William Boisseau1, Cyril Dargazanli2, Stanislas Smajda2, Jean Capron2, Michel Piotin2, Celina Ducroux2, Michel Shamy2, Dariush Dowlatshahi2, Richard I Aviv2, Robert Fahed2. 1. From the Interventional Neuroradiology Department (W.B., S.S., M.P., C.D.), Rothschild Foundation Hospital, Paris; Interventional Neuroradiology Department (C.D.), Gui de Chauliac Hospital, Montpellier; Neurology Department (J.C.), Saint-Antoine Hospital, Paris, France; and Department of Medicine, Division of Neurology (M.S., D.D., R.F.), and Department of Radiology (R.I.A., R.F.), The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Canada. boisseau.william@gmail.com. 2. From the Interventional Neuroradiology Department (W.B., S.S., M.P., C.D.), Rothschild Foundation Hospital, Paris; Interventional Neuroradiology Department (C.D.), Gui de Chauliac Hospital, Montpellier; Neurology Department (J.C.), Saint-Antoine Hospital, Paris, France; and Department of Medicine, Division of Neurology (M.S., D.D., R.F.), and Department of Radiology (R.I.A., R.F.), The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Canada.
Abstract
OBJECTIVE: To determine whether the ABC/2 method could accurately and reliably measure infarct volume and guide thrombectomy decision in acute stroke cases presenting with late or unknown onset. METHODS: Four physicians who routinely use MRI for acute stroke imaging, blinded to the RAPID results, measured the diffusion-weighted imaging (DWI) infarct volume using the ABC/2 method. Measurements with ABC/2 (the index test) were compared with RAPID (the reference standard) to calculate sensitivity, specificity, and accuracy measures for various volume cutpoints. Thrombectomy decisions based on RAPID and raters' measurements using the criteria from the Diffusion-Weighted Imaging or Computerized Tomography Perfusion Assessment With Clinical Mismatch in the Triage of Wake-Up and Late-Presenting Strokes Undergoing Neurointervention With Trevo (DAWN) trial criteria were compared. Interrater and intrarater agreement was measured using kappa statistics. RESULTS: Accuracy with the ABC/2 method was greater than 80% for each rater and each volume cut point. Interrater and intrarater agreement was substantial to excellent for each volume cut point. Treatment decisions with ABC/2 volume estimations showed strong interrater and intrarater agreement, and led to similar thrombectomy decisions compared with RAPID in more than 85% of cases. CONCLUSION: DWI infarct volume measurement using ABC/2 method shows strong accuracy and reliability and may be an acceptable alternative to RAPID software for the application of DAWN criteria for thrombectomy decision-making.
OBJECTIVE: To determine whether the ABC/2 method could accurately and reliably measure infarct volume and guide thrombectomy decision in acute stroke cases presenting with late or unknown onset. METHODS: Four physicians who routinely use MRI for acute stroke imaging, blinded to the RAPID results, measured the diffusion-weighted imaging (DWI) infarct volume using the ABC/2 method. Measurements with ABC/2 (the index test) were compared with RAPID (the reference standard) to calculate sensitivity, specificity, and accuracy measures for various volume cutpoints. Thrombectomy decisions based on RAPID and raters' measurements using the criteria from the Diffusion-Weighted Imaging or Computerized Tomography Perfusion Assessment With Clinical Mismatch in the Triage of Wake-Up and Late-Presenting Strokes Undergoing Neurointervention With Trevo (DAWN) trial criteria were compared. Interrater and intrarater agreement was measured using kappa statistics. RESULTS: Accuracy with the ABC/2 method was greater than 80% for each rater and each volume cut point. Interrater and intrarater agreement was substantial to excellent for each volume cut point. Treatment decisions with ABC/2 volume estimations showed strong interrater and intrarater agreement, and led to similar thrombectomy decisions compared with RAPID in more than 85% of cases. CONCLUSION: DWI infarct volume measurement using ABC/2 method shows strong accuracy and reliability and may be an acceptable alternative to RAPID software for the application of DAWN criteria for thrombectomy decision-making.
Authors: Lehel Lakatos; Manuel Bolognese; Martin Müller; Mareike Österreich; Alexander von Hessling Journal: Front Neurol Date: 2022-07-08 Impact factor: 4.086