Hiroyuki Takao, Presenter: Research grant, FUJIFILM Holdings Corporation

Yuichi Murayama, Abstract Co-Author: Research grant, FUJIFILM Holdings Corporation

Norio Nakata MD, Abstract Co-Author: Nothing to Disclose

Kostadin Karagiozov, Abstract Co-Author: Nothing to Disclose

Issei Kan, Abstract Co-Author: Nothing to Disclose

Toshiaki Abe, Abstract Co-Author: Nothing to Disclose

We conclude that i-Stroke is very helpful for emergent management of AIS and shows the effective integration between diagnostic imaging and decision making of t-PA therapy.

Early diagnosis and treatment of acute ischemic stroke (AIS) are essential for patient recovery. In Japan, however, delays tend to occur in locating an available emergency facility for their treatment, sometimes leading to initial misdiagnosis and less than optimal initial therapy. A 1995 study by NINDS showed that intravenous administration of Tissue Plasminogen Activator(t-PA) within 3 hours of onset is efficacious for victims of AIS. Early diagnosis and treatment are essential for proper response. Not all hospitals can have　radiologists and neurosurgeons with high-level diagnostic and therapeutic skills for this purpose available 24h a day. Therefore better interaction in time and space is needed without increasing the need of medical staff. To solve this problem with huge social and healthcare impact we introduced a new approach to diagnosis, decision-making and treatment using the latest communication innovations.

We have developed an iPhone application (the i-Stroke) for immediate, real-time delivery of patient information, whether in or out of the hospital. With it, patient status reports can be updated in real time via a handheld terminal. The system incorporates: 1. A call-up function for the acquisition/transfer of relevant images.2.Quick, simple access and user-friendly review of images(CT, MR, DSA, and 3D angiography) as an emergency from a PACS server on a “touch” operated screen, easy handling of multiple(and 3D)images, inclusive rotation.3.Diffusion and Perfusion weighted images processed by fusion, determining the “mismatch”. 4.Review of patient data, decision-making, tracking and recording in real time of the whole process. 5. t-PA dosage calculation.

The “time window” in AIS management by rt-PA creates healthcare system demands that can be resolved by proper technological solutions. Team interaction, as in the hospital environment was created, providing additional cost-effectiveness of AIS treatment

Takao, H, Murayama, Y, Nakata, N, Karagiozov, K, Kan, I, Abe, T, Emergency Interactive Viewer System Using Smartphone (iPhone) Specialized in the Diagnosis and Therapy Support of Acute Cerebral Stroke.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013575.html