This review focuses on the current landscape and future direction for low-field magnetic resonance imaging in the prehospital setting, with a discussion of current and upcoming devices, and potential barriers to ambulance integration and how these may be overcome.
Abstract
Stroke is a leading cause of morbidity and mortality globally. Prehospital stroke care is a rapidly growing field to improve stroke outcomes. Methods to assess patients in the prehospital setting include clinical scales and portable neuroimaging that are usually restricted to mobile stroke unit computed tomography scanners, which are not widely available. Lightweight low-field magnetic resonance imaging devices at the <0.1T range offer an opportunity for portable lightweight imaging for the prehospital setting, with the advantage of greater tissue assessment to diagnose stroke. This review focuses on the current landscape and future direction for low-field magnetic resonance imaging in the prehospital setting, with a discussion of current and upcoming devices, and potential barriers to ambulance integration and how these may be overcome. Low-field magnetic resonance imaging provides an exciting opportunity for portable and safe imaging for the prehospital setting for the early diagnosis of stroke and the initiation of triage and treatment. These devices have the potential to be much more widely available and accessible than the current prehospital assessment model of mobile stroke units and provide additional detail for treatment decisions compared with non-imaging-supported telehealth prehospital assessments.
Low-field and portable MRI show promising diagnostic potential for AIS and TIA, particularly when conventional MRI is unavailable, delayed, or impractical, but current evidence is limited by small, predominantly single-center studies with substantial risk of bias.
Rachana R. Borkar, Sai Dhanush Reddy Jeggari, Kamal Kandel et al.· Brain Science· 0 citations
Low-field magnetic resonance imaging (LF-MRI) has recently emerged as a novel approach to extend MRI capability into critical care environments and offers a unique opportunity to support repeated imaging during periods when neurological examination is unreliable or limited.
Lina Zheng, Z. Law, X. Nie et al.· Stroke· 0 citations
The current clinical evidence base is reviewed, including the role of LF-MRI in supporting stroke-type classification and tissue confirmation, in wake-up and unknown-onset stroke for tissue-based triage, and in post-therapeutic settings to enable serial assessment after thrombolysis or thrombectomy.
A. Sorby-Adams, N. Pintér, Keith W. Muir et al.· Stroke· 0 citations
No single technology provides capabilities similar to noncomputed tomography in terms of detection and differentiation of ischemic and hemorrhagic stroke, but a combination of ultrasound and near-infrared spectroscopy may complement each other in hemorrhage detection.
Maximilian Kaffes, Maxwell S. Damian, Stephen M. Davis et al.· Journal of the American Hear...· 0 citations
Investigating the cost-effectiveness of alternate neuroimaging approaches in the evaluation of patients presenting to the emergency department with dizziness when high-field MRI is not available found observation for high-field MRI remained the most cost-effective strategy across a wide range of model parameters.
This review critically appraise how CT and MRI are integrated hierarchically across these scenarios, and how emerging fast MRI and quantitative biomarkers may reshape future selection paradigms.
Kai Xu, J. Lyu, Xin Lou· Journal of Magnetic Resonanc...· 0 citations
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