Olea Imagein: Could you please introduce yourself to our readers?
Tae-Hee Cho: I have been working as a neurologist at the University Hospital of Lyon for the last 15 years, in the vascular neurology department of Prof. Norbert Nighoghossian team. Our department is specialized in the management of acute stroke, where my daily activity is above all that of a caregiver. Our service, where the care management starts in parallel with the radiology department, is composed of 35 beds dedicated to stroke patients. I am also a teacher and a researcher affiliated to the CREATIS laboratory in Lyon. My research focuses on cerebral imaging as a prognostic tool and assistance to treatment for stroke patients. In this context, our team got involved in the MARVELOUS project.
O.I: Could you please describe the MARVELOUS project?
T.H.C: The MARVELOUS project is conducted as part of the “investments for the future”, whose funding is granted by a RHU (University Hospital Research) program. The project involves clinical departments – the neurovascular and cardiovascular departments, the latter directed by Prof. Michel Ovize – as well as several academic research teams and private partners, including Olea Medical®.
MARVELOUS aims at improving the way we analyze and apply magnetic resonance imaging in the care of the two diseases that are responsible for the bulk of global disability and mortality: cerebral and myocardial infarction.
The MARVELOUS project started from a simple observation: the same patients often suffer from both pathologies, either successively or concomitantly. These patients often share the same risk factors, and will subsequently benefit from similar prevention programs.
Although the organs are different, their acute pathophysiology share many similarities: a sudden interruption of blood flow leads to cellular damage, even faster at the cerebral than at the myocardial level. In both cases, the most efficient treatment to save brain and heart tissue is to reopen the occluded artery and restore blood flow at the microvascular level (i.e. reperfusion). The similarities do not stop here, since the techniques to restore blood supply as well as the means of prevention also show analogies. Therefore, one can find and foster a synergy in both fundamental and clinical research for stroke and myocardial infarction. The neurology and cardiology teams in our institution enjoyed a fruitful collaboration for many years, and the MARVELOUS project is the logical outcome of these exchanges.
The objectives of MARVELOUS are to improve the care given to the patients by exploring two distinct parts: experimental research conducted through animal and cell modeling, and a clinical part. As part of the neurological team, I will mainly talk about brain.
The aim of the clinical part is to develop an enhanced imaging tool for the diagnostic and prognostic assessment of patients. Imaging plays a different role in stroke and myocardial infarction management, since no treatment can be decided without prior imaging Olea Imagein I n n o v a t i o n f o r l i f e # 49 in stroke patients, whereas the cardiologists can more easily confirm their diagnosis. Indeed, when a patient presents stroke symptoms – hemiplegia, speech disorders – the clinician cannot assess without imaging if the patient suffers from a bleeding (cerebral hematoma), or from a more common cerebral infarction. Imaging is therefore essential. For both brain and heart, imaging will help us assess the prognosis and guide treatment – especially for stroke. Not all stroke patients can benefit from revascularization, because extensive brain damage may already have occurred by the time they reach the health care system. In other patients with less severe blood flow reductions, treatment may be of benefit even beyond 12 hours from symptoms onset. Imaging is crucial in selecting the patients who can still benefit from blood flow restoration.
In France – this is not true in other parts of the world – MRI is the most widely used imaging modality for stroke. The MARVELOUS project aims at providing a better and more quantitative analysis of the parameters derived from MRI, and help reach effective therapeutic decisions at the individual level.
O.I: Where did the idea of studying both ischemic brain and heart come from?
T.H.C: From the perspective of neurologists, we have a prominent and absolutely essential need for cerebral imaging. But, in order to know “why” stroke happened, we also need cardiac imaging. Indeed, a large part of the stroke patients...
Read to the full interview here
Issue Number 6
October 2018 - JFR/RSNA Edition
Recent clinical and scientific advances make us reconsider in a new way the care delivered to stroke patients. In this sixth issue of Olea Imagein magazine, multiple themes focusing on ischemic stroke will illustrate the medicine of tomorrow. How do we interpret cerebral perfusion, integrate teleradiology in the healthcare channels, measure the growing contribution of artificial intelligence? Several physicians and researchers, all committed in this race against the clock, shed light on these matters.