Title: Selection of ischemic stroke patients that would benefit from thrombolysis using an automated scoring system (e-ASPECTS) on computated tomography brain scans
Funder: Innovate UK

Abstract: Stroke is the third cause of death and the first cause of adult disability in the UK. Each year, there are about 110,000 strokes in the UK, 1 million in the European Union and 15 million worldwide. For the NHS, the direct and indirect costs amount to £9 billion. The majority of strokes (~90%) are ischaemic and caused by an occlusion of a brain artery. The possibility to treat stroke exists only for 4.5 hours after symptom onset. Therefore, fast and reliable interpretation of computated tomography (CT) scans is necessary for appropriate identification of patients more likely to benefit from treatment. Brainomix Limited is developing the e-ASPECTS software which can automatically interpret the patients’ brain CT scan. This would help physicians to select patients more likely to benefit for life-saving treatment, whilst excluding those at a high risk of an adverse event. e-ASPECTS automates the clinically validated ASPECTS method which was developed by one of Brainomix’s co-founders. The Alberta Stroke Program Early CT score (ASPECTS) enables a quantitative evaluation of early stroke damage on CT scans. The score assesses the presence of damage within 10 regions of the brain usually affected by a stroke. An ASPECTS score of zero indicates extensive damage, while a normal CT scan is assigned a score of 10. Patients with a low ASPECTS score (less than 5) have a high risk of a bleed within their brain and are unlikely to make an independent recovery, despite treatment. Although the clinical utility of ASPECTS is well established, its clinical use is currently restricted because detection of early damage on CT scans requires extensive experience and expertise, which is not always readily available in an acute setting (especially out-of-hours). Furthermore, manual interpretation of CT scans is associated with significant variability. The e-ASPECTS software offers a solution to these limitations, by automating and implementing the validated ASPECTS method. The benefits of e-ASPECTS are of paramount importance. Introducing e-ASPECTS into clinical practise would be good value for money for the Health Service and would improve the outcome of stroke patients. Acute stroke services would provide the same standard 24/7 as even inexperienced physicians would be able to confidently interpret brain CT scans and accurately select patients more likely to benefit from treatment. Brainomix aims to develop the final version of the e-ASPECTS software in a timely manner so that its benefits are realised for stroke patients both in the UK and worldwide. Overall, e-ASPECTS is a very attractive commercial opportunity. Brainomix is ideally placed to deliver e-ASPECTS to the healthcare market by already having developed and internally validated an algorithm, which can be transformed in a timely manner to a product with all the required certifications. Brainomix will capitalize on the international reputation of its team on the field of stroke to ensure a successful route to market. Licensing e-ASPECTS to European and US hospitals will enhance their stroke treatment, while the growing market of hospitals offering stroke services in developing countries significantly increases the potential return from commercializing e-ASPECTS.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: STROKE