Abstract WP52: ASPECTS and eASPECTS Correlation With Baseline and Final Infarct Volume in Acute Ischemic Stroke Thrombectomy Patients
Bibliographic record
Abstract
Alberta Stroke Program Early CT score (ASPECTS) is widely used as cut-off point to indicate thrombolysis therapy in acute ischemic stroke. Its role in predicting patients likely to benefit from endovascular therapy has not been defined yet. ASPECTS presents a poor interrater reliability, and an automated software (eASPECTS) has been recently created to solve this limitation. Our aim was to evaluate correlation between ASPECTS measured by neurorradiologists, eASPECTS and cerebral blood volume (CBV) lesion, as well as to determine the impact of ASPECTS and eASPECTS on final infarct in thrombectomy patients. Methods: Consecutive patients with acute intracranial ICA and proximal MCA (M1) occlusion who underwent endovascular thrombectomy were included. ASPECTS and e-ASPECTS on basal non-contrast CT were evaluated. Admission infarct core was measured on CBV in CT perfusion. We assessed time from symptom onset to neuroimaging evaluation and recanalization (TICI 2b-3) after thrombectomy. Infarct volume was measured on 24-hour control CT. Results: We included 214 patients (88% with MCA occlusion). Median NIHSS was 18 (IQR 14-20) and mean time from symptom onset to CT was 194.11±154.34 min. Complete recanalization rate was 80.84%. Median ASPECTS was 9 (IQR 8-10) and median eASPECTS 9 (IQR 7.75-10), mean CBV infarct core was 55.29±90cc. Correlation (r s ) between ASPECTS and eASPECTS was 0.44 (p<0.01). ASPECTS/eASPECTS and CBV presented a significant correlation only after 180 min of symptom onset (r s =-0.44, p<0.01 / r s =-0.26, p<0.05). Both ASPECTS and eASPECTS (r s =-0.40 and -0.43) correlated with 24h infarct volume in patients with complete recanalization (p<0.01). A logistic regression analysis showed that both ASPECTS (OR 0.56, p<0.01, CI 0.43-0.72) and eASPECTS (OR 0.57, p<0.01, CI 0.44-0.73) predicted independently low final infarct volume, together with recanalization (OR 4.6, p=0.03, CI 1.69-2.34). Conclusions: Correlation of ASPECTS and eASPECTS with CBV was time-dependent as both measurements correlated with CBV when time to CT was>180 min. Both ASPECTS and eASPECTS predicted infarct volume after thrombectomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".