Volume-dependent overestimation of spontaneous intracerebral hematoma volume by the ABC/2 formula

Wang, Chih Wei; Juan, Chun-Jung; Liu, Yi Jui; Hsu, Hui‐Chi; Liu, Hua Shan; Chen, Cheng-Yu; Hsueh, Chun-Jen; Lo, Chung Ping; Kao, Hung Wen; Huang, Guo Shu

doi:10.1080/02841850802647039

Cited by 51 publications

(41 citation statements)

References 16 publications

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“…Because the ABC/2 formula calculates the volume of an ellipsoid based on the maximum diameter of the tumor, such lobular-shaped tumors would be overestimated by the ABC/2 formula similar to the previous studies on ICH (21,24,29). According to the results of this study, the use of the ABC/2 formula should be limited to non-skull base meningiomas with regular and round or ellipsoid shapes.…”

Section: Discussionmentioning

confidence: 70%

“…However, the accuracy of the ABC/2 formula has been previously debated in these fields, particularly in ICH. This is because the ABC/2 formula tends to overestimate volume if the hematoma is of an irregular shape (21,24,29). Because the ABC/2 formula is calculated on the presumption that the lesion is ellipsoid in shape, the calculated volume tends to differ from the exact volume if the form of the lesion differs from ellipsoid.…”

Section: Discussionmentioning

confidence: 99%

“…Because the ABC/2 formula can provide the volume of a lesion easily and within short time, it is useful in clinical practice for cerebrovascular disorders, such as ICH (20)(21)(22)(23)(24)29) or cerebral infarction (30), that require rapid decision-making. However, the accuracy of the ABC/2 formula has been previously debated in these fields, particularly in ICH.…”

Section: Discussionmentioning

confidence: 99%

“…It is the simplest procedure; however, it is uncertain whether the maximum diameter accurately reflects the real volume of the tumor. The ABC/2 formula is frequently used to calculate the volume of intracerebral hemorrhage (ICH) because of its simplicity and quickness; however, the accuracy of the ABC/2 formula has been previously debated (20)(21)(22)(23)(24). Although some studies have used the ABC/2 formula (2,25,26) or the original ellipsoid volume (10,19,27) to measure the volume of intracranial tumors, including meningiomas, few studies have evaluated the accuracy of ABC/2 formula for intracranial tumors.…”

Section: Introductionmentioning

confidence: 99%

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Reliability of the Size Evaluation Method for Meningiomas: Maximum Diameter, ABC/2 Formula, and Planimetry Method

et al. 2016

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reliability of the Size Evaluation Method for Meningiomas: Maximum Diameter, ABC/2 Formula, and Planimetry Method

et al. 2016

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“…Similarly, baseline hematoma volume was not associated with clinical outcome after covariate adjustment, which differs from a recent aaICH study suggesting volume is predictive of early (7-day) mortality and poor functional outcome. 22 Some of the discrepancy may be related to volumetric measurement techniques; the latter study used the ABC/2 technique, which is known to both underestimate and overestimate large, irregular, and anticoagulant-associated hematomas, [23][24][25] whereas we used computer-assisted planimetry specifically developed and validated for ICH measurement. 10 However, a more likely explanation is that our statistical power was limited due to the relatively small sample of patients with IPH volumes in our study; the association with mortality detected in univariate analysis was possibly overshadowed by the robust effect of palliation and GCS.…”

Section: Dowlatshahi Et Al Poor Prognosis In Warfarin-associated Ich mentioning

confidence: 99%

Poor Prognosis in Warfarin-Associated Intracranial Hemorrhage Despite Anticoagulation Reversal

Dowlatshahi

Butcher

Asdaghi

et al. 2012

Stroke

184

128

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on behalf of the Canadian PCC Registry (CanPro) Investigators* Background and Purpose-Anticoagulant-associated intracranial hemorrhage (aaICH) presents with larger hematoma volumes, higher risk of hematoma expansion, and worse outcome than spontaneous intracranial hemorrhage. Prothrombin complex concentrates (PCCs) are indicated for urgent reversal of anticoagulation after aaICH. Given the lack of randomized controlled trial evidence of efficacy, and the potential for thrombotic complications, we aimed to determine outcomes in patients with aaICH treated with PCC. Methods-We conducted a prospective multicenter registry of patients treated with PCC for aaICH in Canada. Patients were identified by local blood banks after the release of PCC. A chart review abstracted clinical, imaging, and laboratory data, including thrombotic events after therapy. Hematoma volumes were measured on brain CT scans and primary outcomes were modified Rankin Scale at discharge and in-hospital mortality. Results-Between 2008 and 2010, 141 patients received PCC for aaICH (71 intraparenchymal hemorrhages). The median age was 78 years (interquartile range, 14), 59.6% were male, and median Glasgow Coma Scale was 14. Median international normalized ratio was 2.6 (interquartile range, 2.0) and median parenchymal hematoma volume was 15.8 mL (interquartile range, 31.8). Median post-PCC therapy international normalized ratio was 1.4: 79.5% of patients had international normalized ratio correction (Ͻ1.5) within 1 hour of PCC therapy. Patients with intraparenchymal hemorrhage had an in-hospital mortality rate of 42.3% with median modified Rankin Scale of 5. Significant hematoma expansion occurred in 45.5%. There were 3 confirmed thrombotic complications within 7 days of PCC therapy. Conclusions-PCC therapy rapidly corrected international normalized ratio in the majority of patients, yet mortality and morbidity rates remained high. Rapid international normalized ratio correction alone may not be sufficient to alter prognosis after aaICH. (Stroke. 2012;43:1812-1817.)

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Accuracy of automated intracerebral hemorrhage volume measurement on non-contrast computed tomography: a Swedish Stroke Register cohort study

et al. 2022

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Purpose Hematoma volume is the strongest predictor of patient outcome after intracerebral hemorrhage (ICH). The aim of this study was to validate novel fully automated software for quantification of ICH volume on non-contrast computed tomography (CT). Methods The population was defined from the Swedish Stroke Register (RS) and included all patients with an ICH diagnosis during 2016–2019 in Region Skåne. Hemorrhage volume on their initial head CT was measured using ABC/2 and manual segmentation (Sectra IDS7 volume measurement tool) and the automated volume quantification tool (qER–NCCT) by Qure.ai. The first 500 were examined by two independent readers. Results A total of 1649 ICH patients were included. The qER–NCCT had 97% sensitivity in identifying ICH. In total, there was excellent agreement between volumetric measurements of ICH volumes by qER–NCCT and manual segmentation by interclass correlation (ICC = 0.96), and good agreement (ICC = 0.86) between qER–NCCT and ABC/2 method. The qER–NCCT showed volume underestimation, mainly in large (> 30 ml) heterogenous hemorrhages. Interrater agreement by (ICC) was 0.996 (95% CI: 0.99–1.00) for manual segmentation. Conclusion Our study showed excellent agreement in volume quantification between the fully automated software qER–NCCT and manual segmentation of ICH on NCCT. The qER–NCCT would be an important additive tool by aiding in early diagnostics and prognostication for patients with ICH and in provide volumetry on a population-wide level. Further refinement of the software should address the underestimation of ICH volume seen in a portion of large, heterogenous, irregularly shaped ICHs.

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Volume-dependent overestimation of spontaneous intracerebral hematoma volume by the ABC/2 formula

Abstract: The ABC/2 formula significantly overestimates the volume of ICH. A positive association between the estimation error and the volume of ICH is demonstrated.

Cited by 51 publications

References 16 publications

Reliability of the Size Evaluation Method for Meningiomas: Maximum Diameter, ABC/2 Formula, and Planimetry Method

Reliability of the Size Evaluation Method for Meningiomas: Maximum Diameter, ABC/2 Formula, and Planimetry Method

Poor Prognosis in Warfarin-Associated Intracranial Hemorrhage Despite Anticoagulation Reversal

Accuracy of automated intracerebral hemorrhage volume measurement on non-contrast computed tomography: a Swedish Stroke Register cohort study

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