Research lead: Mark Parsons
Research team: Daniel Green, Melissa Leung, Dennis Cordato, Longting Lin, Chris Blair, Timmy Pham
Research area: Neurology and Stroke
Name of Project:
The clinical utility of cardiac CT performed during hyperacute stroke imaging
What was the health problem that led you to carry out your research?
Stroke is a disabling medical condition, most often caused by poor blood flow to the brain (ischaemic stroke). The global age-standardised incidence of ischaemic stroke is expected to increase into the future. Unfortunately, in approximately 25% of cases of ischaemic stroke, no clear cause is identified. Recognition of an underlying cause is critical to ensuring appropriate treatment to prevent a recurrent stroke.
Cardiac CT imaging undertaken at the time of emergency stroke assessment is an emerging tool that has recently been demonstrated to identify high risk sources of embolism (clotting) from the heart. This technique has become incorporated as part of the imaging protocol for select patients with acute stroke syndromes at Liverpool Hospital. The aim of our research was to further characterise the utility of this imaging modality and to assess clinical profiles of patients with high-risk sources of embolism found on cardiac CT imaging.
How was the work unique or pioneering?
This project has many “firsts”. Our research group is one of the first in the world to further analyse the benefits of cardiac CT imaging undertaken as protocol in acute stroke assessment. The protocol in use at Liverpool Hospital is the first in Australia to include synchronisation with an electrocardiogram (ECG- gating), which allows for optimisation of imaging quality. Analysis in conjunction with other advanced brain imaging modalities, such as CT perfusion, has allowed us to better understand the burden of stroke amongst patients with intra-cardiac clotting in the acute setting. It is hoped that our findings can help in pioneer a new era of acute cardiac assessment in people experiencing stroke.
We have been fortunate to have a strong collaboration with the Neurology, Cardiology, and Radiology departments at Liverpool Hospital. Prof Mark Parsons, Associate Prof Melissa Leung and Dr Chris Blair were also privileged to receive a grant by the Ingham Institute’s supporters through the Narellan Rotary Club for cardiac imaging in stroke in 2022.
What is the broader implication of the research?
This research contributes to growing evidence around the importance of cardiac assessment at the time of acute stroke imaging. With the availability of high- quality cardiac imaging undertaken at the time of acute stroke, there is now an unprecedented ability to understand potential cardiac causes of stroke. It is hoped, ultimately, that this may allow for optimised treatment strategies to help prevent stroke recurrence.
