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Health·The Trace·Model-prefilled trace·Published 2026-07-20

detection of large vessel occlusion in acute ischemic stroke using Brainomix e-CTA in consecutive patients undergoing multiphase CTA

Source article: Artificial Intelligence-Based CTA Software for Real-World Detection of Large Vessel Occlusion in Acute Ischemic Stroke

Background and purpose Artificial intelligence (AI)-based tools for CT angiography (CTA) have been introduced to support rapid detection of large vessel occlusion (LVO) in acute ischemic stroke. Although regulatory approval has relied mainly on controlled clinical studies, evidence from routine clinical practice remains limited. This study aimed to assess the real-world diagnostic performance and workflow impact of the Brainomix e-CTA software. Materials and methods We conducted a retrospective, single-center ob…

TRV-2026-0307Peer-reviewedPermanent record — cite & verify
Trace impact reading

Contested: both sides are scored from claims and sources, not community votes.

P 69The P score combines the specificity and measured human impact of the grounded problem claim with the strength of this Trace’s cited sources.G 73The G score combines the specificity and measured human impact of the grounded gain claim with the strength of this Trace’s cited sources.
Artificial Intelligence-Based CTA Software for Real-World Detection of Large Vessel Occlusion in Acute Ischemic Stroke

"Brain - CT scan - Metastatic pulmonary adenocarcinoma Case 239" by Pulmonary Pathology is licensed under CC BY-SA 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by-sa/2.0/.

The quick read

Between May 2023 and May 2025, researchers retrospectively evaluated 531 multiphase CTA examinations from consecutive patients with suspected acute ischemic stroke at a single center, comparing Brainomix e-CTA automated LVO detection to expert neuroradiologist interpretation.

The findings matter because high accuracy for proximal occlusions and faster reading times could support triage, but the observed drop to 73% sensitivity for distal M1 occlusions and exclusion of non-target occlusions means clinicians still need expert review and broader validation before relying on the tool alone.

Main points
  • Retrospective single-center study of 531 CTA examinations in consecutive patients with suspected acute ischemic stroke from May 2023 to May 2025.
  • LVO was identified in 19% of cases by expert neuroradiologist reference standard.
  • Sensitivity varied by location: 94% for ICA/proximal M1, 87% for intermediate, 73% for distal M1 occlusions.
Gain

In routine practice between May 2023 and May 2025, Brainomix e-CTA achieved 84% sensitivity and 95% specificity for LVO detection and reduced time to diagnostic conclusion for readers of different experience levels, with 94% sensitivity for ICA/proximal M1 occlusions.

Problem

The same e-CTA tool showed progressively lower sensitivity for more distal occlusions, dropping to 73% for distal M1 with only moderate agreement with experts, and excluded non-target occlusions from primary analysis, requiring adjunctive rather than standalone use.

The rundown

The study compared automated LVO detection using e-CTA against expert neuroradiologist interpretation as a pragmatic clinical reference standard, evaluating sensitivity, specificity, accuracy, and Cohen's kappa by occlusion location.

Time to diagnostic conclusion was compared with and without AI assistance across readers with different experience levels, showing reduction across all reader profiles by the publication date of July 10, 2026.

What this doesn’t fix

Single-center retrospective design with pragmatic neuroradiologist reference standard, and primary endpoint excluded non-target occlusions, limiting generalizability and standalone use for treatment decisions.

Sources

Reader signal

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The debate