Point-of-Care CT Perfusion (PoC CT-P) for Early Stroke Assessment

Abstract The goal of this SBIR Phase I project is to develop a portable and affordable cranial x-ray-based Computed Tomography Perfusion (CT-P) device for expedited front-line evaluation and triage of ischemic cerebral stroke victims. CT-P is the gold standard modality for assessment and classifying stroke patients to determine the best candidates for revascularizing procedures; however, CT-P is generally unavailable early in the current acute care treatment model. Unlike existing conventional CT-P equipment which is generally large, expensive, and stationary, the proposed device would be compact, portable, and affordable to be deployed in nursing homes, urgent care centers, hospital ER triage areas, ICUs, and EMS response vehicles, yet also provide sufficient time and contrast resolution for reliable perfusion metrics. Rapidly acquired point-of-care CT and CT-P images showing blood flow, volume, and transit times will enable (1) early classification of hemorrhage or ischemic, and (2) assessment of the recoverable brain tissue volume. This will enable early screening evaluation for appropriate acute stroke patient prioritization and routing. In addition, it may also provide an economical and safe bedside means of assessing cranial perfusion for follow up care in the ICU, recovery room, or even eventually in a residential care setting. Xoran Technologies LLC specializes in point-of-care (POC) medical imaging and has successfully marketed over 750 POC imaging devices in the US.Project Narrative When an individual is suffering from acute stroke, time is of the essence; however, it is critically important to assess the type of stroke as well as the amount and location of potentially recoverable brain tissue to determine the appropriate routing and priority to achieve the best outcome for that individual. In this project a new compact and portable device is proposed that allows cranial perfusion studies to be performed earlier in the process than the current standard of care, potentially in a nursing home, urgent care center, or in an emergency vehicle such as an ambulance. Public health is affected both by the potential for improved outcomes for individuals, but also for systemwide cost savings and efficiency gains by not transporting patients who are not likely to benefit from a trip to a level one stroke treatment center.