X-LMC: Cross-View Spatiotemporal Collateral Circulation Scoring from DSA

X‑LMC is a spatiotemporal deep‑learning framework that automatically scores leptomeningeal collateral (LMC) status from time‑resolved biplane digital subtraction angiography (DSA). It uses a DINOv2 backbone to encode spatial frames, a token‑level cross‑view attention module to fuse orthogonal projections, and a recurrent network to model contrast bolus dynamics. On a multicenter dataset of 134 M1‑segment occlusion patients, X‑LMC achieved a Quadratic Weighted Kappa of 0.398 and a macro‑F1 of 0.711, outperforming static and other spatiotemporal baselines and matching clinical inter‑rater agreement.

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