Diagnostic performance of an algorithm for automated large vessel occlusion detection on CT angiography. (19th August 2021)

• Record Type: Journal Article
• Authors: Luijten, Sven P R; Wolff, Lennard; Duvekot, Martijne H C; van Doormaal, Pieter-Jan; Moudrous, Walid; Kerkhoff, Henk; Lycklama a Nijeholt, Geert J; Bokkers, Reinoud P H; Yo, Lonneke S F; Hofmeijer, Jeannette; van Zwam, Wim H; van Es, Adriaan C G M; Dippel, Diederik W J; Roozenbeek, Bob; van der Lugt, Aad
• Other Names: author non-byline.; Oostenbrugge Robert J van author non-byline.; Boiten Jelis author non-byline.; Vos Jan Albert author non-byline.; Jansen Ivo GH author non-byline.; Mulder Maxim JHL author non-byline.; Goldhoorn Robert-Jan B author non-byline.; Compagne Kars CJ author non-byline.; Kappelhof Manon author non-byline.; Schonewille Wouter J author non-byline.; Coutinho Jonathan M author non-byline.; Wermer Marieke JH author non-byline.; Walderveen Marianne AA van author non-byline.; Staals Julie author non-byline.; Martens Jasper M author non-byline.; Emmer Bart J author non-byline.; de Bruijn Sebastiaan F author non-byline.; Dijk Lukas C van author non-byline.; van der Worp Bart author non-byline.; Lo Rob H author non-byline.; Dijk Ewoud J van author non-byline.; Boogaarts Hieronymus D author non-byline.; Kort Paul LM de author non-byline.; Tuijl Julia van author non-byline.; Peluso Jo JP author non-byline.; Berg Jan SP van den author non-byline.; Hasselt Boudewijn AAM van author non-byline.; Aerden Leo AM author non-byline.; Dallinga René J author non-byline.; Uyttenboogaart Maarten author non-byline.; Eshghi Omid author non-byline.; Schreuder Tobien HCML author non-byline.; Heijboer Roel JJ author non-byline.; Keizer Koos author non-byline.; Hertog Heleen M den author non-byline.; Sturm Emiel JC author non-byline.; Sprengers Marieke ES author non-byline.; Jenniskens Sjoerd FM author non-byline.; Berg René van den author non-byline.; Yoo Albert J author non-byline.; Beenen Ludo FM author non-byline.; Postma Alida A author non-byline.; Roosendaal Stefan D author non-byline.; van der Kallen Bas FW author non-byline.; van den Wijngaard Ido R author non-byline.; Bot Joost author non-byline.; van Doormaal Pieter-Jan author non-byline.; Flach Zwenneke author non-byline.; Lingsma Hester F author non-byline.; Ghannouti Naziha el author non-byline.; Sterrenberg Martin author non-byline.; Puppels Corina author non-byline.; Pellikaan Wilma author non-byline.; Sprengers Rita author non-byline.; Elfrink Marjan author non-byline.; de Meris Joke author non-byline.; Geerlings Annet author non-byline.; Vemde Gina van author non-byline.; Simons Tiny author non-byline.; Rijswijk Cathelijn van author non-byline.; Messchendorp Gert author non-byline.; Bongenaar Hester author non-byline.; Bodde Karin author non-byline.; Kleijn Sandra author non-byline.; Lodico Jasmijn author non-byline.; Droste Hanneke author non-byline.; Wollaert M author non-byline.; Jeurrissen D author non-byline.; Bos Ernas author non-byline.; Drabbe Yvonne author non-byline.; Aaldering Nicoline author non-byline.; Zweedijk Berber author non-byline.; Khalilzada Mostafa author non-byline.; Venema Esmee author non-byline.; Chalos Vicky author non-byline.; Geuskens Ralph R author non-byline.; Straaten Tim van author non-byline.; Ergezen Saliha author non-byline.; Harmsma Roger RM author non-byline.; Muijres Daan author non-byline.; Jong Anouk de author non-byline.; Hinsenveld Wouter author non-byline.; Berkhemer Olvert A author non-byline.; Huguet J author non-byline.; Groot PFC author non-byline.; Mens Marieke A author non-byline.; Kranendonk Katinka R author non-byline.; Treurniet Kilian M author non-byline.; Tolhuijsen Manon L author non-byline.; Alves Heitor author non-byline.; Rozeman Anouk D author non-byline.; Vermeij Frédérique H author non-byline.; Alblas Kees CL author non-byline.; Mulder Laus JMM author non-byline.; Wijnhoud Annemarie D author non-byline.; Maasland Lisette author non-byline.; Eijkelenburg Roeland PJ van author non-byline.; Biekart Marileen author non-byline.; Willeboer ML author non-byline.; Buijck Bianca author non-byline.; Bakker Jeannette author non-byline.; Hensen Jan-Hein author non-byline.; Plaisier Aarnout author non-byline.; Hoek Amber author non-byline.; Oskam Erick author non-byline.; Zon Mandy MA van der author non-byline.; Zwets Egon D author non-byline.; Kuiper Jan Willem author non-byline.; Moll Bruno JM van author non-byline.; Woudenberg Mirjam author non-byline.; Leeuw Arnoud M de author non-byline.; Noordam-Reijm Anja author non-byline.; Bevelander Timo author non-byline.; Chalos Vicky author non-byline.; Wiegers Eveline JA author non-byline.; Kalkeren Dennis C van author non-byline.; Biggelaar Jochem van den author non-byline.; Vermeulen Tamara author non-byline.;
• Is Part Of: Journal of neurointerventional surgery. Volume 14:Number 8(2022)
• Page Start: 794
• Page End: 798
• Publication Date: 2021-08-19
• Subjects: CT Angiography -- stroke -- thrombectomy; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2021-017842
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Background: Machine learning algorithms hold the potential to contribute to fast and accurate detection of large vessel occlusion (LVO) in patients with suspected acute ischemic stroke. We assessed the diagnostic performance of an automated LVO detection algorithm on CT angiography (CTA). Methods: Data from the MR CLEAN Registry and PRESTO were used including patients with and without LVO. CTA data were analyzed by the algorithm for detection and localization of LVO (intracranial internal carotid artery (ICA)/ICA terminus (ICA-T), M1, or M2). Assessments done by expert neuroradiologists were used as reference. Diagnostic performance was assessed for detection of LVO and per occlusion location by means of sensitivity, specificity, and area under the curve (AUC). Results: We analyzed CTAs of 1110 patients from the MR CLEAN Registry (median age (IQR) 71 years (60–80); 584 men; 1110 with LVO) and of 646 patients from PRESTO (median age (IQR) 73 years (62–82); 358 men; 141 with and 505 without LVO). For detection of LVO, the algorithm yielded a sensitivity of 89% in the MR CLEAN Registry and a sensitivity of 72%, specificity of 78%, and AUC of 0.75 in PRESTO. Sensitivity per occlusion location was 88% for ICA/ICA-T, 94% for M1, and 72% for M2 occlusion in the MR CLEAN Registry, and 80% for ICA/ICA-T, 95% for M1, and 49% for M2 occlusion in PRESTO. Conclusion: The algorithm provided a high detection rate for proximal LVO, but performance varied significantly by occlusion location. Detection of M2 occlusion needs further improvement.