New scan developed to predict stroke risk

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Photo of nurse monitoring a patient entering an MRI scanner

The development of a new type of MRI scan to predict stroke risk has generated media interest.

The scan developed by researchers at the University of Oxford is designed to identify the cholesterol levels of plaques in the carotid arteries, which supply the brain with blood. Plaques high in cholesterol are more likely to cause a stroke.

The project was conducted by the researchers in collaboration with surgeons at the John Radcliffe Hospital in Oxford, and was supported by the Engineering and Physical Sciences Research Council (EPSRC), the Medical Research Council (MRC), the British Heart Foundation, National Institute for Health Research Oxford Biomedical Research Centre, Wellcome, Stroke Association and the Dunhill Medical Trust.

The findings, which have been described in a paper published in the journal Journal of the American College of Cardiology: Cardiovascular Imaging, have been covered by outlets such as The Guardian, Daily Mail and Daily Express.

Currently, the risk of stroke is identified by measuring the size of the plaque in the carotid artery, and those that are judged to be too large can be removed. However this method can miss fatty plaques that are smaller in size but still pose a high risk of rupturing.

The new, non-invasive technique developed by the researchers can differentiate between risky plaques containing large amounts of cholesterol, and more stable ones.

In the study, the researchers used the new MRI scan to measure the amount of cholesterol in the carotid plaques of 26 patients scheduled for surgery. After the plaques were surgically removed, the team looked at the actual cholesterol content in each plaque and found that the new technique was accurate and the more cholesterol they detected within the plaque, the greater the risk.

The team have confirmed and extended their findings in another study on 50 people published in PLOS ONE (1).

Dr Luca Biasiolli, from the University of Oxford, one of the authors of the paper, said: Stroke is a leading cause of disability and the third biggest killer in the UK.

When someone goes to hospital having suffered a minor stroke, it's vital that doctors know whether the patient might be at risk of a further stroke, which could be fatal.

Being able to quantify cholesterol in carotid plaques is a really exciting prospect, as this new MRI technique could help doctors to identify patients at higher risk of stroke and make more informed decisions on their treatments.

Professor Sir Nilesh Samani, Medical Director at the BHF, which part-funded the study, said: When someone suffers a mini-stroke, they often go on to suffer a more serious, or even deadly, stroke in the hours, days or weeks that follow. This exciting research opens up the possibility that in the future we may be able to more accurately identify people with carotid plaques that are likely to rupture and cause a stroke.

These patients can then be treated earlier, for example with surgery to remove the plaque, while others might be spared surgery altogether. More research is now necessary before this advance can come into routine clinical practice. However, if successful this technique has the promise to save lives.

Reference: PN 54-17