Abstract
Background
Noncontrast enhanced computed tomography (NCCT) remains the most common method for
brain imaging patients who present acutely with ischaemic stroke. Computational methods
may improve NCCT analysis in this context. We systematically reviewed current research.
Methods
We searched 7 medical and computer engineering databases for studies testing computational
methods for analysing NCCT in acute ischaemic stroke. Two independent reviewers extracted
the following data; computational method, imaging features investigated, test dataset,
ground truth comparison, and performance. We critically evaluated studies for risk
of bias and applicability using the Quality Assessment of Diagnostic Accuracy Studies
tool (QUADAS-2).
Results
From 11,235 nonduplicated articles, we full-text reviewed 200 and selected 68 for
inclusion. We identified three dominant study types testing a large range of computational
methods for: (1) identifying acute ischaemic stroke (n = 42); (2) ischaemic lesion
segmentation (n = 6); and (3) automated Alberta Stroke Program Early CT Score (n = 20).
Most articles presented small test datasets, poorly documented patient populations,
and did not specify the acuity of the CT scans used in development. There was limited
validation or clinical testing of computational methods. Automated Alberta Stroke
Program Early CT Score methods were the only software systems presented in multiple
publications. Critical evaluation was often limited by lack of data.
Conclusions
Computational techniques for analysing NCCT in patients with acute ischaemic stroke
have not been adequately clinically validated. Further research with larger and more
relevant datasets, in addition to better collaboration between clinicians and researchers,
is needed to aid more widespread clinical adoption and implementation.
Key Words
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Article info
Publication history
Published online: March 03, 2020
Accepted:
January 28,
2020
Received in revised form:
January 16,
2020
Received:
September 17,
2019
Footnotes
Grant Mair is funded by the Stroke Association Edith Murphy Foundation Senior Clinical Lectureship (SA L-SMP 18\1000).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104715
Copyright
© 2020 Elsevier Inc. All rights reserved.
