician with expert interpretation of the brain CT scan. Here we describe a literature review of the clinical importance of reliable assessment of early ischaemic signs on plain CT scans, and of technologies automating these processed scoring systems in ischaemic stroke on CT scans focusing on the e-ASPECTS software. To be suitable for critical appraisal in this evaluation, the published studies needed a sample size of a minimum of 10 cases. All randomised studies were screened and data deemed relevant to demonstration of performance of ASPECTS were appraised. The literature review focused on three domains: i) interpretation of brain CT scans of stroke patients, ii) the application of the ASPECTS score in ischaemic stroke, and iii) automation of brain CT analysis. Finally, the appraised references are discussed in the context of the clinical impact of e-ASPECTS and the expected performance, which will be independently evaluated by a non-inferiority study conducted by the ARCTU.

Published
2015

3. Contents Vol. 42, 2016

Author

Christopher Beynon, Hyeong-Joong Yi, Xia Zhang, Zeljka Calic, Christina Hamisch, Paul J.A.M. Brouwers, Serge Timsit, Martin Griebe, Jijun Shi, Yanlin Zhang, Timolaos Rizos, Ji-Sung Lee, Bernt Harald Helleberg, Jae Min Kim, Gert J. de Borst, Adnan I. Qureshi, Soo Joo Lee, Boris Krischek, Gerben J. J. Plas, Markus A Möhlenbruch, Angela C Webster, Paola Forti, Diogo C Haussen, Michael Kettner, Fayyaz Orfi, Paul J. Nederkoorn, Qiao Han, Chunfeng Liu, Joon-Tae Kim, Joan Montaner, Carlotta Barbara, John A Oostema, Daniela Niemann, Iris Q. Grunwald, Mohammad Rauf Afzal, Shoujiang You, Güliz Acker, Valérie Martin, Huihui Liu, Mark Stroick, Tetsuro Ago, Mathew J. Reeves, Matthijs C. Brouwer, Tai Hwan Park, Thorsten Steiner, Y.B.W.E.M. Roos, Min Uk Jang, Richard I. Lindley, Rainer Kollmar, Helmuth Steinmetz, Jun Lee, Yoshinobu Wakisaka, Tae-Hee Cho, Druckerei Stückle, Hee-Joon Bae, Nauman Jahangir, Yong Ko, Laura Mechtouff, Wei Xuan, Takanari Kitazono, Marco Zoli, Jan-Dirk Vermeij, Roland Veltkamp, Dennis Cordato, Nathan Mewton, Christophe Gaudin, Leticia C. Rebello, Gerrit Brinker, Laurent Suissa, Michael G. Hennerici, Peter Schmiedek, Fabiola Maioli, Peter J. Koudstaal, Matthias Manitz, Beom Joon Kim, Young-Chai Ko, Anne Huibers, Djurre de Waard, Marc Fatar, Klaus Fassbender, Christian Foerch, Umut Yilmaz, Ryu Matsuo, Ekkehart Jenetzky, Philip B. Gorelick, Hanne Ellekjaer, Ahmed A Malik, Kyung Bok Lee, Junya Kuroda, Kyung-Ho Yu, Jiro Kitayama, Dae Hyun Kim, Jong-Moo Park, Oliver C. Singer, Günther Hedtmann, Ki-Hyun Cho, Mario Abruscato, Kyusik Kang, Stefan Helwig, Marcus Czabanka, Eric Greveson, Marjolein Brusse-Keizer, Choong Hyun Kim, Patrick J. Kelly, Peter Sander, Raul G Nogueira, Marco Timmer, Peter A. Ringleb, Andreas Ragoschke-Schumm, Adam Strzelczyk, Sven Thonke, Peter Vajkoczy, Chongke Zhong, M. Fareed K. Suri, Heleen A. Booij, Keun-Sik Hong, Diederik van de Beek, Moon-Ku Han, Pierre Suchon, Jun Hata, Björn Misselwitz, Yves Donazzolo, Juneyoung Lee, Young-Soo Kim, Lenka Schwindling, Stefan H. Kreisel, Seena Dehkharghani, Tobias Neumann-Haefelin, Elodie Ong, Jin Hwan Cheong, Oliver Josef Müller, Jae Kwan Cha, Masahiro Kamouchi, Yong-Jin Cho, Michel Ovize, Sung Il Sohn, Byung-Chul Lee, Willeke F. Westendorp, Safwan Roumia, Mi Sun Oh, Michael Reiner, Vincent Larrue, Trevor Carle, Jihoon Kang, Dana Farahmand, Marie-Hélène Mahagne, Michael Frankel, Silke Walter, Martin Lesmeister, Gaetano Procaccianti, Jan C. Purrucker, Jonathan C. Craig, Anke Reihs, Svenja Schüler, Martin Gallagher, Valeria Nativio, Carina Hohmann, Mikayel Grigoryan, Jae Guk Kim, Benno Ikenberg, M. Laible, Heleen M. den Hertog, Waltraud Pfeilschifter, Jiaping Xu, Mathieu Zuber, Craig S. Anderson, Alison Halliday, Laurent Derex, Bent Indredavik, Jay Chol Choi, Hiromi Ishikawa, Yongjun Cao, Yvo B.W.E.M. Roos, Diederik W.J. Dippel, Jonathan A. Grossberg, Susanne Goerdes, Anastasios Mpotsaris, Philip Masson, Andreas Ferbert, Raf Brouns, Maura Coveri, Jeong-Ho Hong, Igor Sibon, Andrey Lima, Anna Mezzapesa, Alan Cass, Myung Hoon Han, Richard Bulbulia, Luigi Simonetti, Hiroshi Nakane, Pantelis Stavrinou, Zhichao Huang, Noriko Makihara, Mar Castellanos, Giuseppe Di Pasquale, Michele Domenico Spampinato, Roland Goldbrunner, Cecilia Cappelen-Smith, Sradha Kotwal, Wolfgang Reith, Marie-Christine Alessi, Angelika Alonso, Björn Reuter, Sang-Soon Park, Luyao Shi, Nadine Talia, Philippe Grosjean, and Norbert Nighoghossian

Subjects
Neurology, Traditional medicine, business.industry, Medicine, Neurology (clinical), Cardiology and Cardiovascular Medicine, business
Published
2016
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4. First Automated Stroke Imaging Evaluation via Electronic Alberta Stroke Program Early CT Score in a Mobile Stroke Unit

Author

Safwan Roumia, Michael Kettner, Silke Walter, Eric Greveson, Andreas Ragoschke-Schumm, Martin Lesmeister, Lenka Schwindling, Iris Q. Grunwald, Stefan Helwig, Matthias Manitz, Klaus Fassbender, Wolfgang Reith, and Umut Yilmaz

Subjects
medicine.medical_specialty, Emergency Medical Services, Time Factors, Teleradiology, Clinical Decision-Making, MEDLINE, 030218 nuclear medicine & medical imaging, Alberta, Time-to-Treatment, 03 medical and health sciences, Automation, 0302 clinical medicine, Predictive Value of Tests, Occlusion, medicine, Emergency medical services, Humans, Thrombolytic Therapy, Stroke, Aged, business.industry, Delivery of Health Care, Integrated, medicine.disease, Triage, Prehospital thrombolysis, Early Diagnosis, Treatment Outcome, Neurology, Predictive value of tests, Emergency medicine, Feasibility Studies, Radiographic Image Interpretation, Computer-Assisted, Female, Neurology (clinical), Medical emergency, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery, Mobile Health Units, Software
Abstract

Background: Recently, a mobile stroke unit (MSU) was shown to facilitate acute stroke treatment directly at the emergency site. The neuroradiological expertise of the MSU is improved by its ability to detect early ischemic damage via automatic electronic (e) evaluation of CT scans using a novel software program that calculates the electronic Alberta Stroke Program Early CT Score (e-ASPECTS). Methods: The feasibility of integrating e-ASPECTS into an ambulance was examined, and the clinical integration and utility of the software in 15 consecutive cases evaluated. Results: Implementation of e-ASPECTS onto the MSU and into the prehospital stroke management was feasible. The values of e-ASPECTS matched with the results of conventional neuroradiologic analysis by the MSU team. The potential benefits of e-ASPECTS were illustrated by three cases. In case 1, excluding early infarct signs supported the decision to directly perform prehospital thrombolysis. In case 2, in which stroke was caused by large-vessel occlusion, the high e-ASPECTS value supported the decision to initiate intra-arterial treatment and triage the patient to a comprehensive stroke center. In case 3, the e-ASPECTS value was 10, indicating the absence of early infarct signs despite pre-existing cerebral microangiopathy and macroangiopathy, a finding indicating the program's robustness against artefacts. Conclusions: This study on the integration of e-ASPECTS into the prehospital stroke management via a MSU showed for the first time that such integration is feasible, and aids both decision regarding the treatment option and the triage regarding the most appropriate target hospital.

Published
2016

5. e-ASPECTS software is non-inferior to neuroradiologists in applying the ASPECT score to computed tomography scans of acute ischemic stroke patients

Author

Marco Essig, Sharon Tysoe, Christine Roffe, Panagiotis Papanagiotou, René Chapot, Michael C. Harrison, Simon Nagel, Wolfgang Reith, Iris Q. Grunwald, Devesh Sinha, Stephen Gerry, Jens Heidenrich, Holly Maguire, Eric Greveson, Alastair M. Buchan, Silke Walter, Paul Guyler, Klaus Fassbender, Michalis Papadakis, Diana Day, Angelos A. Konstas, Elizabeth A. Warburton, James Hampton-Till, and Olivier Joly

Subjects
Adult, Male, medicine.medical_specialty, Infarction, Computed tomography, Brain Ischemia, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Neuroimaging, Interquartile range, medicine, Humans, Stroke, Acute ischemic stroke, Aged, Retrospective Studies, Tomography, Emission-Computed, Single-Photon, medicine.diagnostic_test, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, ROC Curve, Neurology, Ischemic stroke, Female, Radiology, business, Software, 030217 neurology & neurosurgery
Abstract

Background The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is an established 10-point quantitative topographic computed tomography scan score to assess early ischemic changes. We performed a non-inferiority trial between the e-ASPECTS software and neuroradiologists in scoring ASPECTS on non-contrast enhanced computed tomography images of acute ischemic stroke patients. Methods In this multicenter study, e-ASPECTS and three independent neuroradiologists retrospectively and blindly assessed baseline non-contrast enhanced computed tomography images of 132 patients with acute anterior circulation ischemic stroke. Follow-up scans served as ground truth to determine the definite area of infarction. Sensitivity, specificity, and accuracy for region- and score-based analysis, receiver-operating characteristic curves, Bland-Altman plots and Matthews correlation coefficients relative to the ground truth were calculated and comparisons were made between neuroradiologists and different pre-specified e-ASPECTS operating points. The non-inferiority margin was set to 10% for both sensitivity and specificity on region-based analysis. Results In total 2640 (132 patients × 20 regions per patient) ASPECTS regions were scored. Mean time from onset to baseline computed tomography was 146 ± 124 min and median NIH Stroke Scale (NIHSS) was 11 (6–17, interquartile range). Median ASPECTS for ground truth on follow-up imaging was 8 (6.5–9, interquartile range). In the region-based analysis, two e-ASPECTS operating points (sensitivity, specificity, and accuracy of 44%, 93%, 87% and 44%, 91%, 85%) were statistically non-inferior to all three neuroradiologists (all p-values Conclusions e-ASPECTS was non-inferior to three neuroradiologists in scoring ASPECTS on non-contrast enhanced computed tomography images of acute stroke patients.

Published
2016

6. Urban 3D semantic modelling using stereo vision

Author

Ali Shahrokni, Eric Greveson, Sunando Sengupta, and Philip H. S. Torr

Subjects
Ground truth, business.industry, Computer science, 3D reconstruction, ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION, Mobile robot, Iterative reconstruction, Image segmentation, Stereopsis, Odometry, Segmentation, Computer vision, Artificial intelligence, Motion planning, business, Surface reconstruction
Abstract

In this paper we propose a robust algorithm that generates an efficient and accurate dense 3D reconstruction with associated semantic labellings. Intelligent autonomous systems require accurate 3D reconstructions for applications such as navigation and localisation. Such systems also need to recognise their surroundings in order to identify and interact with objects of interest. Considerable emphasis has been given to generating a good reconstruction but less effort has gone into generating a 3D semantic model. The inputs to our algorithm are street level stereo image pairs acquired from a camera mounted on a moving vehicle. The depth-maps, generated from the stereo pairs across time, are fused into a global 3D volume online in order to accommodate arbitrary long image sequences. The street level images are automatically labelled using a Conditional Random Field (CRF) framework exploiting stereo images, and label estimates are aggregated to annotate the 3D volume. We evaluate our approach on the KITTI odometry dataset and have manually generated ground truth for object class segmentation. Our qualitative evaluation is performed on various sequences of the dataset and we also quantify our results on a representative subset.

Published
2013
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7. Front and Back Matter

Author

Ryu Matsuo, Ekkehart Jenetzky, Adam Strzelczyk, Kyusik Kang, Heleen A. Booij, Helmuth Steinmetz, Yoshinobu Wakisaka, Yanlin Zhang, Jonathan A Grossberg, Vincent Larrue, Willeke F. Westendorp, Xia Zhang, Laura Mechtouff, Wei Xuan, Christina Hamisch, Roland Veltkamp, Peter J. Koudstaal, Zeljka Calic, Mohammad Rauf Afzal, Mathieu Zuber, Young-Soo Kim, Young-Chai Ko, Soo Joo Lee, Gerben J. J. Plas, Markus A Möhlenbruch, Gaetano Procaccianti, Chongke Zhong, Qiao Han, Iris Q. Grunwald, Anna Mezzapesa, Kyung Bok Lee, Stefan Helwig, Peter A. Ringleb, Timolaos Rizos, Fayyaz Orfi, Eric Greveson, Hiromi Ishikawa, Cecilia Cappelen-Smith, Yong Ko, Dennis Cordato, Silke Walter, Jun Hata, Björn Misselwitz, Gert J. de Borst, Serge Timsit, Dae Hyun Kim, Philippe Grosjean, Norbert Nighoghossian, Michael Reiner, Christopher Beynon, Hyeong-Joong Yi, Waltraud Pfeilschifter, Junya Kuroda, Günther Hedtmann, M. Fareed K. Suri, Jiro Kitayama, Mikayel Grigoryan, Tae-Hee Cho, Andreas Ferbert, Mark Stroick, Laurent Derex, Bent Indredavik, Peter Sander, Paola Forti, Diogo C Haussen, Sradha Kotwal, Anne Huibers, Wolfgang Reith, Björn Reuter, Patrick J. Kelly, Heleen M. den Hertog, Jae Min Kim, Jae Guk Kim, Richard I. Lindley, John A Oostema, Diederik van de Beek, Mathew J. Reeves, P. J. A. M. Brouwers, Sang-Soon Park, Umut Yilmaz, Luyao Shi, Oliver C. Singer, Michael Kettner, Chunfeng Liu, Y.B.W.E.M. Roos, Pantelis Stavrinou, Lenka Schwindling, Sung Il Sohn, Jiaping Xu, Joan Montaner, Nadine Talia, Craig S. Anderson, Nathan Mewton, Daniela Niemann, Christophe Gaudin, Diederik W.J. Dippel, Marco Zoli, Alison Halliday, Mario Abruscato, Raul G Nogueira, Peter Vajkoczy, Marie-Hélène Mahagne, Martin Griebe, Mi Sun Oh, Beom Joon Kim, Paul J. Nederkoorn, Fabiola Maioli, Djurre D. de Waard, Juneyoung Lee, Pierre Suchon, Gerrit Brinker, Stefan H. Kreisel, Svenja Schüler, Masahiro Kamouchi, Yong-Jin Cho, Ji-Sung Lee, Bernt Harald Helleberg, Christian Foerch, Jong-Moo Park, Roland Goldbrunner, Marie-Christine Alessi, Takanari Kitazono, Jay Chol Choi, Jijun Shi, Safwan Roumia, Güliz Acker, Marc Fatar, Michael Frankel, Klaus Fassbender, Boris Krischek, Trevor Carle, Valérie Martin, Jihoon Kang, Andreas Ragoschke-Schumm, Carlotta Barbara, Huihui Liu, Matthijs C. Brouwer, Thorsten Steiner, Jan C. Purrucker, Jonathan C. Craig, Anke Reihs, Marcus Czabanka, M. Laible, Benno Ikenberg, Min Uk Jang, Joon-Tae Kim, Angelika Alonso, Yongjun Cao, Hee-Joon Bae, Carina Hohmann, Susanne Goerdes, Angela C Webster, Richard Bulbulia, Adnan I Qureshi, Ki-Hyun Cho, Sven Thonke, Tetsuro Ago, Valeria Nativio, Rainer Kollmar, Shoujiang You, Byung Chul Lee, Philip B. Gorelick, Hanne Ellekjær, Choong Hyun Kim, Laurent Suissa, Michael G. Hennerici, Oliver Josef Müller, Jae Kwan Cha, Tobias Neumann-Haefelin, Tai Hwan Park, Hiroshi Nakane, Raf Brouns, Peter Schmiedek, Moon-Ku Han, Kyung-Ho Yu, Keun-Sik Hong, Jeong-Ho Hong, Dana Farahmand, Elodie Ong, Jin Hwan Cheong, Michel Ovize, Jun Lee, Martin Lesmeister, Jan-Dirk Vermeij, Myung Hoon Han, Alan Cass, Martin Gallagher, Marco Timmer, Luigi Simonetti, Marjolein Brusse-Keizer, Ahmed A Malik, Giuseppe Di Pasquale, Michele Domenico Spampinato, Matthias Manitz, Yves Donazzolo, Yvo B.W.E.M. Roos, Leticia C Rebello, Seena Dehkharghani, Zhichao Huang, Maura Coveri, Igor Sibon, Noriko Makihara, Andrey Lima, Mar Castellanos, Anastasios Mpotsaris, Philip Masson, Druckerei Stückle, and Nauman Jahangir

Subjects
Optics, Neurology, business.industry, Medicine, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Front (military)
Published
2013
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