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PT  - JOURNAL ARTICLE
AU  - Xue, W.
AU  - Vegunta, S.
AU  - Zwart, C.M.
AU  - Aguilar, M.I.
AU  - Patel, A.C.
AU  - Hoxworth, J.M.
AU  - Demaerschalk, B.M.
AU  - Mitchell, J.R.
TI  - Retrospective Validation of a Computer-Assisted Quantification Model of Intracerebral Hemorrhage Volume on Accuracy, Precision, and Acquisition Time, Compared with Standard ABC/2 Manual Volume Calculation
AID  - 10.3174/ajnr.A5256
DP  - 2017 Aug 01
TA  - American Journal of Neuroradiology
PG  - 1536--1542
VI  - 38
IP  - 8
4099  - http://www.ajnr.org/content/38/8/1536.short
4100  - http://www.ajnr.org/content/38/8/1536.full
SO  - Am. J. Neuroradiol.2017 Aug 01; 38
AB  - BACKGROUND AND PURPOSE: Intracerebral hemorrhage accounts for 6.5%–19.6% of all acute strokes. Initial intracerebral hemorrhage volume and expansion are both independent predictors of clinical outcomes and mortality. Therefore, a rapid, unbiased, and precise measurement of intracerebral hemorrhage volume is a key component of clinical management. The most commonly used method, ABC/2, results in overestimation. We developed an interactive segmentation program, SegTool, using a novel graphic processing unit, level set algorithm. Until now, the speed, bias, and precision of SegTool had not been validated.MATERIALS AND METHODS: In a single stroke academic center, 2 vascular neurologists and 2 neuroradiologists independently performed a test-retest experiment that involved repeat measurements of static, unchanging intracerebral hemorrhage volumes on CT from 76 intracerebral hemorrhage cases. Measurements were made with SegTool and ABC/2. True intracerebral hemorrhage volumes were estimated from a consensus of repeat manual tracings by 2 operators. These data allowed us to estimate measurement bias, precision, and speed.RESULTS: The measurements with SegTool were not significantly different from the true intracerebral hemorrhage volumes, while ABC/2 overestimated volume by 45%. The interrater measurement variability with SegTool was 50% less than that with ABC/2. The average measurement times for ABC/2 and SegTool were 35.7 and 44.6 seconds, respectively.CONCLUSIONS: SegTool appears to have attributes superior to ABC/2 in terms of accuracy and interrater reliability with a 9-second delay in measurement time (on average); hence, it could be useful in clinical trials and practice.ICHintracerebral hemorrhageLSlevel setMDC95% minimum detectable change