4.7 Review

Accuracy of Automated Computer-Aided Diagnosis for Stroke Imaging: A Critical Evaluation of Current Evidence

Journal

STROKE
Volume 53, Issue 7, Pages 2393-2403

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STROKEAHA.121.036204

Keywords

artificial intelligence; brain; machine learning; perfusion; stroke

Funding

  1. UK Dementia Research Institute from DRI Ltd - UK Medical Research Council
  2. Alzheimer's Society
  3. Alzheimer's Research UK
  4. Stroke Association Edith Murphy Foundation [SA L-SMP 18\1000]
  5. Stroke Association [TSA_CR_2017/01]
  6. Medical Research Council [MC_PC_17188]
  7. Health Data Research UK from the Medical Research Council
  8. British Heart Foundation [FS/ICRF/20/26002]
  9. NIHR Health Technology Programme
  10. British Heart Foundation

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There is a growing interest in using artificial intelligence in computer applications for medical imaging diagnosis, particularly in stroke. The use of AI methods can help in quickly and accurately diagnosing acute brain pathology, guiding treatment decisions, and improving treatment outcomes. However, diagnostic tools including AI methods are not subjected to the same clinical evaluation standards as drugs.
There is increasing interest in computer applications, using artificial intelligence methodologies, to perform health care tasks previously performed by humans, particularly in medical imaging for diagnosis. In stroke, there are now commercial artificial intelligence software for use with computed tomography or MR imaging to identify acute ischemic brain tissue pathology, arterial obstruction on computed tomography angiography or as hyperattenuated arteries on computed tomography, brain hemorrhage, or size of perfusion defects. A rapid, accurate diagnosis may aid treatment decisions for individual patients and could improve outcome if it leads to effective and safe treatment; or conversely, to disaster if a delayed or incorrect diagnosis results in inappropriate treatment. Despite this potential clinical impact, diagnostic tools including artificial intelligence methods are not subjected to the same clinical evaluation standards as are mandatory for drugs. Here, we provide an evidence-based review of the pros and cons of commercially available automated methods for medical imaging diagnosis, including those based on artificial intelligence, to diagnose acute brain pathology on computed tomography or magnetic resonance imaging in patients with stroke.

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