Brainomix 360 Stroke
The Brainomix 360 Stroke platform is a collection of tools that use AI algorithms to support doctors by providing real-time interpretation of brain scans to help guide treatment and transfer decisions for stroke patients.
- CT
- ASPECTS
- CT Angiography
- ICH
Brainomix 360 e-ASPECTS
Brainomix 360 e-ASPECTS is a computer-aided diagnosis (CADx) software device used to assist clinicians in the assessment and characterization of brain tissue abnormalities using CT image data.
The software automatically registers images and uses an Atlas to segment and analyze ASPECTS (Alberta Stroke Program Early CT) regions. Brainomix 360 e-ASPECTS extracts image data from individual voxels in the image to provide analysis and computer analytics and relates the analysis to the atlas-defined ASPECTS regions. The imaging features are then synthesized by an artificial intelligence algorithm into a single ASPECTS Score. Brainomix 360 e-ASPECTS is indicated for evaluation of patients presenting for diagnostic imaging work up with known MCA or ICA occlusion, for evaluation of extent of disease. Extent of disease refers to the number of ASPECTS regions affected which is reflected in the total score.
Brainomix 360 e-ASPECTS provides information that may be useful in the characterization of ischemic brain tissue injury during image interpretation (within 6 hours from known symptom onset). Brainomix 360 e-ASPECTS provides a comparative analysis to the ASPECTS standard of care radiologist assessment by providing highlighted ASPECTS regions and an automated editable ASPECTS score for clinician review. Brainomix 360 e-ASPECTS additionally provides a visualization of the voxels contributing to the automated ASPECTS score and the voxels excluded from the automated ASPECTS score
Brainomix 360 e-CTA
Brainomix 360 e-CTA is an image processing software package to be used by trained professionals, including, but not limited to physicians and medical technicians. The software runs on standard “off-the-shelf” hardware (physical or virtualized) and can be used to perform image viewing, processing and analysis of images. Data and images are acquired through DICOM compliant imaging devices.
Brainomix 360 e-CTA provides viewing and analysis capabilities for imaging datasets acquired with CTA (CT Angiography). Brainomix 360 e-CTA is not intended for mobile diagnostic use.
Brainomix 360 e-CTP
Brainomix 360 e-CTP is an image processing software package to be used by trained professionals, including but not limited to physicians and medical technicians. The software runs on a standard off-the-shelf computer or a virtual platform, such as VMware, and can be used to perform image viewing, processing, and analysis of images.
Data and images are acquired through DICOM compliant imaging devices. This includes DICOM files uploaded through a web browser interface.
Brainomix 360 e-CTP provides viewing and analysis capabilities for imaging datasets acquired with CT perfusion.
The CT perfusion analysis capabilities are for visualization and analysis of dynamic imaging data, showing properties of changes in contrast over time. This functionality includes calculation of parameters related to tissue flow (perfusion) and tissue blood volume.
Brainomix 360 Triage ICH
Brainomix 360 Triage ICH is a notification only, parallel workflow tool for use by hospital networks and trained clinicians to identify and communicate images of specific patients to a specialist, independent of standard of care workflow.
Brainomix 360 Triage ICH uses an artificial intelligence algorithm to analyze images for findings suggestive of an intracranial hemorrhage (ICH) and to notify an appropriate medical specialist of these findings in parallel to standard of care image interpretation. Identification of suspected findings is not for diagnostic use beyond notification. Specifically, the device analyzes non-contrast CT images of the brain acquired in the acute setting, and sends notifications to a neurovascular or neurosurgical specialist that a suspected intracranial hemorrhage (ICH) has been identified and recommends review of those images.
Images can be previewed through a mobile application. Images that are previewed through the mobile application may be compressed and are for informational purposes only and not intended for diagnostic use beyond notification. Notified clinicians are responsible for viewing non-compressed images on a diagnostic viewer and engaging in appropriate patient evaluation and relevant discussion with a treating physician before making care-related decisions or requests. Brainomix 360 Triage ICH is limited to analysis of imaging data and should not be used in-lieu of full patient evaluation or relied upon to make or confirm diagnosis.
One study noted a significant increase in thrombolysis rates in stroke patients and a trend toward increased transfer for mechanical thrombectomy with Brainomix use.1
Treatment times and outcomes of those patients treated with MT also showed a trend towards improvement with Brainomix use in one study.1
Increased confidence and speed of image interpretation improved local decision-making.1
Image sharing capabilities via the e-Stroke platform between clinicians in a hub and spoke system was also felt to make multidisciplinary treatment decisions more rapid*.
*in one study as there was no real established image sharing method between hospitals with different PACS systems1
Accuracy
ASPECTS
One study found that use of e-ASPECTS resulted in significant improvements in interobserver agreement and accuracy across a large cohort of radiologists and neurologists for assessment of overall ASPECTS score, which is a semi-quantitative scoring system for early ischemic changes on non-contrast CT examinations of the brain.2
CTA
One study found that e-CTA software had an accuracy of 72-76% for detecting acute arterial abnormalities including LVO and collateral scoring combined when compared to expert readers.3
CTP
One study showed that CTP parameters substantially agree across RAPID, Viz CTP, and Brainomix e-CTP software packages. CTP has substantial agreement with final infarct volume in near fully/fully reperfused patients.4
Triage ICH
The Brainomix ICH Triage algorithm showed similar sensitivity, specificity, and area under the curve (AUC) for the detection of any intracranial hemorrhage (ICH) when compared to the ground truth, consisting of two radiology residents in one study.5
The correlation between ASPECTS and automated ASPECTS (0.738 and 0.659) and the accuracy of detecting large vessel occlusion (77% and 71%) was higher for Brainomix than for RapidAI in one study.6
Correlation between ischemic core and final infarct volume was higher for Brainomix (0.757) than for RapidAI (0.595) in one study.6
There was high correlation between the CTP outputs (ischemic core and pneumbra) between Brainomix and RapidAI in one study.6
References
1 Gunda B, Neuhaus A, Sipos I, Stang R, Böjti PP, Takács T, Bereczki D, Kis B, Szikora I, Harston G. Improved Stroke Care in a Primary Stroke Centre Using AI-Decision Support. Cerebrovasc Dis Extra. 2022;12(1):28-32. doi: 10.1159/000522423. Epub 2022 Feb 8. PMID: 35134802; PMCID: PMC9082202.
2 Brinjikji W, Abbasi M, Arnold C, Benson JC, Braksick SA, Campeau N, Carr CM, Cogswell PM, Klaas JP, Liebo GB, Little JT, Luetmer PH, Messina SA, Nagelschneider AA, Schwartz KM, Wood CP, Nasr DM, Kallmes DF. e- ASPECTS software improves interobserver agreement and accuracy of interpretation of aspects score. Interv Neuroradiol. 2021 Dec;27(6):781-787. doi: 10.1177/15910199211011861. Epub 2021 Apr 14. PMID: 33853441; PMCID: PMC8673896.
3 Mair G, White P, Bath PM, Muir K, Martin C, Dye D, Chappell F, von Kummer R, Macleod M, Sprigg N, Wardlaw JM; RITeS Collaboration. Accuracy of artificial intelligence software for CT angiography in stroke. Ann Clin Transl Neurol. 2023 Jul;10(7):1072-1082. doi: 10.1002/acn3.51790. Epub 2023 May 19. PMID: 37208850; PMCID: PMC10351662.
4 Pisani L, Haussen DC, Mohammaden M, Perry da Camara C, Jillella DV, Rodrigues GM, Bouslama M, Al-Bayati A, Prater A, Liberato B, Frankel MR, Nogueira RG. Comparison of CT Perfusion Software Packages for Thrombectomy Eligibility. Ann Neurol. 2023 Nov;94(5):848-855. doi: 10.1002/ana.26748. Epub 2023 Aug 16. PMID: 37584452.
5 Schmitt N, Mokli Y, Weyland CS, Gerry S, Herweh C, Ringleb PA, Nagel S. Automated detection and segmentation of intracranial hemorrhage suspect hyperdensities in noncontrast-enhanced CT scans of acute stroke patients. Eur Radiol. 2022 Apr;32(4):2246- 2254. doi: 10.1007/s00330-021-08352-4. Epub 2021 Nov 13. PMID: 34773465; PMCID: PMC8921016.
6 Mallon DH, Taylor EJR, Vittay OI, Sheeka A, Doig D, Lobotesis K. Comparison of automated ASPECTS, large vessel occlusion detection and CTP analysis provided by Brainomix and RapidAI in patients with suspected ischaemic stroke. J Stroke Cerebrovasc Dis. 2022 Oct;31(10):106702. doi: 10.1016/j.jstrokecerebrovasdis.2022.106702 . Epub 2022 Aug 19. PMID: 35994882
