How AI-Enabled Enterprise Imaging is Improving the Quality and Access to Timely Care for Patients with Acute Stroke

Timely remote access to advanced neuroimaging can go a long way to facilitating recently updated acute stroke guidelines extending the window for clot-dissolving thrombolytic administration from 4.5 hours to as long as 24 hours in select patients with a favorable perfusion profile on computed tomography (CT) scans, according to Arun V. Talkad, MD, the ministry director of stroke at the Order of St. Francis (OSF) HealthCare in Peoria, Ill.

In a recent interview with Diagnostic Imaging, Dr. Talkad discussed initial integration of the Rapid Enterprise Platform (RapidAI) at three OSF facilities and newly announced plans to expand the technology to all 18 OSF hospitals.

Prior to initial use of the AI enterprise platform, Dr. Talkad noted that stroke specialists covering outlying referring hospitals often have to make treatment recommendations without seeing the images themselves. He indicated that the platform's core value is giving remote physicians the same visual access an on-site clinician would have. Dr. Talkad emphasized the clinical stakes of the quicker access to imaging.

“Every minute of stroke, we lose 1.9 million brain cells, and so over the course of an hour, just one hour of stroke, we lose 120 million brain cells. That's the same amount of brain cells we lose in normal 3.6 years of aging,” pointed out Dr. Talkad.

(Editor’s note: For related content, see “Can DSC MRI-Derived Oxygen Ejection Fraction Predict Diffusion Reversal in Patients Treated for Acute Ischemic Stroke?,” “AI in Neuroradiology: Keys to Workflow Integration, Governance, and Facilitating Improved Outcomes” and “Can Multidirectional DWI Improve Low-Field MRI Detection of Acute Ischemic Stroke?”)

Dr. Talkad said there are significant implications for health care equity as well. The combination of the recently updated guidelines from the American Heart Association and the American Stroke Association along with OPTION trial data showing benefit from CT perfusion-guided treatment out to 24 hours enables facilities without in-house imaging expertise to identify eligible patients with acute stroke for clot-dissolving thrombolytic therapy well beyond the traditional treatment window provided they have connected AI software for sharing images, according to Dr. Talkad.

“Right now, only about 25 percent of patients show up within that first three- to 4.5-hour window that even allows us to be able to treat them, and if about 80 percent of people are showing up within 24 hours, now I might be able to treat 80 percent of patients. Obviously, I'm not going to treat all of them, but just tripling the amount of people that I could treat is going to now offer the benefit of having so many more people continue to go home,” emphasized Dr. Talkad.