Evidence map›Paper›PMID 41758218›Full record

Trial reportClinical neuroradiology2026

Brain Atrophy and White Matter Changes Grading Agreement on NCCT and MRI in Ischemic Stroke.

William Betzner, Nishita Singh, Ibrahim Alhabli, Mohammed Almekhlafi, Fouzi Bala, Faysal Benali, Kaden Lam, Cody Doolan, Joseph Carere, Luciana Catanese and 5 more

Abstract readObservational StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

William BetznerDepartment of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada. william.betzner@ucalgary.ca.
Nishita SinghDepartment of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Ibrahim AlhabliDepartment of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
Mohammed AlmekhlafiDepartment of Clinical Neurosciences, Radiology and Community Health Sciences, University of Calgary, Calgary, Canada.
Fouzi BalaDiagnostic and Interventional Neuroradiology Department, Centre Hospitalier Universitaire de Tours, Tours, France.
Faysal BenaliDepartment of Radiology, AZ Vesalius, Tongeren, Belgium.
Kaden LamDepartment of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
Cody DoolanDepartment of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
Joseph CarereSport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
Luciana CataneseDepartment of Medicine, Division of Neurology, McMaster University, Hamilton, Canada.
Tolu SajobiDepartment of Community Health Sciences & Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
Aleksander TkachKelowna General Hospital, Kelowna, Canada.
Richard SwartzDivision of Neurology, Sunnybrook Health Science Centre, Toronto, Canada.
Bijoy K MenonDepartment of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
Aravind GaneshDepartment of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada. aganesh@ucalgary.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBrain frailty measures like atrophy and white matter changes (WMC) are becoming increasingly relevant in stroke outcome prediction but are conventionally thought to be best seen on MRI compared to CT. We assessed agreement between baseline CT vs follow-up MRI ratings for brain atrophy and WMC; and compared their discriminative ability for 90-day functional outcomes in acute ischemic stroke.

methodsIn this post-hoc, observational analysis of baseline CT and follow-up MRI data from the Alteplase compared to Tenecteplase (AcT) randomised-controlled trial, experts assessed brain atrophy, periventricular and deep WMC using established visual-rating scales. Binary agreement (none-mild vs. moderate-severe) and agreement across the full scores between atrophy and WMC measures on CT and MRI were calculated using Gwet's agreement coefficient (AC1). Logistic regression estimated discrimination for 90-day modified Rankin Scale (mRS) 0-1. Agreement of AUCs for CT and MRI models were compared using DeLong's test.

resultsAmong 1577 AcT participants, 491(31.1%) had interpretable CT and MRI. Binary agreement was substantial for periventricular (AC1 = 0.70) and total WMC (AC1 = 0.68) scores, Koedam scale (AC1 = 0.76) and frontal atrophy (AC1 = 0.80). Almost perfect agreement (AC1:0.81-0.97) was found for deep WMC (AC1 = 0.85), and the other atrophy scores (AC1 = 0.81-0.97). There was no significant difference between NCCT or MRI in discriminating 90-day mRS 0-1 for any measures.

conclusionsCT ratings of brain atrophy and WMC by experts have substantial to almost-perfect agreement compared to MRI. Both achieve similar discrimination of 90-day functional outcomes. This implies the reasonable use of CT scans in evaluating brain frailty measures in clinical practice and stroke trials.

Indexed as

BrainIschemic StrokeMagnetic Resonance ImagingTomography, X-Ray ComputedWhite MatterAgedAtrophyFemaleFibrinolytic AgentsHumansMaleReproducibility of ResultsTissue Plasminogen ActivatorFibrinolytic AgentsTissue Plasminogen ActivatorAtrophyComputed tomographyMagnetic resonance imagingStrokeWhite matter

Identifiers

PMID41758218

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.