Case Report: Preliminary Images From an Electromagnetic Portable Brain Scanner for Diagnosis and Monitoring of Acute Stroke

Stroke Classification With Microwave Signals Using Explainable Wavelet Convolutional Neural Network

Stroke is one of the leading causes of death and disability. To address this challenge, microwave imaging has been proposed as a portable medical imaging modality. However, accurate stroke classification using microwave signals is still an open challenge. In addition, identified features of microwave signals used for stroke classification need to be linked back to the original data. This work attempts to address these issues by proposing a wavelet convolutional neural network (CNN), which combines multiresolution analysis and CNN to learn distinctive patterns in the scalogram for accurate classification. A game theoretic approach is used to explain the model and indicate distinctive features for discriminating stroke types. The proposed algorithm is tested in simulation and experiments. Different types of noise and manufacturing tolerances are modeled using data collected from healthy human trials and added to the simulation data to bridge the gap between the simulation and real-life data. The achieved classification accuracy using the proposed method ranges from 81.7% for 3D simulations to 95.7% for lab experiments using simple head phantoms. Obtained explanations using the method indicate the relevance of wavelet coefficients on frequencies 0.95-1.45 GHz and the time slot of 1.3 to 1.7 ns for distinguishing ischemic from hemorrhagic strokes.

Neurophysiology tools to lower the stroke onset to treatment time during the golden hour: microwaves, bioelectrical impedance and near infrared spectroscopy

Reperfusion therapy administration timing in acute ischaemic stroke is the main determinant of patients' mortality and long-term disability. Indeed, the first hour from the stroke onset is defined the "golden hour", in which the treatment has the highest efficacy and lowest side effects. Delayed ambulance transport, inappropriate triage and difficulty in accessing CT scans lead to delayed onset to treatment time (OTT) in clinical practice. To date brain CT scan is needed to rule out intracranial haemorrhage, which is a major contraindication to thrombolytic therapy. The availability, dimension and portability make CT suitable mainly for intrahospital use, determining further delays in the therapies administration. This review aims at evaluating portable neurophysiology technologies developed with the scope of speeding up the diagnostic phase of acute stroke and, therefore, the initiation of intravenous thrombolysis. Medline databases were explored for studies concerning near infrared spectroscopy (NIRS), bioelectrical impedance spectroscopy (BIS) and Microwave imaging (MWI) as methods for stroke diagnosis. A total of 1368 articles were found, and 12 of these fit with our criteria and were included in the review. For each technology, the following parameters were evaluated: diagnostic accuracy, ability to differentiate ischaemic and haemorrhagic stroke, diagnosis time from stroke onset, portability and technology readiness level (TRL). All the described methods seem to be able to identify acute stroke even though the number of studies is very limited. Low cost and portability make them potentially usable during ambulance transport, possibly leading to a reduction of stroke OTT along with the related huge benefits in terms of patients outcome and health care costs. In addition, unlike standard imaging techniques, neurophysiological techniques could allow continuous monitoring of patients for timely intrahospital stroke diagnosis.KEY MESSAGESFirst hour from the stroke onset is defined the "golden hour", in which the treatment has the highest efficacy and lowest side effects.The delay for stroke onset to brain imaging time is one of the major reasons why only a minority of patients with acute ischaemic stroke are eligible to reperfusion therapies.Neurophysiology techniques (NIRS, BIS and MWI) could have a potential high impact in reducing the time to treatment in stroke patients.

Adaptive Clustering Distorted Born Iterative Method for Microwave Brain Tomography with Stroke Detection and Classification

A modified distorted Born iterative method (DBIM), which includes clustering of reconstructed electrical properties (EPs) after certain iterations, is presented for brain imaging aiming at stroke detection and classification. For this approach to work, a rough estimation of number of different materials (or bio-tissues) in the imaged domain and their corresponding rough dielectric properties (permittivity and conductivity) are needed as a prior information. The proposed adaptive clustering DBIM (AC-DBIM) is compared with three conventional methods (DBIM, multiplicative regularized contrast source inversion (MR-CSI), and CSI for shape and location reconstruction (SL-CSI)) in two-dimensional scenario on a head phantom and numerical head model with different strokes. Three-dimensional simulations are also conducted to indicate the suitability of AC-DBIM in real-life brain imaging. Lastly, the proposed algorithm is assessed using a clinical electromagnetic head scanner developed on phantoms. The simulation and experimental results show superiority of AC-DBIM compared to conventional methods. AC-DBIM achieves significant improvement in the size and shape reconstruction and reduction in errors and standard deviation of the reconstructed _r and at clinical scenarios compared with conventional DBIM.