CLAIRE-DSA: Fluoroscopic Image Classification for Quality Assurance of Computer Vision Pipelines in Acute Ischemic Stroke

Computer vision models can be used to assist during mechanical thrombectomy (MT) for acute ischemic stroke (AIS), but poor image quality often degrades performance. This work presents CLAIRE-DSA, a deep learning--based framework designed to categorize key image properties in minimum intensity projections (MinIPs) acquired during MT for AIS, supporting downstream quality control and workflow optimization. CLAIRE-DSA uses pre-trained ResNet backbone models, fine-tuned to predict nine image properties (e.g., presence of contrast, projection angle, motion artefact severity). Separate classifiers were trained on an annotated dataset containing 1,758 fluoroscopic MinIPs. The model achieved excellent performance on all labels, with ROC-AUC ranging from 0.91 to 0.98, and precision ranging from 0.70 to 1.00. The ability of CLAIRE-DSA to identify suitable images was evaluated on a segmentation task by filtering poor quality images and comparing segmentation performance on filtered and unfiltered datasets. Segmentation success rate increased from 42% to 69%, p < 0.001. CLAIRE-DSA demonstrates strong potential as an automated tool for accurately classifying image properties in DSA series of acute ischemic stroke patients, supporting image annotation and quality control in clinical and research applications. Source code is available at https://gitlab.com/icai-stroke-lab/wp3neurointerventionalai/claire-dsa.