The Alberta Stroke Program Early CT Score (ASPECTS) is used in clinical decision-making for patients with ischemic stroke. It measures early ischemic changes by evaluating 10 predefined regions of the middle cerebral artery territory for focal hypoattenuation.
Key takeaways:
Reader experience can affect ASPECTS accuracy and studies have reported variability in interrater agreement. Diagnostic accuracy is important in stroke triage and treatment decisions, particularly when expert stroke neuroradiology support is not immediately available.
A recently published retrospective study by Dr. Lambert and co-authors found that access to automated scores from Rapid ASPECTS when evaluating baseline non-contrast CT scans resulted in more uniform and accurate ASPECTS scoring.
The study included 174 patients with anterior circulation occlusions whose baseline NCCT scans were available. The patients were admitted to University Hospitals Leuven between 2015 and 2018 and underwent thrombectomy for acute ischemic stroke.
Two experienced neuroradiologists reviewed the NCCT scans separately and established the criterion standard. Test readers included a radiology resident, a stroke neurologist, a neurology resident and two radiologists interested in neuroradiology.
Rapid ASPECTS evaluated the scans and generated automated scores. Several weeks after the initial scoring, the readers reviewed the same scans again with their previous scores and the automated ASPECTS scores available.
Agreement between the individual test readers and the criterion standard improved with software assistance, as did interrater agreement. Overall accuracy, measured by area under the curve, improved from 0.72 to 0.82 (P < .004).
The findings suggest that Rapid ASPECTS assistance can support more uniform and accurate scoring when clinicians evaluate NCCT scans from patients with acute stroke. Rapid ASPECTS has FDA CADx clearance for assisting clinicians with ASPECTS assessment. Learn more about Rapid ASPECTS.