{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:09:30Z","timestamp":1777612170245,"version":"3.51.4"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Fakult\u00e4t Heidelberg der Universit\u00e4t Heidelberg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Neuroradiol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Individual regions of the Alberta Stroke Programme Early CT Score (ASPECTS) may contribute differently to the clinical symptoms in large vessel occlusion (LVO). Here, we investigated whether the predictive performance on clinical outcome can be increased by considering specific ASPECTS subregions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A\u00a0consecutive series of patients with LVO affecting the middle cerebral artery territory and subsequent endovascular treatment (EVT) between January 2015 and July 2020 was analyzed, including affected ASPECTS regions. A\u00a0multivariate logistic regression was performed to assess the individual impact of ASPECTS regions on good clinical outcome (defined as modified Rankin scale after 90\u00a0days of 0\u20132). Machine-learning-driven logistic regression models were trained (training\u202f=\u200970%, testing\u202f=\u200930%) to predict good clinical outcome using i)\u00a0cumulative ASPECTS and ii) location-specific ASPECTS, and their performance compared using deLong\u2019s test. Furthermore, additional analyses using binarized as well as linear clinical outcomes using regression and machine-learning techniques were applied to thoroughly assess the potential predictive properties of individual ASPECTS regions and their combinations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 1109 patients (77.3\u00a0years\u202f\u00b1\u200911.6, 43.8% male), 419 achieved a\u00a0good clinical outcome and a\u00a0median NIHSS after 24\u202fh of\u00a012 (interquartile range, IQR 4\u201321). Individual ASPECTS regions showed different impact on good clinical outcome in the multivariate logistic regression, with strongest effects for insula (odds ratio, OR 0.56, 95% confidence interval, CI 0.42\u20130.75) and M5 (OR 0.53, 95% CI 0.29\u20130.97) regions. Accuracy (ACC) in predicting good clinical outcome of the test set did not differ between when considering i)\u00a0cumulative ASPECTS and ii) location-specific ASPECTS (ACC\u202f=\u20090.619, 95% CI 0.58\u20130.64 vs. ACC\u202f=\u20090.629, 95% CI 0.60\u20130.65; <jats:italic>p<\/jats:italic>\u202f=\u20090.933).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Cumulative ASPECTS assessment in LVO remains a\u00a0stable and reliable predictor for clinical outcome and is not inferior to a\u00a0weighted (location-specific) ASPECTS assessment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00062-022-01258-8","type":"journal-article","created":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T16:04:53Z","timestamp":1674749093000},"page":"661-668","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Location-specific ASPECTS does not improve Outcome Prediction in Large Vessel Occlusion compared to\u00a0Cumulative ASPECTS"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3085-3886","authenticated-orcid":false,"given":"Ulf","family":"Neuberger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik F.","family":"Vollherbst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Ulfert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Sch\u00f6nenberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Herweh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Nagel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Ringleb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus A.","family":"M\u00f6hlenbruch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Bendszus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Vollmuth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,1,26]]},"reference":[{"key":"1258_CR1","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1016\/S0140-6736(00)02237-6","volume":"355","author":"PA Barber","year":"2000","unstructured":"Barber\u00a0PA, Demchuk\u00a0AM, Zhang\u00a0J, Buchan\u00a0AM. 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U.\u00a0Neuberger, D.F.\u00a0Vollherbst, C.\u00a0Ulfert, S.\u00a0Sch\u00f6nenberger, P.A.\u00a0Ringleb, M.A.\u00a0M\u00f6hlenbruch, M.\u00a0Bendszus and P.\u00a0Vollmuth declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and its later amendments. Because of its retrospective character, additional written informed consent was waived by the local ethics committee (S-784\/2018).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}