Simple scan may have identical outcomes as advanced imaging

Stroke patients who are treated based on simple imaging may have identical clinical outcomes to those treated based on advanced imaging, a new study suggests.

The researchers have shown that a computed tomography (CT scan) could be sufficient for determining thrombectomy treatment in stroke.

Thrombectomy surgery can be performed to remove a large blood clot lodged in a blood vessel. It has been shown to be an effective treatment for improving clinical outcomes in stroke up to 24 hours from onset.

"The results show that simple imaging, while not perfect, may be good enough. This basic technique is faster, which means patients could potentially be treated more quickly," said Amrou Sarraj, Associate Professor from the University of Texas Health Science Centre at Houston.

"The advanced imaging of CT perfusion isn't available everywhere, so this could open up the door to identify more people for potential treatment, especially in remote areas," Sarraj added.

For the study, presented at the European Stroke Organisation Conference (ESOC) 2018 in Sweden, the researchers enrolled 445 patients who received both simple and advanced imaging at nine academic health centres from January 2016 to February 2018.

The study also revealed that 42 per cent of patients who were excluded from thrombectomy by one of the imaging profiles but had a good profile on the other type of imaging, had positive clinical outcomes.

"Our results should not be interpreted that advanced perfusion images are not necessary or should not be acquired at all as they still identified a group of patients who may be treated with thrombectomy when CT alone was not enough," said Sarraj.

"The numbers involved are significant because 17.6 per cent of patients could have been excluded from having surgery if the CT or CT perfusion were relied on alone, so there's a real opportunity here to help more people if both forms of imaging are available," Sarraj noted.