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Peer-reviewedCC BYFrontiers in Radiology

Automated detection of the CT-angiography spot sign in acute intracerebral hemorrhage

  • Dar Dowlatshahi1
  • Dar Dowlatshahi2
  • Santanu Chakraborty3
  • Tim Ramsay4
  • Matthew J. Hogan1
  • Matthew J. Hogan2
4 affiliations
  1. 1Department of Medicine (Neurology), University of Ottawa, Ottawa, ON, Canada
  2. 2Neurosciences Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
  3. 3Department of Medical Imaging (Neuroradiology), University of Ottawa, Ottawa, ON, Canada
  4. 4Methodological and Implementation Research Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Abstract

Early hematoma expansion is a major determinant of outcome after intracerebral hemorrhage (ICH). The CTA spot sign predicts hematoma expansion and poor outcome but requires specialized expertise for interpretation. Automated detection facilitates imaging-based selection strategies for hemostatic therapies. We evaluated the diagnostic performance of an automated algorithm for spot sign detection using multiphase CTA. We analyzed patients presenting with spontaneous ICH within 4.5 h of symptom onset who underwent multiphase CTA. Fifty scans were randomly selected from a prospective registry. The automated algorithm independently classified each scan as spot sign positive or negative. An expert neuroradiologist served as reference standard. Sensitivity for spot sign detection was 95.7%, specificity was 74.1%. In this pilot study, automated detection of the CTA spot sign on dynamic CTA was feasible and demonstrated high sensitivity but moderate specificity, supporting further independent validation of CARL. Such tools may standardize spot sign identification, support clinical trial enrollment, and have the potential to facilitate rapid selection of patients at high risk of hematoma expansion.

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Cite

BibTeXRIS
BibTeX
@article{dowlatshahi2026automated,
  title = {{Automated detection of the CT-angiography spot sign in acute intracerebral hemorrhage}},
  author = {Dar Dowlatshahi and Dar Dowlatshahi and Santanu Chakraborty and Tim Ramsay and Matthew J. Hogan and Matthew J. Hogan},
  journal = {Frontiers in Radiology},
  year = {2026},
  month = oct,
  doi = {10.3389/fradi.2026.1898570},
  url = {https://doi.org/10.3389/fradi.2026.1898570},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Automated detection of the CT-angiography spot sign in acute intracerebral hemorrhage
AU  - Dar Dowlatshahi
AU  - Dar Dowlatshahi
AU  - Santanu Chakraborty
AU  - Tim Ramsay
AU  - Matthew J. Hogan
AU  - Matthew J. Hogan
PY  - 2026
DA  - 2026/10/26
JO  - Frontiers in Radiology
DO  - 10.3389/fradi.2026.1898570
UR  - https://doi.org/10.3389/fradi.2026.1898570
AB  - Early hematoma expansion is a major determinant of outcome after intracerebral hemorrhage (ICH). The CTA spot sign predicts hematoma expansion and poor outcome but requires specialized expertise for interpretation. Automated detection facilitates imaging-based selection strategies for hemostatic therapies. We evaluated the diagnostic performance of an automated algorithm for spot sign detection using multiphase CTA. We analyzed patients presenting with spontaneous ICH within 4.5 h of symptom onset who underwent multiphase CTA. Fifty scans were randomly selected from a prospective registry. The automated algorithm independently classified each scan as spot sign positive or negative. An expert neuroradiologist served as reference standard. Sensitivity for spot sign detection was 95.7%, specificity was 74.1%. In this pilot study, automated detection of the CTA spot sign on dynamic CTA was feasible and demonstrated high sensitivity but moderate specificity, supporting further independent validation of CARL. Such tools may standardize spot sign identification, support clinical trial enrollment, and have the potential to facilitate rapid selection of patients at high risk of hematoma expansion.
SN  - 2673-8740
ER  -