Teleradiology-based stroke network in Western and Southern Transdanubia in Hungary

Osszefoglalo. Bevezetes: A stroke kezelesenek lehetősegei az utobbi evekben jelentősen megvaltoztak: a thrombolysis utan bevezetesre kerult a mechanikus thrombectomia, es a terapias időablak is jelentősen kitagult az utobbi evek nagy multicentrikus tanulmanyai alapjan. Ezek a lehetősegek uj igenyeket fogalmaztak meg a kepalkoto diagnosztikaval szemben: az ischaemia okozta morfologiai elvaltozasok mellett az arterias es a kollateralis rendszer allapotat, valamint bizonyos esetekben az agy szoveti perfuziojat is szukseges meghatarozni. Ezeket a komplex kiertekelesi feladatokat ma mar mestersegesintelligencia-algoritmusok tamogathatjak, melyek a kiertekelest par perc alatt elvegezve segitenek a terapias dontes kialakitasaban. Celkitűzes: A Del- es a Nyugat-dunantuli regioban hat intezmeny reszvetelevel egy dedikalt stroke teleradiologiai halozat kialakitasa. Modszer: A stroke-CT-kiertekelő szoftver es a kepkommunikacio integracioja, a vizsgalati protokollok technikai parametereinek egysegesitese, a kiertekelesi eredmenyek teleradiologiai megjelenitese valosult meg a halozat kialakitasa soran. Eredmenyek: A halozat egysegesitette nemcsak a stroke-CT-protokollok beallitasait, de beutalasi es ertekelesi szempontjait is. A stroke-CT-kiertekelesek es a mechanikus thrombectomiak szama is emelkedett az elmult egy evben. Kovetkeztetes: A dedikalt teleradiologiai stroke-halozat segitsegevel optimalizalni kivanjuk a regio stroke-ellatasat: egyreszt lehetőleg ne maradjanak ellatatlanul a thrombectomiabol valoszinűleg profitalo betegek, masreszt ne terheljuk az ellatorendszert olyan esetekkel, melyekről a teljes dokumentacio ismereteben derul ki, hogy nem javasolt a beavatkozas. Orv Hetil. 2021; 162(17): 668-675. SUMMARY INTRODUCTION The possibilities of cerebral stroke management have changed substantially during the last few years. Following a few multicentric studies, mechanical thrombectomy became an established method besides thrombolysis. In addition, the therapeutic window for both methods is much wider now than before. These changes described above demanded more information of CT morphological changes due to ischemia, but the condition and functionality of the arterial and collateral system, and occasionally tissue perfusion performance should also be characterized. Recently, evaluation of different computer tomographic (CT) measurements can be done using artificial intelligence based methods, which perform data analysis in a few minutes. OBJECTIVE To establish a dedicated stroke teleradiology network with artificial intelligence based image analysis in Western and Southern Transdanubia in Hungary that involves six partner institutes. METHOD Integration of automated image analysis with teleradiology software was established, and the technical parameters of examination protocols were unified. Results of stroke CT image analysis became accessible through the teleradiology network. RESULTS The daily use of integrated central image analysis and image communication had a positive impact on referrals and therapeutic evaluation of stroke cases. The number of image processing and mechanical thrombectomy increased during the last year. CONCLUSION With the help of the dedicated teleradiology stroke network, we want to optimize the stroke care in the region: on the one hand, patients who are likely to benefit from thrombectomy should not be left unattended, on the other, the health care system should not be burdened with cases, when intervention is not recommended having the complete clinical data accessed. Orv Hetil. 2021; 162(17): 668-675.