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Diagnostic accuracy of automated occlusion detection in CT angiography using e-CTA.

Authors
  • Seker, Fatih1
  • Pfaff, Johannes Alex Rolf1
  • Mokli, Yahia2
  • Berberich, Anne2
  • Namias, Rafael3
  • Gerry, Steven4
  • Nagel, Simon2
  • Bendszus, Martin1
  • Herweh, Christian1
  • 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany. , (Germany)
  • 2 Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany. , (Germany)
  • 3 Bainomix Ltd., Oxford, UK.
  • 4 Centre for Statistics in Medicine, University of Oxford, Oxford, UK.
Type
Published Article
Journal
International Journal of Stroke
Publisher
SAGE Publications
Publication Date
Jan 01, 2022
Volume
17
Issue
1
Pages
77–82
Identifiers
DOI: 10.1177/1747493021992592
PMID: 33527886
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim of this study was to assess the diagnostic accuracy of e-CTA (product name) (Brainomix) in the automatic detection of large vessel occlusions in anterior circulation stroke. Of 487 CT angiographies from patients with large vessel occlusions stroke, 327 were used to train the algorithm while the remaining cases together with 140 negative CT angiographies were used to validate its performance against ground truth. Of these 301 cases, 144 were randomly selected and used for an additional comparative analysis against 4 raters. Sensitivity, specificity, positive and negative predictive value (PPV and NPV), accuracy and level of agreement with ground truth (Cohen's Kappa) were determined and compared to the performance of a neuroradiologist, a radiology resident, and two neurology residents. e-CTA had a sensitivity and specificity of 0.84 (0.77-0.89) and 0.96 (0.91-0.98) respectively for the detection of any large vessel occlusions on the correct side in the whole validation cohort. This performance was identical in the comparative analysis subgroup and was within the range of physicians at different levels of expertise: 0.86-0.97 and 0.91-1.00, respectively. For the detection of proximal occlusions, it was 0.92 (0.84-0.96) and 0.98 (0.94-1.00) for the whole cohort and 0.93 (0.80-0.98) and 1.00 (0.95-1.00) for the comparative analysis, respectively for e-CTA. The range was 0.8-0.97 for sensitivity and 0.97-1.00 for specificity for the four physicians. The performance of e-CTA in detecting any large vessel occlusions is comparable to less experienced physicians but is similar to experienced physicians for detecting proximal large vessel occlusions.

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