Automated ASPECTS Scoring on Non-Contrast CT

The Alberta Stroke Program Early CT Score (ASPECTS) is a 10-point scale that quantifies early ischemic changes across 10 defined regions of the MCA territory on non-contrast CT. A score of 10 indicates no ischemic changes; a score of 0 indicates involvement of all 10 regions. Current stroke guidelines recommend mechanical thrombectomy for patients with ASPECTS of 6 or above, and the score also informs IV thrombolysis eligibility. A one-point difference can determine whether a patient receives intervention.

ASPECTS scoring on non-contrast CT is inherently subjective. Early ischemic changes – subtle hypodensity and sulcal effacement – are difficult to detect consistently, and published data shows significant disagreement between readers, particularly between less experienced and senior radiologists. CINA-ASPECTS applies the same algorithm to every scan, producing a standardized score and a region-by-region heat map that is independent of reader fatigue, experience level, or time of day.

In addition to the ASPECTS score, CINA-ASPECTS provides three visual outputs: a heat map showing the probability of hypodensity or sulcal effacement across each of the 10 MCA territory regions; an outline of the areas identified as infarcted; and a reoriented and resliced NCCT to support consistent anatomical review. These outputs give the radiologist spatial context for the score, supporting faster and more confident reporting in a time-critical stroke workflow.