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Stroke and Vascular Neurology

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Open Access

Real-world evaluation of Brainomix e-Stroke software

Dermot Mallon, Matthew Fallon, Eirini Blana, Cillian McNamara, Arathi Menon, Chak Lam Ip, Jack Garnham, Tarek Yousry, Peter Cowley, Robert Simister, David Doig
DOI: 10.1136/svn-2023-002859 Published 22 December 2023
Dermot Mallon
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
2UCL Queen Square Institute of Neurology, London, UK
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  • ORCID record for Dermot Mallon
Matthew Fallon
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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Eirini Blana
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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Cillian McNamara
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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Arathi Menon
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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Chak Lam Ip
3Comprehensive Stroke Centre, University College London Hospitals NHS Foundation Trust, London, UK
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Jack Garnham
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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Tarek Yousry
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
2UCL Queen Square Institute of Neurology, London, UK
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Peter Cowley
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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Robert Simister
2UCL Queen Square Institute of Neurology, London, UK
3Comprehensive Stroke Centre, University College London Hospitals NHS Foundation Trust, London, UK
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David Doig
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
2UCL Queen Square Institute of Neurology, London, UK
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  • Figure 1
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    Figure 1

    Flow chart of the study cohort. †No e-CTA due to no CTA in 13 cases. CTA, CT angiography; CTP, CT perfusion; NCCT, non-contrast CT.

  • Figure 2
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    Figure 2

    Performance of e-ASPECTS. A heatmap shows strong positive correlation between the ASPECTS and e-ASPECTS (A). Diagnostic statistics are shown for the detection of acute infarct (ie, ASPECTS<10) (B), hyperdense vessels (HD) (C) and acute haemorrhage (D). NPV, negative predictive value; PPV, positive predictive value.

  • Figure 3
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    Figure 3

    e-ASPECTS accuracy by region at the level of the basal ganglia (A) and the supraganglionic level (B).

  • Figure 4
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    Figure 4

    Performance of e-CTA. Diagnostic statistics for all vessel occlusions (Internal Carotid Artery [ICA], M1 and M2 Middle Cerebral Artery [MCA]) (A) and for large vessel occlusions (LVOs) only (ICA and M1 MCA) (B). CTA, CT angiography; NPV, negative predictive value; PPV, positive predictive value.

  • Figure 5
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    Figure 5

    Scatter plots of the core infarct volume (A), penumbra volume (B) and mismatch ratio (C) volumes derived from Brainomix e-CTP and Siemens syngo.via. Orange data points refer to values greater than 10. CTP, CT perfusion.

Tables

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  • Table 1

    Demographics and clinical data of patient cohort

    Demographics
    Age70 (58—81)
    Sex (M:F)300:271 (54%:47%)
    Clinical
     Hypertension302 (54%)
     Type 2 diabetes143 (25%)
     Previous stroke110 (19%)
     Admission modified Rankin score0 (0—2)
     NIHSS at admission7 (3—14)
    Diagnosis
     Acute infarct involving the MCA territory128 (22%)
     Infarcts confined to the ACA territory5 (1%)
     Infarcts confined to the posterior circulation26 (5%)
     Acute haemorrhage59 (10%)
     Other diagnosis5 (1%)
    Vessel occlusion
     Large vessel occlusion62 (11%)
     Medium vessel occlusion18 (3%)
     All occlusions80 (15%)
    Imaging on follow-up
     None131 (23%)
     CT71 (12%)
     MRI369 (65%)
     Time of follow-up imaging (hours)17 (10—28)
    • NIHSS, National Institute of Health Stroke Score.

Supplementary Materials

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  • Supplementary data

    [svn-2023-002859supp001.pdf]

Additional Files

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  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    • Data supplement 1
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Stroke and Vascular Neurology: 10 (1)
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Real-world evaluation of Brainomix e-Stroke software
Dermot Mallon, Matthew Fallon, Eirini Blana, Cillian McNamara, Arathi Menon, Chak Lam Ip, Jack Garnham, Tarek Yousry, Peter Cowley, Robert Simister, David Doig
Stroke and Vascular Neurology Dec 2023, svn-2023-002859; DOI: 10.1136/svn-2023-002859

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Real-world evaluation of Brainomix e-Stroke software
Dermot Mallon, Matthew Fallon, Eirini Blana, Cillian McNamara, Arathi Menon, Chak Lam Ip, Jack Garnham, Tarek Yousry, Peter Cowley, Robert Simister, David Doig
Stroke and Vascular Neurology Dec 2023, svn-2023-002859; DOI: 10.1136/svn-2023-002859
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Real-world evaluation of Brainomix e-Stroke software
Dermot Mallon, Matthew Fallon, Eirini Blana, Cillian McNamara, Arathi Menon, Chak Lam Ip, Jack Garnham, Tarek Yousry, Peter Cowley, Robert Simister, David Doig
Stroke and Vascular Neurology Dec 2023, svn-2023-002859; DOI: 10.1136/svn-2023-002859
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