Multiphase CTA Collateral Circulation is an Excellent CT Indicator than CT ASPECTS in Predicting Clinical Outcome in Acute Ischemic Stroke
Bibliographic record
Abstract
Objective: The prognosis of acute ischemic stroke patients is influenced by collateral vasculature. The present study aimed to evaluate the predictive value of the initial collateral circulation score (ICS) obtained from multiphase computed tomography angiography (mCTA) in determining clinical outcomes. The authors hypothesized that the initial mCTA collateral circulation score may serve as a superior predictor of clinical outcomes compared to the CT Alberta Stroke Program Early CT Score (ASPECTS). Additionally, the first phase CTA ASPECTS (f-CTA ASPECTS) derived from mCTA may offer enhanced predictive accuracy over the CT ASPECTS. Materials and Methods: The authors conducted a retrospective analysis of 300 patients diagnosed with acute ischemic stroke between 2020 and 2021. Collateral scores were assessed using mCTA, and the first phase CTA ASPECTS score was also evaluated. Clinical outcomes were measured using the modified Rankin Scale (mRS) at hospital discharge, categorizing outcomes as good with mRS 0 to 2, or poor with mRS 3 to 6. Both univariate and multiple linear regression models were employed to predict patient outcomes. Results: Univariate analysis demonstrated a significant association between both the collateral score and first phase CTA ASPECTS with clinical outcomes. However, in the multiple linear regression model, only the CTA ASPECTS emerged as a significant predictor of discharge mRS. The model accounted for 45.7% of the variance in mRS at discharge. A comparison of the reperfusion and non-reperfusion groups with good collateral scores revealed no significant difference in discharge mRS outcomes (p=0.954). Conclusion: While both the collateral score and the first phase CTA ASPECTS were associated with clinical outcomes, only the first phase CTA ASPECTS was a statistically significant predictor of mRS at discharge. The absence of a difference in mRS outcomes between reperfusion and non-reperfusion groups among patients with initially good collateral scores on mCTA suggested that aggressive reperfusion procedures may not always be warranted.
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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 | 0.002 | 0.009 |
| 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 | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".