SWITCH2017: Stroke Workshop on Imaging and Treatment CHallenges

Overview

SWITCH is a half-day workshop focused on imaging related to stroke diagnosis and treatment. The main goals of the workshop are 1) to introduce the clinical background of challenges/opportunities related to imaging for stroke that are relevant for researchers working in the MICCAI field, and 2) to stimulate discussion and ideas exchange. To this end, there will be keynotes by clinical experts in stroke imaging and treatment, as well as presentations by researchers of on-going work. The tutorial character of the keynotes makes this workshop a perfect introduction for the ISLES workshop in the afternoon.

Call for papers

SWITCH is soliciting manuscripts that contribute to the workshop, addressing among others one of the following subjects:

• Novel image processing approaches for lesion detection and quantification
• Imaging based approaches to treatment decision making
• Image guidance during interventions
• Imaging based quantification of treatment

We encourage work involving, among others, the following imaging modalities:

• CT-variants (CT, CTA, CTP, multi-phase CTA)
• MR (DWI)
• X-ray

Submissions should follow the LNCS guidelines for formatting, and consists of full papers of at most 8 pages.

All submitted manuscripts will be reviewed by the organizing committee on applicability to the workshop topic, scientific quality and clinical relevance. Note that we value novel methodology as well as thorough evaluation. Accepted manuscripts will get an oral presentation during the workshop at MICCAI. The SWITCH half-day workshop will join the MICCAI initiative for bundled joint Sep 2017: LNCS Proceedings of the satellite events.

Related Workshops

• Switch is held jointly with the Ischemic Stroke Lesion Segmentation (ISLES) 2017!
• The WMH Segmentation Challenge is one of the Grand Challenge at MICCAI 2017!

Tentative Program

• 08:00 - 08:10 Introduction
• 08:10 - 09:00 Keynote: Roland Wiest, Support Center of Advanced Neuroimaging, Inselspital Bern
  Neuroimaging of stroke: A role of MRI · abstract

  MRI ressources are frequently limited, even in larger stroke centers and require a thoroughly organized emergency setting to offer the technology to patients who are eligible for mechanical thrombectomy or wake up stroke. Multimodal MRI can be performed within a time frame of 10-15 minutes and confirm accurate diagnosis of stroke, potential risk stratification for treatment related hemorrhage and eligibility for thrombolysis. Diffusion weighted imaging and perfusion MRI enable prognostic information based on „mismatch“-profiles in anterior circulation stroke, and more recently about prediction of outcomes. Outcome depends on a variety of parameters, encompassing collateral flow and site of occlusion, with the clot appearance on SWI being of potential value for recanalization success after IVT. Accurate knowledge about collateral circulation is paramount to predict infarct growth, final infarct volume, and response to endovascular therapy. Most recent developments in image postprocessing make use of multimodal MR techniques, aiming towards a paradigm shift from cohort-wise and time-based to individual and tissue-based decison making. After acute stroke treatment, structural and functional MRI techniques are important techniques that uncover principles of functional reorganization that enable cohort-based and individual recovery potential and investigations oft he adequate rehabilitation. This talk will provide an overview about most recent MR techniques and their relevance for candidate selection during the acute and early chronic stage after an insult.

• 09:00 - 09:50 Keynote: Kambiz Nael, Mount Sinai Hospital, New York
  CT imaging in care of acute stroke patients · abstract

  In this presentation the role of CT imaging in care of patients with acute ischemic stroke will be reviewed. Different components of comprehensive CT Stroke protocol including non-contrast CT (NCCT), CT angiography and CT perfusion will be reviewed. We will discuss how early ischemic changes are evaluated with ASPECT score and CT perfusion and review the advantages and shortcomings of each method. We specifically discuss the current challenges facing CT perfusion computation and postprocessing. We will discuss potential research that is needed to improve accuracy of CT perfusion in estimation of infarction in order to close the gap with MRI.

• 10:00 - 10:30 Refreshments
• 10:30 - 11:20 Keynote: Vitor Mendes Pereira, University of Toronto
  Mechanical thrombectomy and periprocedural imaging techniques · abstract · bio

  Mechanical Thrombectomy (MT) became recently first line for acute ischémie stroke since seven randomized controlled trials demonstrated overwhelming benefit of the treatment when compared to standard of care of intravenous tAP therapy. Different study designs and approaches were evaluated and, basically, summarizing them all: strokes presenting up to 12h with confirmed proximal occlusion and acceptable baseline parenchymal imaging should be treated with MT as soon as possible. There was a change on paradigm also regarding the devices employed in these studies and on the workflow of the treatment for these patients from imaging to revascularization. This lecture will demonstrate the evolution of the endovascular treatment of acute stroke and evidence created so far as well as main used techniques. It will also demonstrate imaging techniques using during the procedure and after to evaluate issues related to treatment.

  Dr. Vitor Mendes Pereira is an interventional neuroradiologist specialized in minimally invasive procedures of the intracranial and spinal circulation. He studied in Sao Paulo, Brazil and Paris, France. Dr. Pereira has worked as the Head of Interventional Neuroradiology division and Privat-Docent at the University Hospital of Geneva, Switzerland from 2008 to 2014. Currently, He is an Associate Professor of Radiology and Surgery at the University of Toronto and Staff Physician at the Toronto Western Hospital and Hospital for the Sick Children. He is particularly interested in the treatment of complex neurovascular diseases including large and giant aneurysms, curative treatment of arteriovenous malformations, dural malformations, and spinal vascular disorders and pediatric vascular malformations. He is leading clinical research on stroke as global co-PI for the STAR trial, European interventional PI for the SWIFT-PRIME study and International PI for the SWIFT DIRECT trial. He is also a member of multiple scientific committees and part of the leadership of other clinical studies like DAWN trial, PROMISE study, and PREMIER trial. On the basic sciences research, he is interested in the natural history of brain aneurysms and arteriovenous malformations. He and his group are studying the use of Computational Fluid Dynamics (CFD) for aneurysm rupture risk assessment, intracranial stenting evaluation, and therapeutic planning. He also works with the development of new dynamic imaging modalities to assess cerebral flow. He is a pioneer in the use of optical flow imaging in digital subtracted angiography. He is an active member of several medical societies and he has also contributed over 170 publications to his field on various aspects of neuroendovascular therapy.

• 11:20 - 12:00 Presentations by authors of accepted papers

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