Comparison of automated and manual DWI-ASPECTS in acute ischemic stroke: total and region-specific assessment
- PDF / 2,714,806 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 98 Downloads / 178 Views
NEURO
Comparison of automated and manual DWI-ASPECTS in acute ischemic stroke: total and region-specific assessment XiaoQing Cheng 1 & XiaoQin Su 1 & JiaQian Shi 2 & QuanHui Liu 2 & ChangSheng Zhou 1 & Zheng Dong 2 & Wei Xing 3 & HaiTao Lu 3 & ChengWei Pan 4 & XiuLi Li 4 & YiZhou Yu 4 & LongJiang Zhang 1 & GuangMing Lu 1,2 Received: 10 July 2020 / Revised: 14 September 2020 / Accepted: 10 November 2020 # European Society of Radiology 2020
Abstract Objective To compare the DWI-Alberta Stroke Program Early Computed Tomography Score calculated by a deep learning– based automatic software tool (eDWI-ASPECTS) with the neuroradiologists’ evaluation for the acute stroke, with emphasis on its performance on 10 individual ASPECTS regions, and to determine the reasons for inconsistencies between eDWI-ASPECTS and neuroradiologists’ evaluation. Methods This retrospective study included patients with middle cerebral artery stroke who underwent MRI from 2010 to 2019. All scans were evaluated by eDWI-ASPECTS and two independent neuroradiologists (with 15 and 5 years of experience in stroke study). Inter-rater agreement and agreement between manual vs. automated methods for total and each region were evaluated by calculating Kendall’s tau-b, intraclass correlation coefficient (ICC), and kappa coefficient. Results In total, 309 patients met our study criteria. For total ASPECTS, eDWI-ASPECTS and manual raters had a strong positive correlation (Kendall’s tau-b = 0.827 for junior raters vs. eDWI-ASPECTS; Kendall’s tau-b = 0.870 for inter-raters; Kendall’s tau-b = 0.848 for senior raters vs. eDWI-ASPECTS) and excellent agreement (ICC = 0.923 for junior raters and automated scores; ICC = 0.954 for inter-raters; ICC = 0.939 for senior raters and automated scores). Agreement was different for individual ASPECTS regions. All regions except for M5 region (κ = 0.216 for junior raters and automated scores), internal capsule (κ = 0.525 for junior raters and automated scores), and caudate (κ = 0.586 for senior raters and automated scores) showed good to excellent concordance. Conclusion The eDWI-ASPECTS performed equally well as senior neuroradiologists’ evaluation, although interference by uncertain scoring rules and midline shift resulted in poor to moderate consistency in the M5, internal capsule, and caudate nucleus regions. Key Points • The eDWI-ASPECTS based on deep learning perform equally well as senior neuroradiologists’ evaluations. • Among the individual ASPECTS regions, the M5, internal capsule, and caudate regions mainly affected the overall consistency. • Uncertain scoring rules and midline shift are the main reasons for regional inconsistency. Keywords Stroke . Brain ischemia . Magnetic resonance imaging . Middle cerebral artery Abbreviations ASPECTS DWI
eDWI-ASPECTS Alberta Stroke Program Early CT Score Diffusion-weighted imaging
FA
Automated DWI-Alberta Stroke Program Early CT Score Flip angle
XiaoQing Cheng and XiaoQin Su contributed equally to this work. * LongJiang Zhang [email protected]
2
Department of Medical Ima
Data Loading...
