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Cana'microwavehelmet'reallydetectstrokes?HealthNewsNHSChoices

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Cana'microwavehelmet'reallydetectstrokes?
BehindtheHeadlines
TuesdayJune172014

Strokesrequirethecorrecttreatmentassoonaspossible
Microwavehelmetcanspotastroke,reportsBBCNews.
Therearetwotypesofstroke.Themajorityofstrokesarecausedbyaclotstoppingbloodflowtoanareaofthebrain.Thistypeofstrokecanbetreated
withanticlottingmedicationstobreakupordissolvebloodclots.However,thistypeoftreatmentisdisastrousifthestoketurnsouttohavebeencaused
bybleedingintothebrain.
Currentlytheonlywaytotellthedifferenceisforapatienttohaveascaninhospital.Goingtohospitalandwaitingforascancandelaytreatment,and
thesoonertreatmentisgiven,thelessdamagethestrokeislikelytodo.
TheheadlineontheBBCwaspromptedbyaproofofconceptstudythathasshownthatamicrowavescatteringtechniquecandistinguishbetween
thetwotypesofstrokes.Thehelmetdeviceusedbyresearchersisportableandcouldthereforebeusedbyparamedicsandotherhealthprofessionals
beforeapatientgetstohospital.Thiscouldallowtreatmenttostartvitalminutesearlier.
Inthestudies,whenthecutoffwassettoidentifyallhaemorrhagicstrokes,somepeoplewithischaemicstrokesweremisclassified.Buttheresearchers
hopethatinformationfromalargerdatasetfromanongoingclinicalstudywillallowthemtobetterdifferentiatebetweenthetwo.
Thisearlystageresearchisencouraging,butfurtherworkisrequiredbeforeNHSambulancesareequippedwithmicrowavehelmetsforpeoplewho
mayhavehadstrokes.

Wheredidthestorycomefrom?
ThestudywascarriedoutbyresearchersfromChalmersUniversityofTechnology,UniversityofGothenburg,SahlgrenskaUniversityHospitaland
MedTechWest,allinGothenburg,Sweden.
ItwasfundedbyVINNOVA(SwedishGovernmentAgencyofInnovationSystems)withintheVINNExcellenceCentreChase,bySSF(Swedish
FoundationforStrategicResearch)withintheStrategicResearchCentreCharmant,andbytheSwedishResearchCouncil.Itwaspublishedinthepeer
reviewedjournalIEEETransactionsonBiomedicalEngineering.
TheresearchwaswellreportedbytheBBC.

Whatkindofresearchwasthis?
Thisstudywasadescriptionofthebackground,designandsignalanalysisoftwomicrowavebasedstrokedetectionsystems,andaproofofconcept
clinicalstudyonpeoplewhodhadastrokeandhealthypeople.
Theresearcherswantedtodevelopanewwayofdiagnosingstrokethatwascapableofdifferentiatingbetweenischaemicstroke(causedbyclots
stoppingbloodgettingtothebrain)andhaemorrhagicstroke(causedbybleedingintothebrain).TheywantedittobeusedwhenpatientsarriveatA&E
orbyparamedicstoenableappropriateanticlottingmedicationtobestartedassoonaspossibleinpeoplewhohaveastrokecausedbyabloodclot
(ischaemicstroke).Theneedtodistinguishbetweenthetwotypesofstrokeisvital,asgivinganticlottingtreatmenttosomeonewithahaemorrhagic
strokecouldbedisastrous.
Theresearcherswereinterestedinapplyingmicrowavescatteringtothisproblem.Theydevelopedtwoprototypehelmetswith10or12microwave
patchantennas.Oneatatime,eachantennaisusedasatransmitter,withtheremainingantennasinreceivingmode.
Microwavescatteringcandetectstrokesbecausethescatteringpropertiesofwhiteandgreymatteraredifferenttothoseofblood.Thepoweroutputof
theimagingsystemswereabout1mW,about100timeslowerthanthe125mWtransmittedbymobilephones.

Whatdidtheresearchinvolve?
Inthefirstclinicalstudy,20patientsdiagnosedwithacutestrokewerestudiedinaspecialisthospitalclinicbetweensevenand132hoursafterstroke
onset.Ofthe20patients,ninehadahaemorrhagicstrokeand11hadanischaemicstroke.Inthisstudythefirstprototypewasused,whichwasbased
onabicyclehelmetandhad10patchantennas.
Inthesecondclinicalstudy,25patientswithstrokewerestudiedonahospitalward,betweenfourand27hoursafterstrokeonset.Ofthe25patients,10
hadahaemorrhagicstrokeand15hadanischaemicstroke.Inaddition,65healthypeoplewereimaged.Inthisstudythesecondprototypewasused,
whichwasacustombuilthelmetwith12patchantennas.
http://www.nhs.uk/news/2014/06June/Pages/canamicrowavehelmetreallydetectstrokes.aspx

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Cana'microwavehelmet'reallydetectstrokes?HealthNewsNHSChoices

Thesignalsobtainedwereanalysedbyacomputeralgorithm.

Whatwerethebasicresults?
Inthefirstclinicalstudy,ifthecutoffwassettoidentifyallpatientswithhaemorrhagicstroke,fourofthe11patientswithischaemicstrokewere
misclassifiedwithhaemorrhagicstroke.
Inthesecondclinicalstudy,whenthecutoffwassettoidentifyallpatientswithhaemorrhagicstroke,oneofthe15patientswithischaemicstrokewas
misclassifiedwithhaemorrhagicstroke.
Thetechniquewasevenbetteratdistinguishingbetweenpatientswithhaemorrhagicstrokeandhealthypeople.

Howdidtheresearchersinterprettheresults?
Theresearchersconcludethat:TherelativesimplicityandsizeofmicrowavebasedsystemscomparedtoCT[computedtomography]orMRI[magnetic
resonanceimaging]scannersmakethemeasilyapplicableinaprehospitalsetting.Wesuggestthatmicrowavetechnologycouldresultinasubstantial
increaseofpatientsreachingastrokediagnosisintimeforintroductionofthrombolytic[anticlotting]treatment.
Thesocioeconomicramificationsofsuchadevelopmentareobviousnotonlyintheindustrialworldbutalso,andperhapsevenmoreso,inthe
developingworld,theysaid.

Conclusion
Thisstudyhasshownthathaemorrhagicstrokescouldpotentiallybedistinguishedfromischaemicstrokesbyanalysingmicrowavescattering
measurements.
WhilethetwotypesofstrokecanalreadybeaccuratelydiagnosedbyCTorMRIscansinhospital,themicrowavehelmetdevelopmentisimportant
becauseitcouldpotentiallybeusedbeforesomeonearrivesinhospital.Thiswouldavoidanytimedelayandallowpeoplewithischaemicstroketo
receivetheanticlottingmedicationthattheyneedassoonaspossible,potentiallyreducingtheextentofdamagethestrokecauses.
Thetechniqueisntperfectyet,buttheresearchersarehopefulthatinformationfromalargerdatasetfromanongoingclinicalstudywillimprovethe
predictivepowerofthealgorithms.
Theyalsosaythatintroductionofprehospitalthrombolytic[anticlotting]treatmentbasedonamicrowavescandiagnosiswillhavetoawaitstudiesof
largerclinicalcohorts.
Sowhilethisearlystageresearchisencouraging,furtherworkisrequiredbeforemicrowavehelmetsareusedtodistinguishbetweenischaemicand
haemorrhagicstrokes.Moreworkisalsoneededtoprovewhethertheycouldimprovethecareandtreatmentofpeoplewhovehadastroke.
AnalysisbyBazian.EditedbyNHSChoices.FollowBehindtheHeadlinesonTwitter.JointheHealthyEvidenceforum.
Analysisby
EditedbyNHSChoices

Linkstotheheadlines
Microwavehelmet'canspotastroke'.BBCNews,June172014

Linkstothescience
PerssonM,etal.Microwavebasedstrokediagnosismakingglobalprehospitalthrombolytictreatmentpossible.TransactionsonBiomedical
Engineering.PublishedonlineJune162014
HealthyEvidenceforum

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wouldtherebeanyrecentresearchonartificialsweetenersandhealtheffects,
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HiEveryonejustjoinedthisinterestingforumandwantedtosayhello...from
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Weakresearch
Underwhelmedbythesmallnumberofstudieslookedatforthearticleabout
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