Nationwide questionnaire survey on neuroimaging strategy for acute ischemic stroke in Japan

Abstract

Background and Purpose: Acute ischemic stroke is treatable with acute reperfusion therapy. Imaging evaluation by CT or MRI is essential for the diagnosis of acute ischemic stroke. Recently, the effectiveness of imaging-based se- lection for reperfusion therapy has been proved in various clinical trials. To clarify the current status of neuroimaging strategy for acute ischemic stroke in Japan, we conducted a nationwide survey. Methods: A web questionnaire on neu- roimaging strategy from January to December 2017 was mailed to neurosurgeons and neurologists in 2112 institutes in August 2018. Results: Of 2112 institutes, 556 sites (26%) were responded. Within 556 respondents, 507 (91%) sites were performing medical treatment for acute stroke. Of the 507 respondents, 311 (61%) performed diagnostic imaging of acute stroke with both CT and MRI, and door to imaging time was within 20 minutes in 312 respondents (61%). Three hundred and twenty-two (322) sites were performing endovascular treatment (EVT) for acute ischemic stroke and of these 263 respondents were performing EVT to late presenting cases. Within 263 respondents, only 30 (12%) used perfusion imaging to determine the indication of EVT in late presenting cases. Conclusions: In Japan, di- agnosis of acute ischemic stroke using both CT and MRI was mostly common, and perfusion imaging for patient se- lection was rarely used.