ESO-WSO 2020: “Novel Imaging in Stroke”
Ammad Mahmood, MBChB
European Stroke Organisation-World Stroke Organization 2020 Virtual Conference
November 7-9, 2020
This session covered a number of novel techniques used in stroke imaging with a number of distinguished speakers. Cutting-edge advances in pre-hospital imaging in the ambulance, imaging used in making decisions about reperfusion therapies, and diagnostic imaging used in aetiological classification were all discussed.
Pre-hospital imaging – Jeffrey Saver
Advantages of triage in the field of patients into ischemic (LVO and non-LVO) and hemorrhagic stroke enables routing to the most appropriate facility, minimizing delays to treatment access and the need for inter-hospital transfers. Quasi-imaging approaches involving innovative approaches such as radio frequency, infrared, or EEG ‘stroke helmets’ may help identify patients with LVO in the future. Ultrasound assessment of vessel patency in the field yielded 91% accuracy in identifying LVO in one study. Mobile stroke units with CT capability are already in use and allow CT, CTA, and possibly CTP in the field. Automated image processing software can aid in interpretation of CT results quickly. Future technologies may include mobile stroke units in helicopters or small aircraft, mobile neuro-intervention suites, and mobile MRI imaging. Prof. Saver presented some cases from the Los Angeles mobile stroke unit experience highlighting the optimization of patient management achieved through early triage. Lastly, he highlighted the ongoing BEST-MSU trial, which will evaluate the benefit of MSUs in stroke management in several cities in the United States.