SPINNERS
(2026)Objective
Cross-sectional non-inferiority diagnostic study assessing whether flat-detector CT (FDCT) in the angio suite reliably excludes intracranial hemorrhage before EVT compared with multi-detector CT (MDCT).
Study Summary
• Sensitivity: 0.926 (0.889-0.957).
• Specificity: 0.908 (0.908-0.961).
• Non-inferiority overall not met (95% margin).
• Performance improved in NIHSS >=10 and at experienced centers.
• Specificity: 0.908 (0.908-0.961).
• Non-inferiority overall not met (95% margin).
• Performance improved in NIHSS >=10 and at experienced centers.
Intervention
Flat-detector CT (FDCT) in the angio suite vs multi-detector CT (MDCT) reference standard, with 6 independent readers
Inclusion Criteria
USA, Switzerland, Finland, Spain. Suspected stroke within 24 h; mothership or transfer with repeat scan; NIHSS >=7; FDCT feasible within 4 h after MDCT with no intervention between scans. N=251 (125 IS, 113 HS, 13 isolated infratentorial ICH).
Study Design
Arms: FDCT (index test) vs MDCT (ground truth)
Patients per Arm: N=251 (single-arm diagnostic; FDCT and MDCT in all patients)
Outcome
• Sensitivity: 0.926 (0.889-0.957).
• Specificity: 0.908 (0.908-0.961).
• Non-inferiority margin 95% not met overall.
• Higher accuracy in NIHSS >=10 and experienced centers.
• Challenging cases (imaging quality, obscure location) can be missed.
• Specificity: 0.908 (0.908-0.961).
• Non-inferiority margin 95% not met overall.
• Higher accuracy in NIHSS >=10 and experienced centers.
• Challenging cases (imaging quality, obscure location) can be missed.