Back to Search
Start Over
Multicenter comparison using two AI stroke CT perfusion software packages for determining thrombectomy eligibility.
- Source :
-
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2024 Jul; Vol. 33 (7), pp. 107750. Date of Electronic Publication: 2024 May 02. - Publication Year :
- 2024
-
Abstract
- Background: Stroke AI platforms assess infarcted core and potentially salvageable tissue (penumbra) to identify patients suitable for mechanical thrombectomy. Few studies have compared outputs of these platforms, and none have been multicenter or considered NIHSS or scanner/protocol differences. Our objective was to compare volume estimates and thrombectomy eligibility from two widely used CT perfusion (CTP) packages, Viz.ai and RAPID.AI, in a large multicenter cohort.<br />Methods: We analyzed CTP data of acute stroke patients with large vessel occlusion (LVO) from four institutions. Core and penumbra volumes were estimated by each software and DEFUSE-3 thrombectomy eligibility assessed. Results between software packages were compared and categorized by NIHSS score, scanner manufacturer/model, and institution.<br />Results: Primary analysis of 362 cases found statistically significant differences in both software's volume estimations, with subgroup analysis showing these differences were driven by results from a single scanner model, the Canon Aquilion One. Viz.ai provided larger estimates with mean differences of 8cc and 18cc for core and penumbra, respectively (p<0.001). NIHSS subgroup analysis also showed systematically larger Viz.ai volumes (p<0.001). Despite volume differences, a significant difference in thrombectomy eligibility was not found. Additional subgroup analysis showed significant differences in penumbra volume for the Phillips Ingenuity scanner, and thrombectomy eligibility for the Canon Aquilion One scanner at one center (7 % increased eligibility with Viz.ai, p=0.03).<br />Conclusions: Despite systematic differences in core and penumbra volume estimates between Viz.ai and RAPID.AI, DEFUSE-3 eligibility was not statistically different in primary or NIHSS subgroup analysis. A DEFUSE-3 eligibility difference, however, was seen on one scanner at one institution, suggesting scanner model and local CTP protocols can influence performance and cause discrepancies in thrombectomy eligibility. We thus recommend centers discuss optimal scanning protocols with software vendors and scanner manufacturers to maximize CTP accuracy.<br />Competing Interests: Declaration of competing interest BA has nothing to disclose is funded in part through NIH U24 NS107225-05. DMM is on Speaker's Bureau for Chiesi and AstraZeneca. CI, KVS, RS, LP, RC, KVO, DT, BP, BH, SK, have nothing to disclose. BCM is an advisor to Sevarro, Inc. DSB has industry-funded research grants from GE Healthcare and Siemens Medical Solutions USA.<br /> (Copyright © 2024. Published by Elsevier Inc.)
- Subjects :
- Humans
Female
Male
Aged
Reproducibility of Results
Middle Aged
Ischemic Stroke diagnostic imaging
Ischemic Stroke therapy
Ischemic Stroke surgery
Ischemic Stroke physiopathology
Ischemic Stroke diagnosis
Retrospective Studies
Clinical Decision-Making
Stroke diagnostic imaging
Stroke therapy
Stroke surgery
Stroke physiopathology
Stroke diagnosis
Tomography, X-Ray Computed
Computed Tomography Angiography
Aged, 80 and over
Thrombectomy adverse effects
Perfusion Imaging methods
Predictive Value of Tests
Software
Radiographic Image Interpretation, Computer-Assisted
Cerebrovascular Circulation
Patient Selection
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8511
- Volume :
- 33
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- Publication Type :
- Academic Journal
- Accession number :
- 38703875
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107750