Portable ultra-low-field MRI in acute stroke care: A pilot study

Area of Science:

• Neurology
• Medical Imaging
• Stroke Medicine

Background:

• Neuroimaging is crucial for stroke treatment but lacks global accessibility.
• Portable ultra-low field (pULF) MRI offers potential to expand access to neuroimaging and improve worldwide stroke care.
• This pilot study introduces pULF-MRI in a European stroke center, comparing its diagnostic utility to high-field (HF) MRI.

Purpose of the Study:

• To evaluate the diagnostic accuracy of pULF-MRI compared to HF-MRI in patients with suspected ischemic stroke.
• To assess the reliability of pULF-MRI for making imaging-based therapeutic decisions.
• To determine the potential role of pULF-MRI in acute stroke care, particularly in resource-limited settings.

Main Methods:

• Seventeen patients with suspected ischemic stroke underwent pULF-MRI (0.064 Tesla Swoop system) alongside standard imaging.
• Scans from both pULF-MRI and HF-MRI were independently assessed by blinded reviewers.
• Diagnostic accuracy and treatment decisions based on pULF-MRI were compared to those based on HF-MRI.

Main Results:

• Ischemic lesions were identified on HF-MRI in 12 out of 17 patients.
• pULF-MRI detected ischemic lesions in 8 of these 12 cases; missed infarcts were small (<6mm).
• Treatment decisions based on pULF-MRI imaging consistently matched actual clinical decisions.

Conclusions:

• pULF-MRI is a promising tool for acute stroke care, offering reliable imaging for treatment decisions and monitoring.
• pULF-MRI can support stroke care when HF-MRI is inaccessible, especially in resource-limited environments.
• Limitations include longer scan times and absence of vessel imaging and hemorrhage-sensitive sequences.