A Yahav-Dovrat1, M Saban2, G Merhav1, I Lankri3, E Abergel4, A Eran1, D Tanne5, R G Nogueira6,7, R Sivan-Hoffmann8,4. 1. From the Department of Radiology (A.Y.-D., G.M., A.E., R.S.-H.). 2. Faculty of Social health and Welfare (M.S.), Haifa University, Haifa, Israel. 3. Faculty of Medicine (I.L.), Technion Israel institute of Technology, Haifa, Israel. 4. Unit of Interventional Neuroradiology (E.A., R.S.-H.). 5. Stroke and Cognition Institute (D.T.), Rambam Health Care Campus, Haifa, Israel. 6. Neuroendovascular Service (R.G.N.), Marcus Stroke and Neuroscience Center Grady Memorial Hospital, Atlanta, Georgia. 7. Departments of Neurology, Neurosurgery, and Radiology (R.G.N.), Emory University School of Medicine, Atlanta, Georgia. 8. From the Department of Radiology (A.Y.-D., G.M., A.E., R.S.-H.) otemsivan3@gmail.com.
Abstract
BACKGROUND AND PURPOSE: Artificial intelligence algorithms have the potential to become an important diagnostic tool to optimize stroke workflow. Viz LVO is a medical product leveraging a convolutional neural network designed to detect large-vessel occlusions on CTA scans and notify the treatment team within minutes via a dedicated mobile application. We aimed to evaluate the detection accuracy of the Viz LVO in real clinical practice at a comprehensive stroke center. MATERIALS AND METHODS: Viz LVO was installed for this study in a comprehensive stroke center. All consecutive head and neck CTAs performed from January 2018 to March 2019 were scanned by the algorithm for detection of large-vessel occlusions. The system results were compared with the formal reports of senior neuroradiologists used as ground truth for the presence of a large-vessel occlusion. RESULTS: A total of 1167 CTAs were included in the study. Of these, 404 were stroke protocols. Seventy-five (6.4%) patients had a large-vessel occlusion as ground truth; 61 were detected by the system. Sensitivity was 0.81, negative predictive value was 0.99, and accuracy was 0.94. In the stroke protocol subgroup, 72 (17.8%) of 404 patients had a large-vessel occlusion, with 59 identified by the system, showing a sensitivity of 0.82, negative predictive value of 0.96, and accuracy of 0.89. CONCLUSIONS: Our experience evaluating Viz LVO shows that the system has the potential for early identification of patients with stroke with large-vessel occlusions, hopefully improving future management and stroke care.
BACKGROUND AND PURPOSE: Artificial intelligence algorithms have the potential to become an important diagnostic tool to optimize stroke workflow. Viz LVO is a medical product leveraging a convolutional neural network designed to detect large-vessel occlusions on CTA scans and notify the treatment team within minutes via a dedicated mobile application. We aimed to evaluate the detection accuracy of the Viz LVO in real clinical practice at a comprehensive stroke center. MATERIALS AND METHODS: Viz LVO was installed for this study in a comprehensive stroke center. All consecutive head and neck CTAs performed from January 2018 to March 2019 were scanned by the algorithm for detection of large-vessel occlusions. The system results were compared with the formal reports of senior neuroradiologists used as ground truth for the presence of a large-vessel occlusion. RESULTS: A total of 1167 CTAs were included in the study. Of these, 404 were stroke protocols. Seventy-five (6.4%) patients had a large-vessel occlusion as ground truth; 61 were detected by the system. Sensitivity was 0.81, negative predictive value was 0.99, and accuracy was 0.94. In the stroke protocol subgroup, 72 (17.8%) of 404 patients had a large-vessel occlusion, with 59 identified by the system, showing a sensitivity of 0.82, negative predictive value of 0.96, and accuracy of 0.89. CONCLUSIONS: Our experience evaluating Viz LVO shows that the system has the potential for early identification of patients with stroke with large-vessel occlusions, hopefully improving future management and stroke care.
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