• David Rodriguez-Luna, Matthew Boyko, Suresh Subramaniam, Evgenia Klourfeld, Patricia Jo, Brendan J Diederichs, Jayme C Kosior, Dar Dowlatshahi, Richard I Aviv, Carlos A Molina, Michael D Hill, Andrew M Demchuk, and PREDICT/Sunnybrook ICH CTA study group.
• From the Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital and Vall d'Hebron Research Institute, Barcelona, Spain (D.R.-L., C.A.M.); Calgary Stroke Program, Department of Clinical Neurosciences and Radiology, University of Calgary, Calgary, AB, Canada (D.R.-L., M.B., S.S., E.K., P.J., B.J.D., M.D.H., A.M.D.); Cybertrial Medical Software Inc, Edmonton, Canada (J.C.K.); Department of Medicine, Neurology, The Ottawa Hospital, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada (D.D.); and Division of Neuroradiology and Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada (R.I.A.).
• Stroke. 2016 Apr 1; 47 (4): 1124-6.

Background And PurposeLimiting intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) expansion is a common target for acute ICH studies and, therefore, accurate measurement of hematoma volumes is required. We investigated the amount of hematoma volume difference between computed tomography scans that can be considered as measurement error.MethodsFive raters performed baseline (<6 hours) and 24-hour total hematoma (ICH+IVH) computer-assisted volumetric analysis from 40 selected ICH patients from the Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus CT (PREDICT) study cohort twice. Estimates of intrarater and interrater reliability are expressed as intraclass correlation coefficients and minimum detectable difference (MDD).ResultsTotal hematoma volumetric analyses had excellent intra- and interrater agreements (intraclass correlation coefficients 0.994 and 0.992, respectively). MDD for intra- and interrater volumes was 6.68 and 7.72 mL, respectively, and were higher the larger total hematoma volume was and in patients with subarachnoid hemorrhage or IVH. MDD for total hematoma volume measurement of 10.4 mL was found in patients with largest hematoma volumes. In patients with subarachnoid hemorrhage or IVH, MDD for total hematoma volume was 10.3 and 10.4 mL, respectively. In patients without IVH, MDD for intra- and interrater pure ICH volumes were 3.82 and 5.83 mL, respectively.ConclusionsA threshold higher than 10.4 mL seems to be reliable to avoid error of total hematoma volume measurement in a broad range of patients. An absolute ICH volume increase of >6 mL, commonly used as outcome in ICH studies, seems well above MDD and, therefore, could be used to reliably detect ICH expansion.© 2016 American Heart Association, Inc.

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