BACKGROUND AND PURPOSE: Early ischemic changes on pretreatment NCCT quantified using ASPECTS have been demonstrated to predict outcomes after IAT. We sought to determine the interobserver reliability of ASPECTS for patients with AIS with PAO and to determine whether pretreatment ASPECTS dichotomized at 7 would demonstrate at least substantial κ agreement. MATERIALS AND METHODS: From our prospective IAT data base, we identified consecutive patients with anterior circulation PAO who underwent IAT over a 6-year period. Only those with an evaluable pretreatment NCCT were included. ASPECTS was graded independently by 2 experienced readers. Interrater agreement was assessed for total ASPECTS, dichotomized ASPECTS (≤ 7 versus >7), and each ASPECTS region. Statistical analysis included determination of Cohen κ coefficients and concordance correlation coefficients. PABAK coefficients were also calculated. RESULTS: One hundred fifty-five patients met our study criteria. Median pretreatment ASPECTS was 8 (interquartile range 7-9). Interrater agreement for total ASPECTS was substantial (concordance correlation coefficient = 0.77). The mean ASPECTS difference between readers was 0.2 (95% confidence interval, -2.8 to 2.4). For dichotomized ASPECTS, there was a 76.8% (119/155) observed rate of agreement, with a moderate κ = 0.53 (PABAK = 0.54). By region, agreement was worst in the internal capsule and the cortical areas, ranging from fair to moderate. After adjusting for prevalence and bias, agreement improved to substantial or near perfect in most regions. CONCLUSIONS: Interobserver reliability is substantial for total ASPECTS but is only moderate for ASPECTS dichotomized at 7. This may limit the utility of dichotomized ASPECTS for IAT selection.
BACKGROUND AND PURPOSE: Early ischemic changes on pretreatment NCCT quantified using ASPECTS have been demonstrated to predict outcomes after IAT. We sought to determine the interobserver reliability of ASPECTS for patients with AIS with PAO and to determine whether pretreatment ASPECTS dichotomized at 7 would demonstrate at least substantial κ agreement. MATERIALS AND METHODS: From our prospective IAT data base, we identified consecutive patients with anterior circulation PAO who underwent IAT over a 6-year period. Only those with an evaluable pretreatment NCCT were included. ASPECTS was graded independently by 2 experienced readers. Interrater agreement was assessed for total ASPECTS, dichotomized ASPECTS (≤ 7 versus >7), and each ASPECTS region. Statistical analysis included determination of Cohen κ coefficients and concordance correlation coefficients. PABAK coefficients were also calculated. RESULTS: One hundred fifty-five patients met our study criteria. Median pretreatment ASPECTS was 8 (interquartile range 7-9). Interrater agreement for total ASPECTS was substantial (concordance correlation coefficient = 0.77). The mean ASPECTS difference between readers was 0.2 (95% confidence interval, -2.8 to 2.4). For dichotomized ASPECTS, there was a 76.8% (119/155) observed rate of agreement, with a moderate κ = 0.53 (PABAK = 0.54). By region, agreement was worst in the internal capsule and the cortical areas, ranging from fair to moderate. After adjusting for prevalence and bias, agreement improved to substantial or near perfect in most regions. CONCLUSIONS: Interobserver reliability is substantial for total ASPECTS but is only moderate for ASPECTS dichotomized at 7. This may limit the utility of dichotomized ASPECTS for IAT selection.
Authors: A Furlan; R Higashida; L Wechsler; M Gent; H Rowley; C Kase; M Pessin; A Ahuja; F Callahan; W M Clark; F Silver; F Rivera Journal: JAMA Date: 1999-12-01 Impact factor: 56.272
Authors: Shelagh B Coutts; Michael D Hill; Andrew M Demchuk; Philip A Barber; J H Warwick Pexman; Alastair M Buchan Journal: Stroke Date: 2003-09-11 Impact factor: 7.914
Authors: Kenneth S Butcher; Sang Bong Lee; Mark W Parsons; Louise Allport; John Fink; Brian Tress; Geoffrey Donnan; Stephen M Davis Journal: Stroke Date: 2007-02-01 Impact factor: 7.914
Authors: R von Kummer; K L Allen; R Holle; L Bozzao; S Bastianello; C Manelfe; E Bluhmki; P Ringleb; D H Meier; W Hacke Journal: Radiology Date: 1997-11 Impact factor: 11.105
Authors: J H Pexman; P A Barber; M D Hill; R J Sevick; A M Demchuk; M E Hudon; W Y Hu; A M Buchan Journal: AJNR Am J Neuroradiol Date: 2001-09 Impact factor: 3.825
Authors: Shelagh B Coutts; Andrew M Demchuk; Philip A Barber; William Y Hu; Jessica E Simon; Alastair M Buchan; Michael D Hill Journal: Stroke Date: 2004-04-08 Impact factor: 7.914
Authors: Joanna M Wardlaw; Rüdiger von Kummer; Andrew J Farrall; Francesca M Chappell; Michael Hill; David Perry Journal: PLoS One Date: 2010-12-30 Impact factor: 3.240
Authors: Berend C Stoel; Henk A Marquering; Marius Staring; Ludo F Beenen; Cornelis H Slump; Yvo B Roos; Charles B Majoie Journal: J Med Imaging (Bellingham) Date: 2015-03-24
Authors: Meaghan Reid; Akinrinola O Famuyide; Nils D Forkert; Aron Sahand Talai; James W Evans; Amith Sitaram; Moiz Hafeez; Mohamed Najm; Bijoy K Menon; Andrew Demchuk; Mayank Goyal; Rani Gupta Sah; Christopher D d'Esterre; Philip Barber Journal: Clin Neuroradiol Date: 2018-08-21 Impact factor: 3.649
Authors: Koteswara Rao Nalamolu; Ishwarya Venkatesh; Adithya Mohandass; Jeffrey D Klopfenstein; David M Pinson; David Z Wang; Adinarayana Kunamneni; Krishna Kumar Veeravalli Journal: Neuromolecular Med Date: 2019-05-10 Impact factor: 3.843
Authors: V K Sundaram; J Goldstein; D Wheelwright; A Aggarwal; P S Pawha; A Doshi; J T Fifi; R De Leacy; J Mocco; J Puig; K Nael Journal: AJNR Am J Neuroradiol Date: 2019-11-14 Impact factor: 3.825
Authors: Marina Padroni; Sandra Boned; Marc Ribó; Marian Muchada; David Rodriguez-Luna; Pilar Coscojuela; Alejandro Tomasello; Jordi Cabero; Jorge Pagola; Noelia Rodriguez-Villatoro; Jesus M Juega; Estela Sanjuan; Carlos A Molina; Marta Rubiera Journal: Interv Neurol Date: 2016-06-28
Authors: Feras Akbik; Joshua A Hirsch; Pedro Telles Cougo-Pinto; Ronil V Chandra; Claus Z Simonsen; Thabele Leslie-Mazwi Journal: Curr Treat Options Cardiovasc Med Date: 2016-05