Abstract TP109: Developing Novel Portable Neuroimaging To Deliver Urgent Prehospital Stroke Care

Abstract

Introduction: Patients with stroke in rural and remote areas have limited access to time-critical stroke care and have worse outcomes. Mobile stroke units (MSUs) are increasingly used worldwide to deliver prehospital stroke care, improving treatment times. However, current brain scanners are too large, heavy, and costly to be used in standard ambulances to access rural regions. The Micro-X solution is a fixed gantry computed tomography (CT) device, using unique cold-cathode technology, in which microscopic carbon nanotubes emit electrons instantaneously when voltage is applied, without heat production, instead of the heated tungsten filament used in conventional CT. This novel technology reduces size and weight, enabling development of a novel CT scanner weighing under 50 kg, a ten-fold reduction compared to the scanner currently used in most MSUs. Methods: In partnership with the Australian Stroke Alliance, Micro-X is developing a novel lightweight brain scanner for use in ambulances. Based on data from an early prototype cadaver study, we are undertaking further validation studies, including a two-part preclinical study: (1) phantom study using 4 phantoms (CATphan, anthropomorphic, Jaszczak SPECT, and Nuclear Medicine); and (2) subsequent cadaver study, scanning cadavers within 24h of death, compared to standard CT. Results: The early prototype cadaver study demonstrated feasibility, including identification of lateral and third ventricles when compared to concurrent CT. Through technical improvements in hardware and software, including improved scanner geometry and algorithm development, the planned phantom study will provide data on contrast resolution, quantitative spatial resolution, identification of anatomical structures, and haemorrhage detection compared with conventional CT. The subsequent cadaver study will provide further validation on anatomy identification and artifact reduction and ensure whole-brain coverage. Conclusion: Preclinical evaluation of this novel lightweight technology compared with conventional CT will provide technical assessment and image validation. This will provide diagnostic confidence to perform pilot in-vivo studies, with the potential to revolutionise prehospital stroke care.