Following our recent post on the global increase in the use of medical imaging, we now turn our attention to the use of imaging for stroke; our area of focus. Data compiled by the United States Center for Disease Control (CDC) shows that, with some temporal ups and downs, the use of CT and MR for stroke has climbed by more than 50% over the past 15 years, and is now used in over 90% of strokes. Following the trend line, it looks like we’ll be close to medical imaging being used in 100% of strokes in the next 5-10 years.

  Emergency department visits with with magnetic resonance imaging or computed tomography test ordered or provided, by visit diagnosis: United States 2001-2011

 

Emergency department visits with with magnetic resonance imaging or computed tomography test ordered or provided, by visit diagnosis: United States 2001-2011

What’s driving this trend?

The answer is multivariate, but the primary driver is the broader acceptance of imaging as the critical biomarker for stroke. A stroke can be approximated by behavioral tests like the National Institutes of Health Stroke Scale (NIHSS) or the Los Angeles Prehospital Stroke Screen (LAPSS); but the stroke subtype, and, therefore, the best treatment path, is near-impossible to define without high-quality imaging.

The dramatic growth in the use of imaging for stroke has mirrored the explosion in the number of studies that validate that imaging-based variables can predict patients outcome and the likelihood that either tPA or endovascular therapy might work.

With the number of stroke patients being imaged nearing 100%, we predict that the number of CT scans ordered will almost double over the ten years. Yup, you read that right. Because it’s not only about the number of patients scanned, it’s the types of scans as well.

Guidelines for stroke triage were updated last year following the publication of successful EVT trials to acknowledge the need to determine a patient’s candidacy for EVT. In addition to the standard, non-contrast CT scan routinely performed to rule out hemorrhagic stroke, a contrast-enhanced CT called CT angiogram is now also recommended to help visualize the patient’s blood vessels better. This more detailed view of the vasculature is crucial for determining a patient’s candidacy for endovascular therapy, but can also provide vital information on the value of administering tPA (or not).

Making all of this valuable information available is half the battle; a trained eye (or trained software) is also needed to glean this wisdom from the scans and make decisions quickly and accurately. At QuikFlo, we hope to provide one of the solutions that bring this expertise to every hospital, everywhere in the world.

By Vinny Jindal - CEO, QuikFlo Health Inc.