Assessment of a Handheld Near-Infrared Light Device in Detecting Intracranial Hematomas in Mbarara, Uganda

Traumatic brain injury (TBI) is one of the leading causes of mortality worldwide. Low- and middle-income countries have limited access to computed tomography scans (CT), which are essential in TBI care. The Infrascanner 2000™ is a low-cost, portable near-infrared device that could be used as a triage device to prioritize the use of a confirmatory CT scan in detecting post-traumatic intracranial bleeds. The aim of this observational study (NCT04505293) was to determine the diagnostic performance of the Infrascanner 2000™ in comparison with CT in TBI patients in Mbarara Regional Referral Hospital (MRRH), Uganda.

Patients with suspected head trauma in MRRH who received a head CT were included. They were scanned with the Infrascanner™ within 30 minutes after their CT. The patients' demographics, clinical characteristics, and device diagnostic performance were recorded. Data from our previous study at Duke University Hospital was combined with this study data to determine factors that could account for differences found in device performance.

Of the 384 patients in MRRH, 180 had intracranial hematomas. The device had a sensitivity of 88.9% and a specificity of 37.7%. This high sensitivity applied to all tested hemorrhage locations and various hemorrhage types. The combined study had a sensitivity of 87.4% and a specificity of 75.1%. Dark skin color was found to be a factor resulting in the low specificity observed.

Our data demonstrate that the Infrascanner 2000™ performs well at detecting intracranial hematomas with high sensitivity and low false negatives. The decrease in specificity may be related to darker skin color; however, additional studies using updated versions of the device are needed.