Candice Delcourt1,2,3, Cheryl Carcel1,2, Danni Zheng1,2, Shoichiro Sato1,4, Hisatomi Arima1,5, Sonu Bhaskar2,6,7, Pierre Janin2,8, Rustam Al-Shahi Salman9, Yongjun Cao10, Shihong Zhang11, Emma Heeley12, Leo Davies2,3, John Chalmers1, Craig S Anderson13,14,15. 1. The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia. 2. Sydney MedicalSchool, University of Sydney, Sydney, New South Wales, Australia. 3. Neurology Department, Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, New South Wales, Australia. 4. National Cerebral and Cardiovascular Center, Suita, Japan. 5. Department of Public Health, Fukuoka University, Fukuoka, Japan. 6. Neurology Department, Liverpool Hospital, Sydney, New South Wales, Australia. 7. Ingham Institute for Applied Medical Research, UNSW, Sydney, New South Wales, Australia. 8. Intensive Care Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia. 9. Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom. 10. Department of Neurology, Second Affiliated Hospital of Soochow University, Suzhou, China. 11. Neurological Department, West China Hospital, Sichuan University, Chengdu, China. 12. Data Intelligence, Strategic Research Investment, Cancer Institute NSW, Sydney, New South Wales, Australia. 13. The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia, canderson@george.org.au. 14. Neurology Department, Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, New South Wales, Australia, canderson@george.org.au. 15. The George Institute China, Peking University Health Sciences Center, Beijing, China, canderson@george.org.au.
Abstract
BACKGROUND AND PURPOSE: Hematoma volume is a key determinant of outcome in acute intracerebral hemorrhage (ICH). We aimed to compare estimates of ICH volume between simple (ABC/2, length, width, and height) and gold standard planimetric software approaches. METHODS: Data are from the second Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). Multivariable linear regression was used to compare ICH volumes on baseline CT scans using the ABC/2, modified ABC/2 (mABC/2), and MIStar software. Other aspects of ICH morphology examined included location, irregularity, heterogeneity, intraventricular and subarachnoid hemorrhage extension (SAH) of hematoma, and associated white matter lesions and brain atrophy. RESULTS: In 2,084 patients with manual and semiautomated measurements, median (IQR) ICH volumes for each approach were: ABC/2 11.1 (5.11-20.88 mL), mABC/2 7.8 (3.88-14.11 mL), and MIStar 10.7 (5.59-18.66 mL). Median differences between ABC/2 and MIStar, and mABC/2 and MIStar were 0.34 (-1.01 to 2.96) and -2.4 (-4.95 to -0.7416), respectively. Hematoma volumes differed significantly with irregular shape (ABC/2 and MIStar, p < 0.001; mABC/2 and MIStar, p = 0.007) and larger volumes (mABC/2 and MIStar, p < 0.001; ABC/2 and MIStar, p = 0.07). ICH with SAH showed a significant discrepancy between ABC/2 and MIStar (p < 0.001). CONCLUSIONS: Overall, ABC/2 performs better than mABC/2 in estimating ICH volume. The largest discrepancies were evidenced against automated software for irregular-shaped and large ICH with SAH, but the clinical significance of this is uncertain.
BACKGROUND AND PURPOSE:Hematoma volume is a key determinant of outcome in acute intracerebral hemorrhage (ICH). We aimed to compare estimates of ICH volume between simple (ABC/2, length, width, and height) and gold standard planimetric software approaches. METHODS: Data are from the second Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). Multivariable linear regression was used to compare ICH volumes on baseline CT scans using the ABC/2, modified ABC/2 (mABC/2), and MIStar software. Other aspects of ICH morphology examined included location, irregularity, heterogeneity, intraventricular and subarachnoid hemorrhage extension (SAH) of hematoma, and associated white matter lesions and brain atrophy. RESULTS: In 2,084 patients with manual and semiautomated measurements, median (IQR) ICH volumes for each approach were: ABC/2 11.1 (5.11-20.88 mL), mABC/2 7.8 (3.88-14.11 mL), and MIStar 10.7 (5.59-18.66 mL). Median differences between ABC/2 and MIStar, and mABC/2 and MIStar were 0.34 (-1.01 to 2.96) and -2.4 (-4.95 to -0.7416), respectively. Hematoma volumes differed significantly with irregular shape (ABC/2 and MIStar, p < 0.001; mABC/2 and MIStar, p = 0.007) and larger volumes (mABC/2 and MIStar, p < 0.001; ABC/2 and MIStar, p = 0.07). ICH with SAH showed a significant discrepancy between ABC/2 and MIStar (p < 0.001). CONCLUSIONS: Overall, ABC/2 performs better than mABC/2 in estimating ICH volume. The largest discrepancies were evidenced against automated software for irregular-shaped and large ICH with SAH, but the clinical significance of this is uncertain.
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