Portable MRI shows promise in detecting infarcts for those with acute ischemic stroke

But you don't tell us how fast it is. TIME IS BRAIN; or don't you know that? 

Why not do these fast ones?

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds; February 2017 

Smart Brain-Wave Cap Recognises Stroke Before the Patient Reaches the Hospital

 October 2023

And then this to rule out a bleeder.

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes April 2017

 

The latest here:

Portable MRI shows promise in detecting infarcts for those with acute ischemic stroke

Key takeaways:

• The portable MRI detected a high percentage of stroke-related infarct.
• Hyperfine has “practical advantages” over high-field MRI, researchers said.

Portable bedside MRI showed promise in detecting infarcts revealed on high-field MRI in those with acute ischemic stroke, with better performance on larger sized infarcts, according to a poster from the International Stroke Conference.

“FDA approval of Hyperfine has led to interest in using low-field MRI in acute ischemic stroke,” James Shay, MD, a behavioral neurology fellow at Ohio State University Wexner Medical Center, and colleagues wrote. “Portable MRI has practical advantages over high-field MRI and prior studies have evaluated pMRI predominantly in the ICU settings.”

New research suggests that a novel portable MRI shows promise in detecting infarcts for those with acute ischemic stroke. Image: Adobe Stock

Researchers aimed to determine performance of Hyperfine, an FDA-approved, portable, bedside MRI, on patients with floor-level acute ischemic stroke.

Their study was a retrospective review of 12 individuals (mean age 58.5 years; 58.3% female) who had undergone pMRI during their hospitalization.

Shay and fellow researchers reviewed their institutional pMRI (Hyperfine), an 0.064 Tesla that includes diffusion-weighted imaging (DWI), to visually confirm infarcts on high-field MRI (hMRI). The hMRI is considered “gold standard,” the researchers wrote, excluding all incomplete or technically limited scans. Infarct size was measured based upon maximum longitudinal axis on MRI DWI.

According to results, the mean time from hMRI to pMRI was 46.2 hours (range, -0.9 to 126.9 hours).

In nine of 12 patients, pMRI revealed acute infarcts (seven of 12 pMRI scans demonstrated all infarcts seen on hMRI, while two of 12 pMRI scans identified some but not all), while three pMRI DWI were negative and 12 hMRI scans revealed a total of 15 infarct lesions.

Among those 15, 10 were also visible on pMRI, with mean size of non-visible infarcts 7.7 mm, compared with pMRI visible infarct mean size of 21.7mm. The smallest infarct that was visible on the pMRI was 7.7 mm.

“Understanding limitations of pMRI will allow clinical teams to maximize patient selection for use in [acute ischemic stroke] population,” Shay and colleagues wrote.

Sources/Disclosures

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Source:

Shay J, et al. Portable bedside low-field MRI imaging acute infarct detection on floor level acute ischemic stroke patients. Presented at: International Stroke Conference; Feb. 7-9, 2024; Phoenix.

Disclosures: Shay reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Out of the Basement: Early Results Promising for Portable MRI

The times reported for this is still way slower that these other methods. If speed is of the essence this would not become standard use. WHOM is going to speak truth to power on this?  We'll see if they even deign to print my comment.

Unless maybe you want your ER department to get these faster ones:

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds   February 2017

 

Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds March 2017

 

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes April 2017

Out of the Basement: Early Results Promising for Portable MRI

— Feasibility study indicates no interference in ICU, no metal issues

by Crystal Phend, Senior Editor, MedPage Today February 20, 2020

LOS ANGELES -- An investigational low-power MRI scanner appeared safe and feasible for use at the bedside in a standard neuroscience ICU, researchers reported.
The 64-mT portable machine under development by Hyperfine Research required no shielding, no special power supply, no changes to the equipment used in the patient's room, and no precautions for ferrous metal, Bradley Cahn, BS, of Yale University School of Medicine in New Haven, Connecticut, and colleagues reported here at the International Stroke Conference.
Among 96 stroke patients scanned non-acutely (minimum 9 hours post-onset, mean 87 hours), there were no "significant" adverse events. Overall, 87% of participants completed the full exam: six participants experienced claustrophobia, and five didn't fit head and shoulders comfortably into the 30-cm opening.
Acquisition times were about 7.5 minutes for T2-weighted scans, 9.5 for FLAIR, 9.8 for diffusion-weighted imaging, and just shy of 29 minutes for a full exam.
Portable CT machines are already in clinical use for stroke, notably in mobile stroke units, noted Ralph Sacco, MD, chairman of neurology at the University of Miami and past president of the American Heart Association.
"If we could get MRI as quickly as CT scanning, some of us would prefer MRI over CT," he said in an interview.
MRI is a more sensitive indicator of brain injury and can pick up ischemia much earlier in the process when CT might still give a false negative, he noted.
The bulky machines needed to generate high-powered 3- and even 7-T MRI, risk posed by stray metal, as well as the wait and acquisition times have been hurdles, though, Sacco added.
"We have this incredibly safe technology, MRI, and we've put it in depths of the hospital's basement where you have to travel with the patient to get to it," said Cahn. "We've flipped that and brought the magnet into the patient's room."
There are plenty of other possible useful applications, though, said Cahn. Availability in the emergency room and ambulance "would be huge."
However, 28 minutes -- while fast for MRI -- might be just too long to consider overthrowing CT as the standard for urgent diagnosis in most circumstances, said ISC session moderator Justin Fraser, MD, of the University of Kentucky in Lexington. But it could be particularly useful for posterior circulation strokes, to determine futility of thrombectomy, he suggested.
The device still needs to be tested in the acute setting, though, Cahn noted.
"I think what they intended to prove, they proved that it was both feasible and safe to do in this limited, single-center population," commented Peter Panagos, MD, of Washington University School of Medicine in St. Louis, and American Heart Association/American Stroke Association Stroke Council Chair.
The study included both intubated and non-intubated adults in the neuroscience ICU who needed imaging as standard of care. Those with contraindications to 1.5-T MRI were excluded.
In theory, the device should be compatible with MR-compatible pacemakers and similar devices, but that hasn't been tested yet either, noted Cahn. "We just don't know how the low field strength interacts with devices like that. For example, some devices [that] are safe at 3 T may not be at 7 T and vice versa."
Nor were any scans done with contrast administration. Those studies will come, Cahn said, and the device continues to be iteratively improved.

Disclosures

The trial was supported by Hyperfine Research, which is developing the device, and by the American Heart Association.
Cahn disclosed receiving grants from Hyperfine Research.
Coauthors included some employees of Hyperfine Research.
Panagos and Fraser disclosed no relevant relationships with industry.

Primary Source

International Stroke Conference

Source Reference: Cahn BA, et al "Deployment of Portable, Bedside, Low-Field Magnetic Resonance Imaging for Evaluation of Stroke Patients" ISC 2020; Abstract 57.