Real-world evaluation of the accuracy of the Viz.AI automated intracranial hemorrhage volume calculation tool.

Background: Appropriate management of spontaneous intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) requires rapid, accurate volume estimation. Viz.AI has developed an artificial intelligence (AI)-powered ICH calculation tool that may improve existing methods.

Methods: Adult patients presenting to a large healthcare system between December 2015 and December 2021 with spontaneous ICH greater than 10mL and within 72 hours since ictus were analyzed for hematoma volume. mABC/2 (modified ABC/2) was measured by a board-certified neurosurgeon. Semi-autonomous segmentation (SAS) was performed by a trained medical student on 3D Slicer, adjudicated by a board-certified neurosurgeon and used as a surrogate ground-truth volume.

Results: 139 CTs met inclusion criteria. Mean ICH volume via ground-truth SAS was 47.69±27.19 mL. Mean ICH volume difference between SAS and AI and SAS and mABC/2 was 4.77±4.06 mL and 8.36±9.48 mL, respectively (p<0.01). Bland-Altman plots yielded AI and SAS limits of agreement between -4.45 and 13.18 mL, and mABC/2 and SAS limits of agreement between -21.35 and 27.02 mL. The average absolute difference between IVH volume yielded by SAS and AI was 3.26±3.55 mL. Bland-Altman plots yielded IVH volume limits of agreement between -7.48 mLand 10.47 mL. AI was 94.6% sensitive and 94.0% specific for detecting IVH in the presence of ICH. The average time-to-volume for SAS and AI was 424±208 and 151±49.7 s (P<0.01), respectively.

Conclusion: Viz.AI is more accurate than mABC/2, and more rapid than SAS. The combination of speed and accuracy makes Viz.AI viable for clinical decision-making and clinical trial use.