Diagnostic accuracy of Aidoc and RapidAI for large vessel occlusion detection in CT angiography

Product: BriefCase - Pulmonary Embolism Triage Company: Aidoc

A retrospective analysis comparing AIDoc and RAPIDAI in the detection of large vessel occlusions

Brain Circulation, 2025

Abstract

Stroke is defined as an acute and focal neurological dysfunction that occurs secondary to cerebrovascular dysfunction. In 2021, stroke was the fifth leading cause of death in the United States (US), thus signifying it serious and negative burden.[1] Strokes can either be classified into ischemic or hemorrhagic. Ischemic strokes account for about 87% of all strokes in the US and occur when blood flow to the brain is reduced due to vessel occlusion. Large vessel occlusions (LVOs), which account for roughly 30% of ischemic strokes, are characterized by an occlusion of the vertebral, basilar, carotid, or proximal middle cerebral artery (segment M1). LVOs are associated with an increased risk of death and decreased positive outcomes compared to other strokes due to a larger ischemic area.[2]

Time is of essence when it comes to diagnosing and treating strokes, as patients who receive quicker treatment have better outcomes;[3] therefore, finding the most effective and quickest way to diagnose ischemic strokes is of great importance. Artificial intelligence (AI) has become a popular topic in the medical community, with the belief that AI can make physicians function more quickly and efficiently. One area of health care where AI has shown to be particularly useful is in diagnosing ischemic strokes, a leading cause of death and disability worldwide.[4,5]

AIDoc is a technological company that has gained US Food and Drug Administration (FDA) approval for flagging LVOs in head computed tomography angiography (CTA) scans.[4] RAPIDAI is another AI software that has been FDA approved for analysis of CTA scans for LVOs. Herein, we present a single-center retrospective study comparing these two methods of diagnosing LVOs. In addition, we conducted a systematic review with the intent to find accurate sensitivity and specificity values of these two AI methods in diagnosing LVOs. The systematic review was performed due to inconsistent sensitivities and specificities being reported in the literature.[6–10] The decision to compare these two AI modalities over other AI tools, such as Brainomix and Viz.ai, was made due to RAPIDAI and AIDoc being the only two AI methods our institution currently uses in helping diagnose ischemic strokes. In addition, RAPIDAI is one of the most popular AI modalities currently in practice, as there are multiple studies assessing its effectiveness and comparing it against other AI modalities.[8,9,11–13]

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