E-081 Prognostic role of parameters acquired by multiphase computed tomography angiography in acute stroke patients treated with endovascular reperfusion therapies
Bibliographic record
Abstract
Purpose We planned to compare the prognostic value of CT based parameters of infarct volume, collateral status, and thrombus burden in acute stroke patients treated with endovascular reperfusion therapy. Methods Consecutive patients treated with anterior circulation occlusions confirmed by multiphase CT angiography (mCTA) that performed endovascular reperfusion therapy were included. MCTA was performed as previously reported. Collaterals were evaluated by single phase CT angiography (sCTA) and mCTA. Alberta Stroke program early CT score (ASPECTS) was analyzed for infarct burden measurement. Clot burden score was assessed for thrombus burden. Factors associated with good outcome (3 month mRS of 0˜2) and poor outcomes (3 month mRS of 5˜6) were analysed. Results 84 patients were included. Intravenous thrombolysis was performed in 25%. Recan success was achieved in 75/84 (89.3%). A total of 49/84 (58.3%) were functionally independent at 3 months. For receiver operating curve analysis of good outcomes, C-statistics for sCTA was 0.683, followed by mCTA 0.645, and ASPECTS 0.620. However, when collateral status was incorporated in a multivariate analysis for predicting good outcomes including ASPECTS among other parameters, its significance faltered, while the significance of ASPECTS remained. For receiver operating curve analysis of good outcomes, c-statistics for sCTA was 0.758, followed by mCTA 0.740, and ASPECTS 0.603. In the multivariate analysis, both sCTA (odd ratio: 0.225, 95% confidence interval: 0.082–0.617, p=0.004) and mCTA (0.123, 0.027–0.565. p=0.007) predicted poor outcomes including ASPECTS among other parameters. Thrombus burden did not correlate with 3 month functional status. Conclusions Infarct volume accessed by ASPECTS strongly predict positive outcome, while collateral status accessed by CT are better markers of negative outcomes. The added benefit of multiphase CT in grading of collaterals for prognostication is not evident in this study. Disclosures J. Choi: None. S. Lee: None. M. Choi: None. S. Lee: None. J. Lee: None. J. Hong: None.
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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 | 0.001 | 0.003 |
| 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 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".