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Published at October 22

Automated neuroradiological support systems for multiple cerebrovascular disease markers -- A systematic review and meta-analysis

cs.CR

cs.AR

Released Date: October 22, 2024

Authors: Jesse Phitidis¹, Alison Q. O'Neil, William N. Whiteley, Beatrice Alex², Joanna M. Wardlaw³, Miguel O. Bernabeu⁴, Maria Valdés Hernández³

Aff.: ¹Centre for Clinical Brain Sciences, University of Edinburgh; ²School of Literature, Languages and Culture, University of Edinburgh; ³UK Dementia Research Institute, Centre at The University of Edinburgh; ⁴Usher Institute, University of Edinburgh

Arxiv: https://arxiv.org/abs/2410.17124v1

Pathologies and anatomy:

ICH: intracerebral haemorrhage, (L)VO: (large) vessel occlusion, BA: brain aneurysm,

ISL: ischaemic stroke lesion, PVS: enlarged perivascular spaces, SVD: small vessel disease,

WMH: white matter hyperintensities, EDH: epidural hematoma, SDH: subdural haemorrhage,

SAH: subarachnoid haemorrhage, IVH: intraventricular haemorrhage, IPH: intraparenchymal

haemorrhage, ICA: internal carotid artery, MCA: middle cerebral artery.

Modalities:

NCCT: non-contrast computed tomography, CTA: computed tomography angiography,

CTP: computed tomography perfusion, MRI: magnetic resonance imaging, T1: T1-weighted

MRI, T2: T2-weighted MRI, T2*: T2*-weighted MRI, FLAIR: fluid-attenuated inversion

recovery MRI, SWI: susceptibility-weighted imaging MRI, DWI: diffusion-weighted imaging

MRI, GRE: gradient echo MRI, TOF: time-of-flight MRI angiography.

Other abbreviations:

AI: artificial intelligence, DL: deep learning, ML: machine learning, RB: rule-based.

(AI is stated as the method class when the company states the product as being AI and further

investigation does not clarify the method).

Company

Product

Pathology

Modality

Features

Method

class

Approval

(sub-product)

aidoc,

icometrix

Always-on

ICH, VO,

M1 LVO,

NCCT,

CTA,

CTP

Identification of

suspected findings

per pathology.

Core segmentation

and volume for

(M1 L)VO from

CTP.

FDA (II), CE (I)

(BriefCase ICI

triage)

(BriefCase LVO

triage)

(Briefcase BA

triage)

(icobrain-cva)

annalise.ai

Enterprise

CTB

ICH, ISL,

BA,

atrophy,

PVS,

SVD,

…

(130 total)

NCCT

Detection or seg-

mentation of 130

radiological

findings including

ICH subtypes,

infarcts, PVS, and

SVD.

FDA (II), CE (IIb)

Avicenna.AI

Cina

ICH, LVO,

ISL

NCCT,

CTA

Identification of

suspected ICH or

LVO. ASPECTS

with infarct outline

and probability map

of hypoattenuation

and sulcal efface-

ment.

FDA (II), CE (I)

(CINA-ICH)

(CINA-LVO)

CE (I)

(CINA-

ASPECTS)

BRAINOMIX

e-Stroke

ICH, LVO,

ISL

NCCT,

CTA,

CTP

ASPECTS with

infarct volume

and hypoattenuation

heat map (hyper-

attenuation also

detected indicating

bleeding).

Bounding box

on CTA for vessel

occlusion. Core

and penumbra

segmentation and

volume and mis-

match ratio from

CTP.

ML,

RB,

FDA (II), CE (IIa)

(e-CTA)

CE (IIa)

(e-CTP)

(e-ASPECTS)

BRAINSCAN.AI

BrainScan

ICH, ISL,

atrophy

NCCT

Segmentation and

probability map of

ICH subtypes and

acute and chronic

ISL as well as areas

of atrophy.

CE (IIa)

Cercare Medical

Cercare

Stroke

ICH, LVO

NCCT,

CTA,

MRI

Detects ICH.

Identifies

and provides

volume of

infarcted lesions.

Identifies exact

location of LVO.

Perfusion maps

from CT or MRI

perfusion

imaging and

additional

biomarkers of

oxygenation.

CE (IIa)

CEREBRIU

APOLLO

BRAIN

ICH, ISL

FLAIR,

T2*,

SWI,

DWI

Detects ICH and

ISL.

CE (I)

Combinostics

cMRI

WMH,

Atrophy

T1,

FLAIR

Segmentation of

brain and atrophy

per region and

WMH per region;

longitudinal analysis

available. Outputs

structured report.

FDA (II), CE (IIa)

cortechs.ai

Neuro-

Quant

WMH,

atrophy

T1,

FLAIR

Brain atrophy per

region from T1.

Segmentation and

volume of WMH

and longitudinal

analysis from

FLAIR.

ML,

RB,

FDA (II), CE (IIa)

DEEP01

DeepCT

ICH, LVO

NCCT,

CTA

Detection of ICH

(region, subtype,

volume, modified

Fisher scale,

Marshall score,

IMPACT score,

midline shift, and

Evans index).

Detection and

localisation of

LVO.

FDA (II), CE (I)

icometrix

icobrain

ISL,

WMH,

atrophy

CTP,

T1,

FLAIR

Segmentation of

ischaemic core and

penumbra from

CTP. Segmen-

tation and volume

and longitudinal

analysis of FLAIR

hyperintensities and

T1 hypointensities.

Brain volume

change metrics by

region from T1.

FDA (II), CE (I)

INMED AI

NeuroShield

ICH,

WMH,

CMB,

atrophy

NCCT,

MRI

Brain atrophy by

region, WMH and

CMBs (no info),

detection and seg-

mentation of ICH

and triage.

FDA (II)

(NeuroShieldMR)

JLK

MEDIHUB

STROKE

ICH, ISL

NCCT,

CTP, T1,

T2,

FLAIR,

GRE,

PWI,

DWI

ICH localisation

and subtype (EDH,

SDH, SAH, IVH,

intracerebral) from

NCCT. Ischaemic

stroke subtype

probability

from DWI and

optional FLAIR, T1,

T2. Severity

probability

according

to the NIH stroke

scale from DWI.

Volume mismatch

from DWI/PWI.

On-set time

prediction and

ischaemic core seg-

mentation from

DWI/FLAIR.

Collateral map

analysis, ischaemic

core and penumbra

volume and mis-

match from CTP.

Infarct segmentation

and prognosis from

DWI and early

detection from

NCCT.

DL,

CE (I)

(JBS-01K)

(JBS-04K)

mediaire

mdbrain

WMH,

atrophy,

T1,

FLAIR,

TOF

Brain volume by

region and long-

itudinal changes

from T1. Segmen-

tation of WMH

and regional

assessment and

longitudinal

changes from T1

/FLAIR. Segmen-

tation of BA from

TOF.

CE (I)

Methinks

Stroke

Suite

ICH, LVO

NCCT,

CTA

Notification of ICH

and LVO for

patient triage.

CE (I)

neurophet

AQUA

WMH,

atrophy

T1,

FLAIR

Brain atrophy by

region and longit-

udinal analysis

from T1.

WMH burden score

from FLAIR.

CE (IIa)

NICOLAB

Stroke-

Viewer

ICH, LVO,

ISL

NCCT,

CTA,

CTP

Segmentation and

volume of ICH

and SAH from

NCCT. ASPECTS

scoring. Identific-

ation and bounding

box of LVO and

collateral score

from CTA. Core

and mismatch

volumes from CTP.

DL,

FDA (II), CE (I)

PIXYL

Pixyl.Neuro

WMH,

atrophy

T1,

FLAIR

Segmentation and

volume of WMH

by region

and longitudinally

and brain atrophy

by region and

longitudinally.

FDA (II), CE (IIa)

Quantib

WMH,

atrophy

MRI

Brain atrophy by

region and longit-

udinal changes.

Segmentation of

WMH and longit-

udinal changes.

FDA (II), CE (IIa)

QUBIOtech

NEURO-

CLOUD

VOL

WMH,

atrophy

T1,

FLAIR

Brain atrophy

quantification by

region and longit-

udinal changes

from T1. Segmen-

tation of WMH by

region and longit-

udinal changes

from FLAIR.

ML,

CE (I)

qure.ai

qER

ICH, ISL

NCCT

Bounding box and

volume for ICH

subtypes (IPH, IVH,

SDH, SAH, EDH).

Detects and quanti-

fies midline shift.

ASPECTS score

and outlines hypo-

attenuated area.

Bounding box for

acute and chronic

infarcts (including

lacunar).

FDA (II), CE (IIa)

RapidAI

Rapid

Stroke

ICH, LVO,

ISL

NCCT,

CTA,

CTP

Identification of

ICH and segment-

ation and volume

of hyperattenuated

region from NCCT.

ASPECTS score.

Colour coded

overlay

of regions of blood

vessel density

asymmetry from

CTA. Identification

of LVO in the ICA

or MCA. Hypo-

attenuation and

mismatch volume

from CTP.

ML,

DL,

FDA (II), CE (I)

SHUKUN

Digital

Brain

ICH, BA,

ISL

NCCT,

CTA

Segments ICH and

ischaemia from

NCCT. Provides

diameter measure-

ments and

ASPECTS.

Measures

dimensions of

BA from CTA.

CE (I)

Viz.ai

Viz

Radiology

Suite

ICH, LVO,

NCCT,

CTA

Detection of LVO

and BA from CTA.

Detection of ICH

and SDH from

NCCT.

FDA (II), CE (I)

(Viz LVO)

(Viz ICH)

FDA (II)

(Viz

ANEURYSM)

VUNO

DeepBrain

WMH,

Atrophy

T1,

FLAIR

Brain atrophy per

region, WMH, and

cortical thickness.

Brain structures

segmented include

2 vessels.

FDA (II), CE (IIa)

Heuron

StroCare

Suite,

AgingCare

Suite

ICH, LVO,

ISL,

Atrophy

NCCT,

CTA,

CTP,

ICH detection and

triage from NCCT.

LVO detection and

hemisphere from

NCCT. ASPECTS

and regional analy-

sis from NCCT.

LVO detection and

hemisphere from

CTA. Volume mis-

match from CTP.

Atrophy per region

from T1.

FDA (II)

(StroCare Suite

ICH)

Quibim

QP-Brain

WMH,

Atrophy

T1,

FLAIR

Brain atrophy per

region from T1.

Segmentation and

volume of WMH

and longitudinal

analysis from

FLAIR.

AI, DL

FDA (II), CE (IIb)

QYNAPSE

QyScore

WMH,

Atrophy

T1,

FLAIR

Brain atrophy per

region from T1.

Segmentation and

volume of WMH

from T1 and FLAIR.

FDA (II), CE (IIa)

United Imaging

Intelligence

uAI

Discover

ICH, ISL,

WMH,

Atrophy,

PVS,

Lacunes,

CMB, BA

NCCT,

CTA,

CTP,

MRI

Segmentation of

ICH, edema, and

midline shift from

NCCT. ASPECTS

score per region

from NCCT.

Detection of BA

from CTA. Segmen-

tation of infarct core

and mismatch areas

from CTP. Quantit-

ative evaluation of

ISL, lacunes, WMH,

PVS, CMB, and

atrophy from MRI to

provide a total

CSVD score.