Enhancing Diagnosis of Large Vessel Occlusions in CT Head Scans: Assessing the Impact of Maximum Intensity Projection Reconstructions

Doaa Alzaher; Mawaheb Kalalah; Ali Aljishi

doi:10.5455/ajdi.20240810054515

Abstract
Background: Timely and accurate diagnosis of large vessel occlusions in CT head and CTA scans is crucial for stroke patient management. Maximum Intensity Projection (MIP) reconstructions have emerged as a potential aid in improving diagnostic accuracy for large vessel occlusions.
Methods: This comparative diagnostic accuracy study was conducted at the Dammam Medical Complex in Saudi Arabia, involving ten radiology residents from different experience levels. Residents reviewed 10 cases each, with half accompanied by MIP reconstructions. They assessed occlusion presence and rated their confidence using a Likert scale.
Results: Junior and senior residents exhibited similar correct detection rates (86.0% vs. 78.0%, p = 0.298) and confidence levels (4.3 vs. 4.3, p = 0.772) but differed in evaluation time (201.9 seconds vs. 133.7 seconds, p < 0.001). MIP usage exhibited positive trends in correct detection rates and shorter evaluation times for senior residents but lacked statistical significance. In the feedback analysis, a clear majority of 90% of the residents expressed agreement or strong agreement that MIP enhanced their confidence in scan interpretation.
Conclusion: While no statistically significant differences were found in accuracy or confidence levels, MIP reconstructions showed promise in enhancing correct detection rates and expediting case evaluations, especially among senior residents. The majority of participants expressed strong confidence enhancement due to MIP usage.

Key words: Stroke; CT; Brain; Angiogram; Occlusion