ICPME - Stroke - Imaging the Ischemic Penumbra

Stroke - Imaging the Ischemic Penumbra

A lecture for radiologists, neuroradiologists, neurologists, radiologic technologists, and other healthcare providers involved in stroke imaging, diagnosis, and treatment.

This activity is available on CD and ONLINE.

This activity is discontinued
Tests accepted until
8/31/2010

Overview

Strokes cause death every 3.3 minutes in the United States and are a leading cause of disability.¹ The number of potential patients who are actually treated for acute ischemic stroke is disappointingly low, and effective treatments are making a minor impact on this major public health problem. Imaging is not regularly used to identify the ischemic penumbra, a key concept in stroke physiology, though it is capable of doing so in a clinically relevant manner. Evidence is accumulating that identification of the ischemic penumbra and making treatment decisions on the basis of its presence provide substantial benefits to patient outcomes.²

This lecture will discuss the physiology of stroke, the concept of imaging the ischemic penumbra, and describe current stroke treatment options.

¹ Lutsep HL. Current status of hemorrhagic stroke and acute nonthrombolytic ischemic stroke treatment. Stroke. 2004;35[suppl I]:2746-2747.
² Gonzalez RG. Imaging-guided acute ischemic stroke therapy: From "time is brain" to "physiology is brain". Am J Neuroradiol. 2006 Apr;27(4):728-735.

Educational Objectives

In an acute stroke patient:

Assess the relationship between imaging the ischemic penumbra and therapy for maximum clinical impact.
Determine the area of ischemic penumbra using MRI diffusion/perfusion mismatch.
Correlate current imaging and therapeutic practice to patient outcome data.
Evaluate ongoing research and the future role of acute image-guided stroke therapy.

Accreditation and Credit

Physicians
International Center for Postgraduate Medical Education (ICPME) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

ICPME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Radiologic Technologists
This program has been approved by the the American Society of Radiologic Technologists (ASRT) for 0.50 hour of ARRT Category A continuing education credit.

How to Participate in this Activity

Online Instructions

Click on the "ENROLL NOW" and follow the instructions to enroll in this course online.
The course will be accessible from your "MY ACCOUNT" page.

CD Instructions
The interactive CD ROM contains extended features designed for viewing on a computer. Participants can access chapters at their own pace.

Click on "ORDER NOW" and follow the instruction to order the CD. Shipping charges apply.
The CD will lauch when inserted into a computer. Instructions for navigating can be found in The Lesson Book.

To Apply for Credit

There are no fees to apply for credit. Estimated time to complete this activity is 30 minutes.
To receive credit, view the entire program and submit a completed program EVALUATION form. To submit your EVALUATION form for credit:

Online

Log-in to your account at www.icpme.us to complete the online EVALUATION. The EVALUATION can be accessed through the course link in your account.
Instructions to print a credit certificate will be generated upon completion of the online EVALUATION.

Mail or Fax

Print and complete the EVALUATION form found on the CD.
Please be sure to sign the attestation statement on the form. Credit will not be granted without your completed EVALUATION form and signature.
Mail or fax your completed form to the ICPME address indicated.
A certificate will be mailed to you within 30 days

Faculty Biography

Dr. Gonzalez is Chief of Neuroradiology at the Massachusetts General Hospital and Professor of Radiology at Harvard Medical School. He received his MD from Harvard and a PhD in chemistry from the University of California at Santa Cruz. He did post doctoral work in Molecular Biophysics at MIT, internship and residency at the Brigham and Women's Hospital and a neuroradiology fellowship at MGH. His primary research interests involve the development and application of advanced neuroimaging methods including MR spectroscopy and functional MRI and CT. Areas of active investigation include acute stroke diagnosis and its treatment, and the pathogenesis of neuroAIDS. He has published over 125 peer-reviewed manuscripts, over 75 chapters and reviews, and 2 books. He is the recipient of several NIH and DOD grants in the areas of neuroAIDS, Alzheimers Disease, brain tumors, and stroke.

Conflicts of Interest Disclosure

In accordance with the ICPME Policy on Resolution of Conflicts of Interest, faculty, advisors, planners, and managers who are in a position to control the content of CME activities are asked to disclose any relationships with companies whose products or services may relate to the content of this presentation. Faculty, advisors, planners, and managers have reported the following relationships with commercial interests related to the content of this CME activity:

Faculty:
R. Gilberto Gonzalez, MD, PhD. No relevant conflicts of interest reported.

Advisors, planners, and managers:
Wayner M. Clark, MD. No relevant conflicts of interest reported.
Katie D. Vo, MD. No relevant conflicts of interest reported.
Cassandra Nunez. No relevant conflicts of interest reported.
Victoria Phoenix. No relevant conflicts of interest reported.
Lisa H. Schleelein, MEd. No relevant conflicts of interest reported.

There will be a brief discussion of CTA, which requires off-label use of iodinated contrast. There will also be a brief discussion of the following off-label treatments for stroke:
–    IA tPA or Urokinase (Pro-ACT)
–    IV tPA after 3 hours
–    IV-IA tPA sequential strategies
–    IA clot angioplasty
–    Hypertensive therapy