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Low-Field MRI of Stroke: Challenges and Opportunities
Seema S Bhat1, Tiago T Fernandes2, Pavan Poojar1,3
1Medical Imaging Research Centre, Dayananda Sagar College of Engineering, Bangalore, India.
Abstract:
Stroke is a leading cause of death and disability worldwide. The reasons for increased stroke burden in developing countries are inadequately controlled risk factors resulting from poor public awareness and inadequate infrastructure. Computed tomography and MRI are common neuroimaging modalities used to assess stroke with diffusion-weighted MRI, in particular, being the recommended choice for acute stroke imaging. However, access to these imaging modalities is primarily restricted to major cities and high-income groups. In the case of stroke, the time-window of treatment to limit the damage is of a few hours and needs a point-of-care diagnosis. A low-cost MR system typically achieved at the ultra-low- and very-low-field would meet the need for a geographically accessible and portable solution. We review studies focused on accessible stroke imaging and recent developments in MR methodologies, including hardware, to image at low fields. We hypothesize that in the absence of a formal, rapid stroke triaging system, the value of timely on-site delivery of the scanner to the stroke patient can be significant. To this end, we discuss multiple recent hardware and methods developments in the low-field regime. Our review suggests a compelling need to explore further the trade-offs between high signal, contrast, and accessibility at low fields in low-income communities. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY STAGE: 6.
Insights
Accessible, low-cost MRI systems could improve stroke diagnosis in underserved areas. This technology offers a portable solution for timely, point-of-care stroke imaging, addressing critical access barriers in developing countries.
Area of Science:
- Medical Imaging
- Neurology
- Biomedical Engineering
Background:
- Stroke is a major global cause of death and disability, with a disproportionately high burden in developing countries due to uncontrolled risk factors and limited healthcare infrastructure.
- Current neuroimaging techniques like computed tomography (CT) and magnetic resonance imaging (MRI), particularly diffusion-weighted MRI, are crucial for acute stroke diagnosis but are often inaccessible in remote or low-income regions.
- The narrow therapeutic window for stroke necessitates rapid diagnosis, highlighting the need for point-of-care solutions beyond major urban centers.
Purpose of the Study:
- To review existing studies on accessible stroke imaging solutions.
- To explore recent advancements in low-field magnetic resonance (MR) imaging hardware and methodologies for stroke assessment.
- To evaluate the potential of low-cost, portable MR systems for improving stroke diagnosis and patient outcomes in resource-limited settings.
Main Methods:
- Comprehensive literature review of studies focusing on accessible neuroimaging for stroke.
- Analysis of recent developments in low-field MR hardware, including ultra-low- and very-low-field systems.
- Discussion of MR imaging methodologies adapted for low-field applications and their potential for point-of-care use.
Main Results:
- Low-field MR systems offer a potential pathway to geographically accessible and portable stroke imaging solutions.
- Recent hardware and methodological advancements in the low-field regime show promise for on-site stroke diagnosis.
- The timely delivery of imaging scanners to stroke patients in the absence of formal triaging systems could be highly significant.
Conclusions:
- There is a compelling need to further investigate the balance between signal quality, contrast, and accessibility of low-field MR imaging in low-income communities.
- Developing and deploying low-cost, portable MR technology is crucial for bridging the diagnostic gap in stroke care globally.
- Further research into the trade-offs at low fields is essential to optimize accessible stroke imaging solutions.
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