Alberta Stroke Program Early CT Score
ASPECTS is a 10-point topographic score that quantifies early ischemic change across the middle cerebral artery territory on non-contrast CT in acute stroke. Starting from 10, a point is subtracted for each of ten defined regions showing early ischemia, giving a fast, reproducible measure of infarct extent — lower scores mean more established injury. It became central to acute-stroke workflow because it was used to select (and exclude) patients in the landmark thrombectomy trials, and it remains one of the most-referenced scores at the CT scanner.
Introduced the 10-point non-contrast-CT topographic score of early MCA ischemia, later adopted to select and exclude patients in the landmark thrombectomy trials.
ASFNR clinical state-of-practice: For posterior circulation large vessel occlusion stroke, use noncontrast CT to exclude hemorrhage, CT angiography to identify occlusion, and MRI with DWI as reference standard. Imaging scores like PC-ASPECTS help select patients for thrombectomy.
Retrospective analysis of 552 patients: quantitative infarct volumetry placed the thrombectomy benefit ceiling at 110 mL. Benefit at 50–110 mL (cOR 0.38, 95% CI 0.15–0.97), lost >110 mL. ASPECTS misclassified 'large core'—these patients had poor outcome 11.8% vs small-core 11.7%.
A refined AI-ASPECTS model using an expanded middle cerebral artery atlas and optimized lesion thresholds (2%–29%) improved correlation with NIHSS (r= -0.414) and functional outcome prediction (AUC 0.723) compared to conventional AI (AUC 0.654) and expert readers (AUC 0.641) on…
StrokeSENS ASPECTS, an AI tool, improved sensitivity for early ischemic changes on NCCT by 9.7 pp (p<0.001) and inter-reader agreement (κ 0.32→0.61) in an 8-reader, 100-case retrospective MRMC study of MCA/ICA occlusion patients.
In 283 anterior circulation LVO stroke patients, adding the Perfusion Collateral Impairment Score (PCIS) to standard collateral scores improved 90-day poor-outcome prediction (COVES+PCIS aOR 1.53, 95% CI 1.17–2.01), but PCIS alone did not outperform comparators after correction.
A DL-generated high-contrast thin-slice CT (HCCT) from plain NCCT pushed inter-rater ASPECTS correlation from 0.72 to 0.94 (p<0.001) in 303 LVO stroke patients across 4 centers — outperforming standard NCCT for early ischemic change detection and favorable-outcome prediction.
FDA 510(k) clearance granted to Brainomix 360 Hyperdensity, an AI-based software for detecting hyperdense vessel signs on CT — a key early marker of large-vessel occlusion stroke. Product code QIH.
Background Ischemic lesion net water uptake (NWU), a CT biomarker of cerebral edema, has been linked to poor outcomes in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Whether NWU outperforms other imaging markers in predicting futile recanaliza...
RadPigeon is an independent radiology news digest and is not affiliated with or endorsed by Barber et al. (ASPECTS Study Group). “ASPECTS” is a trademark of its owner and is named here only to refer to the system. Always consult the official source for the exact, current criteria.
