Abstract Details

Title Portable, Bedside, Low-field Magnetic Resonance Imaging in an Intensive Care Setting for Intracranial Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S9 - Cerebrovascular Disease: Intracerebral Hemorrhage (4:54 PM-5:06 PM)

Poster/Presentation
Number 008

Objective To obtain preliminary data regarding the ability of a bedside POC MRI scanner to detect ICH.

Background Radiographic diagnosis of intracranial hemorrhage (ICH) is a critical determinant of stroke care pathways requiring patient transport to a neuroimaging suite. Advances in low-field MRI have made it possible to obtain clinically useful imaging at the point of care (POC).

Design/Methods We studied 36 patients with a diagnosis of ICH (n=18) or ischemic stroke (n=18). Five blinded readers independently evaluated T2W and FLAIR exams acquired prospectively on a 64 mT, portable bedside MRI system (Hyperfine Research, Inc). Kappa coefficients (κ) were calculated to determine inter-rater agreement. Ground truth was obtained from the clinical report of the closest conventional imaging study (17.9 ± 10.4 hours) and verified by a core reader. For each exam, majority consensus among raters was used to determine sensitivity.

Results ICH volume ranged from 4 to 101 cc (median of 13 cc). Exams were acquired within 7 days of symptom onset (51.1 ± 28.8 hours). A pathologic lesion was identified on every exam with 100% sensitivity. Sensitivity for distinguishing any hemorrhage was 89% and specificity was 83%. The mean sensitivity and specificity for individual raters was 79% and 69%, respectively. When limited to supratentorial hemorrhage, consensus sensitivity was 94%. For ICH cases detected by all raters (n=9), there was 100% accuracy for localizing the bleed (lobar vs. non-lobar) with perfect agreement among raters (κ = 1, p <0.0001). There was substantial agreement for identifying intraventricular hemorrhage (IVH) (κ = 0.72, p < 0.0001). Sensitivity for IVH was 100% based on rater consensus.

Conclusions These data suggest that low-field, POC MRI may be used to detect hemorrhagic stroke at the bedside. Further work is needed to evaluate this approach in the hyperacute setting and across a wide range of ICH characteristics.

Authors/Disclosures
Jill T. Shah PRESENTER	No disclosure on file
Bradley Cahn	Mr. Cahn has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Matthew Yuen (Yale University)	Mr. Yuen has nothing to disclose.
Mercy H. Mazurek (Harvard Medical School)	Miss Mazurek has nothing to disclose.
Charles Wira	No disclosure on file
Audrey Leasure	Ms. Leasure has nothing to disclose.
Charles Matouk	Charles Matouk has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Silk Road Medical. Charles Matouk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Microvention. Charles Matouk has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Navigantis.
	No disclosure on file
Sam Payabvash	Sam Payabvash has nothing to disclose.
Rachel Beekman, MD (Yale New Haven Medical Center)	Dr. Beekman has nothing to disclose.
Stacy C. Brown, MD (The Queen's Medical Center, Neuroscience Institute)	Dr. Brown has nothing to disclose.
Guido J. Falcone, MD (Yale School of Medicine)	The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.
Kevin Gobeske, MD (Yale School of Medicine, Neurology)	Dr. Gobeske has nothing to disclose.
Nils Petersen, MD (Yale University)	The institution of Dr. Petersen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Silkroad Medical. Dr. Petersen has received research support from NIH.
Adam S. Jasne, MD (Yale)	Dr. Jasne has nothing to disclose.
Richa Sharma, MD (Massachusetts General Hospital, Brigham, Harvard)	Dr. Sharma has received research support from NIH. Dr. Sharma has received intellectual property interests from a discovery or technology relating to health care.
Joseph L. Schindler, MD (Yale University Department of Neurology)	Dr. Schindler has received personal compensation for serving as an employee of Aeromics. Dr. Schindler has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Aeromics. Dr. Schindler has received stock or an ownership interest from Aeromics. Dr. Schindler has received publishing royalties from a publication relating to health care.
Lauren H. Sansing, MD	Dr. Sansing has nothing to disclose.
Emily J. Gilmore, MD (Yale University School of Medicine)	Dr. Gilmore has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for carpl.ai. Dr. Gilmore has received personal compensation in the range of $0-$499 for serving as a Consultant for AAN. Dr. Gilmore has received research support from NIH.
Gordon Sze	Gordon Sze has nothing to disclose.
Matthew Rosen	Matthew Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for DeepSpin. Matthew Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Chipiron. Matthew Rosen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Synex Medical. Matthew Rosen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Nanalysis. Matthew Rosen has stock in Hyperfine. Matthew Rosen has stock in Q Bio. Matthew Rosen has stock in Vizma Life Sciences. Matthew Rosen has stock in Intact Data Services. The institution of Matthew Rosen has received research support from Imagion. Matthew Rosen has received intellectual property interests from a discovery or technology relating to health care.
W. T. Kimberly, MD, PhD (Massachusetts General Hospital)	Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astrocyte Pharmaceuticals. Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acasti Pharma. Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hyperfine Inc.. Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurotherapeutics. Dr. Kimberly has stock in Woolsey Pharmaceuticals. Dr. Kimberly has stock in Acasti Pharma. The institution of Dr. Kimberly has received research support from Biogen. The institution of Dr. Kimberly has received research support from NControl Therapeutics. The institution of Dr. Kimberly has received research support from NIH. The institution of Dr. Kimberly has received research support from American Heart Association. The institution of Dr. Kimberly has received research support from Hyperfine, Inc.. Dr. Kimberly has received intellectual property interests from a discovery or technology relating to health care.
Kevin N. Sheth, MD, FAAN (Yale UniversityDivision of Neuro and Critical Care)	Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.

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