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RecruitingNCT06118840IDEALUpdated Oct 7, 2025

IDEAL Study: Blinded RCT for the Impact of AI Model for Cerebral Aneurysms Detection on Patients' Diagnosis and Outcomes

An interventional study of True-AI-integrated intracranial aneurysms diagnosis strategy and Sham-AI-integrated intracranial aneurysms diagnosis strategy in Intracranial Aneurysm, CT Angiography and Deep Learning, sponsored by Jinling Hospital, China. Recruiting at 21 sites in China. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-10-07.

Sponsored by Jinling Hospital, China · Not applicable, Interventional, and Diagnostic

From the registry’s dates

  • Primary completion was expected by Jul 2026, 3 months ago, but the record still lists the study as recruiting.
  • Started May 2024; still recruiting 2 years 4 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
6,450
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study (IEDAL study) intends to prospectively enroll more than 6450 patients who will undergo head CT angiography (CTA) scanning in the outpatient clinic. It will be carried out in 21 hospitals in more than 10 provinces in China. The patient's head CTA images will be randomly assigned to the True-AI and Sham-AI group with a ratio of 1:1, and the patients and radiologists are unaware of the allocation. The primary outcomes are sensitivity and specificity of detecting intracranial aneurysms. The secondary outcomes focus on the prognosis and outcomes of the patients.

Read the detailed description

A multicenter, prospective, double-blind, randomized controlled trial will be conducted (IDEAL study). Patients who are scheduled to undergo cranial CT angiography (CTA) scanning will be randomly divided into two groups with a ratio of 1:1, one of the group will be assigned to True-AI aided intracranial aneurysms diagnosis strategy (True-AI group) and the other will be assigned to Sham-AI aided intracranial aneurysms diagnosis strategy (Sham-AI group, which has a sensitivity close to 0% and a similar specificity to True-AI). The primary outcomes are diagnostic sensitivity and specificity of detecting aneurysms. Secondary endpoints include other diagnostic performance indexes for intracranial aneurysms; diagnostic performances for other intracranial lesions for intracranial arterial stenosis, occlusion, and intracranial tumors; detection rates of intracranial lesions according to Radiology Reports; workload of head CTA interpretation; resource use; treatment-related indexes during patient follow-up (e.g. clinical follow-up, hospitalization, rate of patients undergoing DSA); life quality; outcomes of aneurysm-related events; repeat head CTA or MRA at 12-month follow; cost-effectiveness analysis between intervention and control arm to evaluate the short- and longterm influence of AI system to the routine practice and patients' prognosis and outcomes.

02

Conditions studied

  • Intracranial Aneurysm
  • CT Angiography
  • Deep Learning
  • Double Bind Interaction

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03

In context

Intracranial Aneurysm

427 studies on the registry are indexed under Intracranial Aneurysm; 115 are open to participants now.

This study's planned enrollment of 6,450 is above the median of 110 across 207 interventional studies indexed under Intracranial Aneurysm.

Browse Intracranial Aneurysm studies →

Lead sponsor

Jinling Hospital, China is the lead sponsor of 126 studies on the registry; 34 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Adult inpatients and outpatients who are scheduled for head CTA scanning.

Exclusion criteria

Exclusion Criteria:

  • Age under 18 years.
  • Patients with contraindications to CTA.
  • Modified Rankin Scale (mRS) score > 3.
  • Refuse to sign informed consent.
  • Participation in other clinical studies of intracranial aneurysms.
  • Patients with failed head CTA scanning or incomplete image data, or poor image quality.
05

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
6,450 participants (estimated)

Study arms

  • Experimental
    True-AI-integrated intracranial aneurysms diagnosis strategy

    For patients who underwent head CTA and assigned to True-AI group, they will be diagnosed by a radiologist who are aided by the True-AI-integrated intracranial aneurysms diagnosis strategy.

    Device: True-AI-integrated intracranial aneurysms diagnosis strategy

  • Sham comparator
    Sham-AI-integrated intracranial aneurysms diagnosis strategy

    For patients who underwent head CTA and assigned to Sham-AI group, they will be diagnosed by a radiologist who are aided by the Sham-AI-integrated intracranial aneurysms diagnosis strategy. To mimic the True-AI, the Sham-AI had a sensitivity close to 0% and a similar specificity to the True-AI.

    Device: Sham-AI-integrated intracranial aneurysms diagnosis strategy

Interventions

  • DeviceTrue-AI-integrated intracranial aneurysms diagnosis strategy

    The True-AI deep-learning based model for intracranial aneurysms detection had a patient-wise sensitivity, lesion-wise sensitivity and specificity of 0.96, 0.87, and 0.80 in the internal validation dataset.

  • DeviceSham-AI-integrated intracranial aneurysms diagnosis strategy

    The Sham-AI deep-learning based model for intracranial aneurysms detection is designed to have a sensitivity close to 0% and a similar specificity to the True-AI. In the internal validation dataset, the Sham-AI had a patient-wise sensitivity, lesion-wise sensitivity, specificity of 0.02, 0.01, and 0.80, respectively.

06

What researchers measure

Primary outcomes

  1. To compare diagnostic sensitivity of intracrnial aneurysms between intervention and control arm.

    The proportion of examinations in which at least one aneurysm is discovered and indicated among groundtruth aneurysms.

    Time frame: 6 months.

  2. To compare diagnostic specificity of intracrnial aneurysms between intervention and control arm.

    The proportion of examinations in which no aneurysms are spotted by the reader among groundtruth non-aneurysms.

    Time frame: 6 months.

Secondary outcomes

  1. To compare other diagnostic performances for intracranial aneurysms between intervention and control arm.

    To compare accuracy, lesion-wise sensitivity, positive predictive value and negative predictive value for intracranial aneurysms between intervention and control arm.

    Time frame: 6 months.

  2. To compare diagnostic performances for other intracranial lesions between intervention and control arm.

    The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for intracranial arterial stenosis, occlusion, and intracranial tumors are compared between intervention and control arm.

    Time frame: 6 months.

  3. To compare detection rates of intracranial lesions according to Radiology Reports between intervention and control arm.

    Detection rates of intracranial aneurysms, intracranial arterial stenosis, occlusion, and intracranial tumors according to Radiology Reports are compared between intervention and control arm.

    Time frame: 6 months.

  4. To assess the workload of head CT angiography interpretation.

    Time of interpreting head CT angiography images, number of consensus meeting are compared between intervention and control arm.

    Time frame: 6 months.

  5. To assess resource use.

    The number of care encounters (in-person) during follow-up, total number of outpatient encounters for aneurysm referral, total number of cerebral artery disease testing are compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  6. Rate of patients of subsequent hospitalization during patient follow-up.

    Rate of patients of subsequent hospitalization is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  7. In-hospital mortality rate during patient follow-up.

    In-hospital mortality rate is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  8. Morbidity (modified Rankin Score ≥ 3) from intracranial haemorrhage or treatment during patient follow-up.

    Morbidity (modified Rankin Score ≥ 3) from intracranial haemorrhage or treatment is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  9. Length of hospital stay during patient follow-up.

    Length of hospital stay is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  10. Rate of hospitalization for intracranial aneurysms during patient follow-up.

    Rate of hospitalization for intracranial aneurysms is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  11. Rate of patients undergoing digital subtraction angiography (DSA) during patient follow-up.

    Rate of patients undergoing digital subtraction angiography (DSA) is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  12. Detection rate of intracranial aneurysms among digital subtraction angiographys (DSA) during patient follow-up.

    Detection rate of intracranial aneurysms among digital subtraction angiographys (DSA) is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  13. Detection rate of no abnormality among digital subtraction angiographys (DSA) during patient follow-up.

    Detection rate of no abnormality among digital subtraction angiographys (DSA) is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  14. Distribution of the methods for aneurysms management (conservative/coil/clip/others) during patient follow-up.

    Distribution of the methods for aneurysms management (conservative/coil/clip/others) is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  15. Rates of aneurysm treatment related complications during patient follow-up.

    Rate of aneurysm treatment related complications (intraoperative rupture, stroke, et al) is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  16. Rate of recurrence or residual of intracranial aneurysm after surgery during patient follow-up.

    Rate of recurrence or residual of intracranial aneurysm after surgery is compared between intervention and control arm.

    Time frame: At 12-month follow-up.

  17. Life quality assessed by EuroQol 5-Dimensional, 5-Level (EQ-5D-5L) during patient follow-up.

    Life quality assessed by EuroQol 5-Dimensional, 5-Level (EQ-5D-5L) scores are compared between intervention and control arm, which ranges from 5 to 25, and higher scores mean a worse outcome.

    Time frame: At 3-month and 12-month follow-up.

  18. Restrictions in daily activities assessed by Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) scores during patient follow-up.

    Restrictions in daily activities assessed by Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) scores are compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  19. Sleep quality assessed by Pittsburgh Sleep Quality Index (PSQI) during patient follow-up.

    Sleep quality assessed by Pittsburgh Sleep Quality Index (PSQI) is compared between intervention and control arm, which ranges from 0 to 21, and higher scores mean a worse outcome.

    Time frame: At 3-month and 12-month follow-up.

  20. Depression Screening assessed by Patient Health Questionnaire-9 (PHQ-9) scores during patient follow-up.

    Depression Screening assessed by Patient Health Questionnaire-9 (PHQ-9) scores are compared between intervention and control arm, which ranges from 0 to 27, and higher scores mean a worse outcome.

    Time frame: At 3-month and 12-month follow-up.

  21. Anxiety and depression assessed by Hospital Anxiety and Depression Scale (HADS) scores during patient follow-up.

    Anxiety and depression assessed by Hospital Anxiety and Depression Scale (HADS) scores are compared between intervention and control arm, which ranges from 0 to 21, and higher scores mean a worse outcome.

    Time frame: At 3-month and 12-month follow-up.

  22. General health assessed by Short-Form 36 Health Survey (SF-36) scores during patient follow-up.

    General health assessed by Short-Form 36 Health Survey (SF-36) scores are compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  23. Functional outcome assessed by Modified Rankin Scale (mRS) scores during patient follow-up.

    Functional outcome assessed by Modified Rankin Scale (mRS) scores are compared between intervention and control arm, which ranges from 0 to 5, and higher scores mean a worse outcome.

    Time frame: At 3-month and 12-month follow-up.

  24. All-cause mortality during patient follow-up.

    All-cause mortality is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  25. Rate of aneurysm growth during patient follow-up.

    Rate of aneurysm growth is compared between intervention and control arm.

    Time frame: At 12-month follow-up.

  26. Rate of aneurysm rupture during patient follow-up.

    Rate of aneurysm rupture is compared between intervention and control arm.

    Time frame: At 12-month follow-up.

  27. Rate of subarachnoid hemorrhage (SAH) during patient follow-up.

    Rate of subarachnoid hemorrhage (SAH) is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  28. Rate of other types of stroke (hemorrhagic stroke, ischemic stroke) during patient follow-up.

    Rate of other types of stroke (hemorrhagic stroke, ischemic stroke) is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  29. Mortality of aneurysms-rupture during patient follow-up.

    Mortality of aneurysms-rupture is compared between intervention and control arm.

    Time frame: At 3-month and 12-month follow-up.

  30. Morphological change by head CTA or magnetic resonance angiography at the 12-month follow-up.

    Morphological change by head CTA or magnetic resonance angiography is assessed.

    Time frame: At 12-month follow-up.

Other outcomes

  1. Patient-wise sensitivity and specificity at different centers, provinces, geography areas and levels of physician.

    To compare diagnostic performances of patient-wise sensitivity and specificity for intracranial aneurysms between intervention and control arm in subgroups of different centers, provinces, geography areas and physician level.

    Time frame: 6 months.

  2. Subgroup analysis of different size (< 5 mm vs. ≥ 5 mm), locations of intracranial aneurysms.

    To compare diagnostic performances for intracranial aneurysms between intervention and control arm in subgroups of different size (internal carotid artery vs. middle cerebral artery vs. anterior cerebral artery vs. posterior communication artery vs. anterior communication artery vs. vertebral basilar artery vs. others), locations (internal carotid artery vs. middle cerebral artery vs. anterior cerebral artery vs. posterior communication artery vs. anterior communication artery vs. vertebral basilar artery vs. others) of intracranial aneurysms.

    Time frame: 6 months.

  3. Subgroup analysis of different gender (male vs. female), age (≤ 54 years or. >54 years), subarachnoid hemorrhage status (with vs. without SAH) of patients

    To compare diagnostic performances for intracranial aneurysms between intervention and control arm in subgroups of different gender (male vs. female), age (≤ 54 years or. \>54 years), subarachnoid hemorrhage status (with vs. without SAH) of patients.

    Time frame: 6 months.

  4. Patient-wise sensitivity and specificity for patients with previous head digital subtraction angiography or surgery or not.

    To compare diagnostic performances of patient-wise sensitivity and specificity for intracranial aneurysms between intervention and control arm in subgroups of patients with previous head angiography or surgery or not.

    Time frame: 6 months.

  5. Patient-wise sensitivity and specificity for patients with subsequent head digital subtraction angiography or surgery or not.

    To compare diagnostic performances of patient-wise sensitivity and specificity for intracranial aneurysms between intervention and control arm in subgroups of patients with subsequent head angiography or surgery or not.

    Time frame: 6 months.

  6. Ethical safety outcomes.

    The monthly reported detection rates of intracranial aneurysms, tumors, stenosis, and occlusive are calculated and compared with the reported detection rates in the previous 3 months during the trial.

    Time frame: 6 months.

  7. Learning curve of AI-augmented intracranial aneurysm diagnosis.

    Dynamic changes in sensitivity and specificity of aneurysm diagnosis from the first 7-days through to the last 7-days of all center trials.

    Time frame: 6 months.

07

Study locations

21 of 21 sites recruiting
  • The First Affiliated Hospital of University of Science and Technology of China
    Hefei, Anhui, China
    Recruiting
  • The First Affiliated Hospital of Wannan Medical College
    Wuhu, Anhui, China
    Recruiting
  • Guizhou Provincial People's Hospital
    Guiyang, Guizhou, China
    Recruiting
  • First Affiliated Hospital of Zhengzhou University
    Zhengzhou, Henan, China
    Recruiting
  • Shiyan People's Hospital
    Shiyan, Hubei, China
    Recruiting
  • Research Institute Of Medical Imaging Jinling Hospital
    Nanjing, Jiangsu 210018, China
    Recruiting
  • Affiliated Hospital of Xuzhou Medical University
    Xuzhou, Jiangsu, China
    Recruiting
  • The First Hospital of Jilin University
    Changchun, Jilin, China
    Recruiting
  • Shandong Provincial Hospital Affiliated to Shandong First Medical University
    Jinan, Shandong, China
    Recruiting
  • Yidu Central Hospital Affiliated to Shandong Second Medical University
    Weifang, Shandong, China
    Recruiting
  • The First Affiliated Hospital of Kunming Medical University
    Kunming, Yunnan, China
    Recruiting
  • Hainan General Hospital
    Haikou, China
    Recruiting
  • The First People's Hospital of Kashgar Region
    Kashgar, China
    Recruiting
  • University Second Hospital
    Lanzhou, China
    Recruiting
  • First People's Hospital of Lianyungang
    Lianyungang, China
    Recruiting
  • Ma'anshan People's Hospital
    Ma’anshan, China
    Recruiting
  • BenQ Medical Center, Affiliated BenQ Hospital of Medical School, Nanjing Medical University
    Nanjing, China
    Recruiting
  • Long Gang Central Hospital of Shenzhen
    Shenzhen, China
    Recruiting
  • The Affiliated Suqian First Hospital of Nanjing Medical University
    Suqian, China
    Recruiting
  • Tianjin Medical University General Hospital
    Tianjin, China
    Recruiting
  • General Hospital of Ningxia Medical University
    Yinchuan, China
    Recruiting
08

References and documents

Publications

  • Shi Z, Hu B, Lu M, Chen Z, Zhang M, Yu Y, Zhou C, Zhong J, Wu B, Zhang X, Wei Y, Zhang LJ; China Aneurysm AI Project Group. Assessing the Impact of an Artificial Intelligence-Based Model for Intracranial Aneurysm Detection in CT Angiography on Patient Diagnosis and Outcomes (IDEAL Study)-a protocol for a multicenter, double-blinded randomized controlled trial. Trials. 2024 Jun 4;25(1):358. doi: 10.1186/s13063-024-08184-9. PubMed 38835091 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 7, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06118840
Lead sponsor
Jinling Hospital, China
Responsible party
Zhang longjiang,MD (Head of Radiology, Jinling Hospital, China) — Principal investigator
First posted
Nov 7, 2023
Start date
May 20, 2024
Primary completion
Jul 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Oct 7, 2025

Study contacts

Longjiang Zhang, MD
Contact
kevinzhlj@163.com
+8613405833176
Trial Manager
principal investigator · Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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