Comparison of CTA and DSA collateral scores in predicting clinical outcome in anterior circulation stroke patients receiving endovascular treatment: A retrospective observational study
Bibliographic record
Abstract
In our study, we performed both computed tomographic angiography (CTA) and digital substraction angiography (DSA) collateral artery flow scoring in anterior system acute stroke patients who underwent mechanical thrombectomy (MT) within the first 16 hours. The study aimed to evaluate the consistency of both scoring methods and their relationship with the 90-day clinical outcomes of the patients. From January to December 2022, the files of patients with middle cerebral artery occlusion who underwent MT and were followed up at a stroke center were retrospectively reviewed. Demographic data, laboratory parameters, Alberta stroke program early computed tomography score, National Institutes of Health Stroke Scale score, grade of recanalization, symptomatic intracranial hemorrhage (European Cooperative Acute Stroke Study III criteria), and 90-day modified Rankin Scale values were recorded. Modified Rankin Scale ≤ 2 was considered a good clinical outcome. CTA and DSA images were independently evaluated by 2 experienced neurologists. The TAN score was used for CTA collateral scoring, while the ASITN score was used for DSA collateral scoring. Fleiss Kappa coefficient was used to assess inter-rater agreement and Spearman rho coefficient was used for correlation between the scores. At 90 days, 62 patients (70%) achieved good clinical outcome. Mean CTA and DSA collateral scores were significantly higher in patients with good outcome (P < .001 for both). Inter-rater agreement was substantial (CTA: κ = 0.65 [0.518-0.775], AC1 = 0.68 [0.556-0.796]; DSA: κ = 0.59 [0.456-0.713], AC1 = 0.61 [0.489-0.732]). In multivariate analysis, DSA collateral score was independently associated with good outcome (adjusted odd ratio [aOR]: 0.01; 95% CI: 0.00-0.46; P = .02), along with admission National Institutes of Health Stroke Scale score (aOR: 5.33; 95% CI: 1.57-18.07; P = .01), and admission Alberta stroke program early computed tomography score (aOR: 0.09; 95% CI: 0.01-0.68; P = .02). In patients undergoing MT, CTA and DSA collateral score ratings are predictive of clinical outcomes at 90-day and are strongly correlated with each other.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".