CINA-ASPECTS

Automated ASPECTS Scoring on Non-Contrast CT

Q: What is ASPECTS and why does it matter?

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 visible ischemic changes; a score of 0 indicates involvement of all 10 regions. According to current stroke guidelines, a low ASPECTS (6 or below) may represent a contraindication to IV thrombolysis and mechanical thrombectomy, reflecting more extensive early infarction. A one-point difference can be decisive in determining a patient’s treatment eligibility.

In acute ischemic stroke, confirming an vessel occlusion is only the first step. ASPECTS scoring follows, and the result helps determining whether the patient is eligible for thrombectomy or tPA. Indicated for patients with known unilateral MCA occlusion, CINA-ASPECTS automates that scoring, delivering a standardized result and a region-by-region heat map.

CE-marked

MDR Class IIb

FDA-cleared

Class II

Two Decisions. One Score That Cannot Vary.

The Alberta stroke program early CT score (ASPECTS) sits at the center of two critical treatment decisions in acute ischemic stroke. Both are time-sensitive. Both depend on a score that, without AI, is subject to significant reader-to-reader disagreement.

Thrombectomy Eligibility

Guidelines recommend mechanical thrombectomy for patients with ASPECTS of 6 or above. A score of 6 and a score of 7 are not clinically equivalent, one leads to intervention, the other does not. Under time pressure, that boundary should not depend on who reads the scan. CINA-ASPECTS delivers a standardized, automated score before the treatment team is called.

Thrombolysis Decision

IV thrombolysis decisions also reference ASPECTS, particularly for early ischemic change assessment. In high-volume emergency settings, with multiple scans to read and a stroke team waiting, cognitive fatigue affects scoring accuracy. CINA-ASPECTS automatically delivers a reproducible result regardless of workload, time of day, or reader experience.

The radiologist receives a numerical ASPECTS score and a visual heat map highlighting probability of hypodensity and/or sulcal effacement by region, supporting faster, more consistent assessment across treatment pathways.

ASPECTS Score Calculation

Automated scoring tool for non-contrast head CT in patients with known ICA or MCA occlusion, quantifying early ischemic changes to support thrombectomy and thrombolysis eligibility decisions in acute ischemic stroke.

AUC 0.82

With AI

89.3%

Specificity

- 6%

Reduction in readers' time

Detection Coverage

Clinical Evidence

Peer-reviewed studies validating CINA-ASPECTS performance.

2024

Ayobi et Al.

AJNR

AI-assisted ASPECTS scoring improved reader accuracy and cut reading time across experience levels in a prospective validation study.

0.82

AUC
with AI

0.78

AUC without AI

2025

O'Connor et Al.

Clinical Neuroimaging

In a multinational study of 327 patients, CINA-ASPECTS demonstrated 72.8% sensitivity and 91.8% specificity, confirming reliable performance across diverse clinical environments and scanner vendors.

91.8%

Specificity

2025

Agripnidis et Al.

European Journal of Radiology

Multicenter diagnostic study across ICH, LVO, and ASPECTS scoring, CINA showed high specificity and consistent accuracy across stroke subtypes, supporting radiologists throughout the stroke imaging workflow.

80.4%

Accuracy

A Radiologist's Perspective

“It’s great to automate the ASPECT Score, because it’s not an easy task. CINA-ASPECTS is a real breakthrough. It’s very useful for radiologists.”

Vincent Dousset

Head of Neuroimaging, CHU de Bordeaux, France

Frequently Asked Questions

What is ASPECTS and why does it matter?

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 visible ischemic changes; a score of 0 indicates involvement of all 10 regions. According to current stroke guidelines, a low ASPECTS (6 or below) may represent a contraindication to IV thrombolysis and mechanical thrombectomy, reflecting more extensive early infarction. A one-point difference can be decisive in determining a patient’s treatment eligibility.

How does CINA-ASPECTS reduce inter-reader variability?

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.

What does CINA-ASPECTS deliver beyond the numerical score?

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.

CINA-ASPECTS, medical images analysis software, a medical device manufactured by Avicenna.AI. This medical device is reserved for health professionals. The performance and outputs of this tool may differ slightly according to the software version and applicable regulations.

This software has been designed and manufactured according to the EN ISO 13485 Quality management system. Read the instructions in the notice carefully before any use.

– Instructions for Use are available.

– Manufacturer: Avicenna.AI (France).

– Medical device Class IIb following the European Regulation on Medical Device (EU) 2017/745.

– Medical device Class II following the Code of Federal Regulations of the United States of America 21CFR on Medical Devices.