Bhavya Rehani MD, Presenter: Nothing to Disclose

Stroke poses a major health challenge in today’s world. “Time is Brain” in stroke and every minute counts in stroke management. To what extent are we able to provide timely imaging to these patients globally and if not what can be done? Our aim was to survey radiologists across developing countries in Asia, Europe and South America to assess the stroke care and find out what in their opinion are the most effective ways to improvise imaging and management.

A standardized questionnaire containing 18 questions was sent to radiologists in 20 developing countries across the world. Radiologists from 18 countries responded (response rate=90%). These include Kenya, Algeria, Rwanda, Sri Lanka, Malaysia, Costa Rica, Macedonia, Bulgaria, Mexico, China, India, Uruguay, Burma and Venezuela among others.

Survey results indicated that most of the countries (72%), lack access to CT scanners. Intravenous tissue plasminogen activator (t PA) is the standard of care of ischemic stroke and cannot be given unless hemorrhage is excluded on CT. Also, this can only be administered for a specific time window after symptom onset. To maximize patients who can benefit from thrombolysis, the key is to have a short Emergency Room Door to CT scan time. Unfortunately, Door to CT scanner time is more than 30 minutes in 83% (95% CI being 80.5-85.4%). Moreover, 77% of the countries had shortage of the drug tPA. Overall, radiologists rated their knowledge as "average" in reading stroke imaging and 77% (95% CI being 74.5-79%) believed that further training would be helpful. Minority had access to Neurointerventionalist (33%) and Telestroke services (27%). When questioned about the three most powerful ways to improvise stroke imaging in their respective countries, the highest rated choices were: training prrograms on stroke imaging to improvise knowledge among radiologists, campaigns to increase awareness in the community and improvising access to CT.

This survey helps radiologists around the world communicate the imaging needs in stroke in their respective countries and how can they be met. This can help radiologists who want to reach out in their humanitarian efforts to improve imaging around the world.

Global outreach programs can use this survey to determine more effective ways of improving stroke imaging and care in developing countries.

Rehani, B, How Can We Make Stroke Imaging Better around the World? :Global Survey of Radiologists in 18 Countries.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018504.html