{
  "abstract": "Background We aim to comprehensively assess and compare the predictive performance of haematoma expansion (HE) scores in a homogeneous cohort of acute intracerebral haemorrhage (ICH) patients.Methods Existing scores for predicting HE in acute ICH patients were included and categorised by imaging modality: non-contrast CT (NCCT), single-phase CT angiography (sCTA) and multiphase CTA (mCTA). The predictive performance of the scores was evaluated with the c-statistic in a population of consecutive adult patients with acute ICH admitted to a tertiary care centre in Southern Alberta, Canada, between February 2012 and May 2020, investigated with a multimodal imaging protocol (NCCT, sCTA and mCTA). The primary outcome was HE (ICH volume growth ≥6 mL or ≥33%), and the secondary outcome was severe HE (ICH volume growth ≥12.5 mL or ≥66%). The DeLong test compared the best-performing scores from each imaging category.Results 16 HE scores were assessed (NCCT=8, sCTA=6 and mCTA=2) in 217 patients with a median age of 70 years (IQR=60–80), and 86 (39.6%) were females. 51 (23.5%) patients experienced HE and 35 (16.1%) had severe HE. The c-statistic for predicting HE ranged from 0.516 to 0.674 for NCCT-based scores, 0.627 to 0.725 for sCTA-based scores and 0.800 to 0.814 for mCTA-based score. The c-statistic for predicting severe HE ranged from 0.505 to 0.666 for NCCT scores, 0.651 to 0.740 for sCTA scores and 0.813 to 0.828 for mCTA scores. A statistically significant difference favouring mCTA over other imaging modalities in predicting both HE and severe HE was observed.Conclusions Advanced imaging demonstrated a stepwise improvement in the predictive performance of HE scores. However, no existing score achieved excellent predictive performance (c-statistics ≥0.90) in our cohort, highlighting the need for further refinement.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy",
        "Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy"
      ],
      "name": "Umberto Pensato"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Koji Tanaka"
    },
    {
      "affiliations": [
        "Department of Medicine, Mahidol University, Salaya, Thailand"
      ],
      "name": "Chitapa Kaveeta"
    },
    {
      "affiliations": [
        "Department of Radiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Johanna Ospel"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "MacKenzie Horn"
    },
    {
      "affiliations": [
        "Department of Neurology, Vall d’Hebron University Hospital, Barcelona, Spain"
      ],
      "name": "David Rodriguez-Luna"
    },
    {
      "affiliations": [
        "Department of Neurology, University of Manitoba, Winnipeg, Manitoba, Canada"
      ],
      "name": "Nishita Singh"
    },
    {
      "affiliations": [
        "Department of Medicine, University of Alberta, Edmonton, Alberta, Canada"
      ],
      "name": "Ankur Banerjee"
    },
    {
      "affiliations": [
        "Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada"
      ],
      "name": "Sanchea Wasyliw"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Kennedy Horn"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Amy Bobyn"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Anneliese Neweduk"
    },
    {
      "affiliations": [
        "Huazhong University of Science and Technology, Wuhan, Hubei, China"
      ],
      "name": "Wu Qiu"
    },
    {
      "affiliations": [
        "Department of Radiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Mayank Goyal"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Bijoy Menon"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Andrew Demchuk"
    }
  ],
  "title": "Stepwise improvement in intracerebral haematoma expansion prediction with advanced imaging: a comprehensive comparison of existing scores",
  "uid": "ed6c2756-67c1-5d73-887e-70b17f53c7f1"
}