Background Application of machine learning (ML) algorithms has shown promising results in estimating ischemic core volumes using non-contrast CT (NCCT).
Objective To assess the performance of the e-Stroke Suite software (Brainomix) in assessing ischemic core volumes on NCCT compared with CT perfusion (CTP) in patients with acute ischemic stroke.
Methods In this retrospective multicenter study, patients with anterior circulation large vessel occlusions who underwent pretreatment NCCT and CTP, successful reperfusion (modified Thrombolysis in Cerbral Infarction ≥2b), and post-treatment MRI, were included from three stroke centers. Automated calculation of ischemic core volumes was obtained on NCCT scans using ML algorithm deployed by e-Stroke Suite and from CTP using Olea software (Olea Medical). Comparative analysis was performed between estimated core volumes on NCCT and CTP and against MRI calculated final infarct volume (FIV).
Results A total of 111 patients were included. Estimated ischemic core volumes (mean±SD, mL) were 20.4±19.0 on NCCT and 19.9±18.6 on CTP, not significantly different (P=0.82). There was moderate (r=0.40) and significant (P<0.001) correlation between estimated core on NCCT and CTP. The mean difference between FIV and estimated core volume on NCCT and CTP was 29.9±34.6 mL and 29.6±35.0 mL, respectively (P=0.94). Correlations between FIV and estimated core volume were similar for NCCT (r=0.30, P=0.001) and CTP (r=0.36, P<0.001).
Conclusions Results show that ML-based estimated ischemic core volumes on NCCT are comparable to those obtained from concurrent CTP in magnitude and in degree of correlation with MR-assessed FIV.
- CT perfusion
Data availability statement
Data are available upon reasonable request.
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Presented at The results of this paper were presented at the ASNR 61st Annual Meeting, Chicago, Ilinois, USA. Abstract#473. April 29-May 3, 2023.
Contributors Study design: AV, JM, KN. Data collection: PS, SK, ET, JXQ, AV, PB, AD, JTF. Data analysis and interpretation: PS, PK, MB-H, GPC, RJ, GD, VS, LL, SC, BS, JTF, RDL, JM, JLS, DSL, KN. Clinical input: PK, MB-H, GPC, JLS, DSL, KN. Writing manuscript: PS, KN. Revising the manuscript for important intellectual content: All authors. Approved the final version to be published: All authors. Guarantor: KN.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests GPC: Stryker Neurovascular, MicroVention, Medtronic, Rapid Medical; JLS: Medtronic Cerenovus, Boehringer Ingelheim, NeuroVasc, Rapid Medical; DSL: Cerenovus, Genentech, Medtronic, Stryker, Olea; KN: Olea Medical, Brainomix; Achala Vagal: Viz AI.
Provenance and peer review Not commissioned; externally peer reviewed.
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