Comparison of automated and visual DWI ASPECTS in acute ischemic stroke.


Journal

Journal of neuroradiology = Journal de neuroradiologie
ISSN: 0150-9861
Titre abrégé: J Neuroradiol
Pays: France
ID NLM: 7705086

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 09 05 2018
revised: 10 12 2018
accepted: 08 02 2019
pubmed: 14 3 2019
medline: 24 4 2020
entrez: 14 3 2019
Statut: ppublish

Résumé

To assess intra-and inter-rater agreement of the ASPECTS (Alberta Stroke Program Early CT Score) based on diffusion-weighted MRI and to compare it with fully - automated methods (eASPECTS). DWI-ASPECTS of scans of 96 patients with acute ischemic stroke was rated by 2 experts. Automated methods based on thresholding the affected volumes of a coregistered atlas, and a regression tree learning method were established. Intra-rater, inter-rater and human-rater vs. automated methods agreements were investigated based on the intraclass correlation coefficients (ICC) and Bland Altman plots. Intra-rater agreement was good for both raters (ICC of 0.91 and 0.93). Inter-rater agreement was worse (ICC = 0.86) indicating a slight bias between both raters. Agreement with automated methods ranged from 0.81 to 0.87. Root-mean-squared deviation was 0.89 and 0.69 for the human raters and ranged from 0.95 to 1.24 for the automated methods. Agreement values are on the same order or higher compared to a literature review of CT-based ASPECTS. Automated methods perform slightly worse than human expert ratings, but they still have enough power to determine the DWI-ASPECTS with good precision in a clinical setting.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
To assess intra-and inter-rater agreement of the ASPECTS (Alberta Stroke Program Early CT Score) based on diffusion-weighted MRI and to compare it with fully - automated methods (eASPECTS).
METHODS METHODS
DWI-ASPECTS of scans of 96 patients with acute ischemic stroke was rated by 2 experts. Automated methods based on thresholding the affected volumes of a coregistered atlas, and a regression tree learning method were established. Intra-rater, inter-rater and human-rater vs. automated methods agreements were investigated based on the intraclass correlation coefficients (ICC) and Bland Altman plots.
RESULTS RESULTS
Intra-rater agreement was good for both raters (ICC of 0.91 and 0.93). Inter-rater agreement was worse (ICC = 0.86) indicating a slight bias between both raters. Agreement with automated methods ranged from 0.81 to 0.87. Root-mean-squared deviation was 0.89 and 0.69 for the human raters and ranged from 0.95 to 1.24 for the automated methods.
CONCLUSIONS CONCLUSIONS
Agreement values are on the same order or higher compared to a literature review of CT-based ASPECTS. Automated methods perform slightly worse than human expert ratings, but they still have enough power to determine the DWI-ASPECTS with good precision in a clinical setting.

Identifiants

pubmed: 30862461
pii: S0150-9861(18)30190-1
doi: 10.1016/j.neurad.2019.02.006
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

288-293

Informations de copyright

Copyright © 2019 Elsevier Masson SAS. All rights reserved.

Auteurs

E Kellner (E)

Department of Radiology, Medical Physics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. Electronic address: elias.kellner@uniklinik-freiburg.de.

M Reisert (M)

Department of Radiology, Medical Physics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

V G Kiselev (VG)

Department of Radiology, Medical Physics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

C J Maurer (CJ)

Department of Diagnostic and Interventional Radiology and Neuroradiology, Augsburg Hospital, Germany.

H Urbach (H)

Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

K Egger (K)

Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

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