RT Journal Article
SR Electronic
T1 Real-world evaluation of Brainomix e-Stroke software
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP 497
OP 504
DO 10.1136/svn-2023-002859
VO 9
IS 5
A1 Mallon, Dermot
A1 Fallon, Matthew
A1 Blana, Eirini
A1 McNamara, Cillian
A1 Menon, Arathi
A1 Ip, Chak Lam
A1 Garnham, Jack
A1 Yousry, Tarek
A1 Cowley, Peter
A1 Simister, Robert
A1 Doig, David
YR 2024
UL http://svn.bmj.com/content/9/5/497.abstract
AB Background and purpose Brainomix e-Stroke is an artificial intelligence-based decision support tool that aids the interpretation of CT imaging in the context of acute stroke. While e-Stroke has the potential to improve the speed and accuracy of diagnosis, real-world validation is essential. The aim of this study was to prospectively evaluate the performance of Brainomix e-Stroke in an unselected cohort of patients with suspected acute ischaemic stroke.Methods The study cohort included all patients admitted to the University College London Hospital Hyperacute Stroke Unit between October 2021 and April 2022. For e-ASPECTS and e-CTA, the ground truth was determined by a neuroradiologist with access to all clinical and imaging data. For e-CTP, the values of the core infarct and ischaemic penumbra were compared with those derived from syngo.via, an alternate software used at our institution.Results 1163 studies were performed in 551 patients admitted during the study period. Of these, 1130 (97.2%) were successfully processed by e-Stroke in an average of 4 min. For identifying acute middle cerebral artery territory ischaemia, e-ASPECTS had an accuracy of 77.0% and was more specific (83.5%) than sensitive (58.6%). The accuracy for identifying hyperdense thrombus was lower (69.1%), which was mainly due to many false positives (positive predictive value of 22.9%). Identification of acute haemorrhage was highly accurate (97.8%) with a sensitivity of 100% and a specificity of 97.6%; false positives were typically caused by areas of calcification. The accuracy of e-CTA for large vessel occlusions was 91.5%. The core infarct and ischaemic penumbra volumes provided by e-CTP strongly correlated with those provided by syngo.via (ρ=0.804—0.979).Conclusion Brainomix e-Stroke software provides rapid and reliable analysis of CT imaging in the acute stroke setting although, in line with the manufacturer’s guidance, it should be used as an adjunct to expert interpretation rather than a standalone decision-making tool.No data are available. Not applicable.