Evaluation of Artificial Intelligence-Powered Identification of Large-Vessel Occlusions in a Comprehensive Stroke Center

AJNR Am J Neuroradiol. 2021 Jan;42(2):247-254. doi: 10.3174/ajnr.A6923. Epub 2020 Dec 31.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / diagnostic imaging*
  • Computed Tomography Angiography / methods
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Male
  • Middle Aged
  • Mobile Applications*
  • Neural Networks, Computer*
  • Predictive Value of Tests
  • Retrospective Studies
  • Stroke / diagnostic imaging*
  • Stroke / etiology