1st VWI Study Group Meeting - ASNR San Diego 2013
Overview of Meeting
The first meeting of the study group was attended by 23 participants including 16 neuroradiologists, 2 MRI physicists, 1 neurosurgeon, 1 neurologist, co-chairs David Mikulis and Bruce Wasserman, and Max Wintermark, representative from the ASNR executive committee. There was a very animated discussion that ensued concerning translation of nascent wall imaging capabilities into standardized cross-vendor protocols for clinical and research applications.
Study Group Objectives
We created the following objectives for the group:
- develop uniform protocols for clinical implementation and reimbursement,
- stimulate research in the field, including multicenter investigations of the pathophysiology and risk factors of neurovascular disease,
- attract people with similar interests in wall imaging from around the world,
- promote education and teaching mechanisms in the field (i.e., webinar), and
- present a unified voice for achieving vendor support for protocol development.
Challenges to Achieving Objectives
Numerous limiting issues were identified including:
Committees Designed to Address these Challenges
Potential solutions to these problems were discussed. Several volunteers offered to serve on committees to identify potential solutions. Not everyone has emailed us confirming their interest in being involved in specific committees, so please inform us if you have been inadvertently omitted. These committees include:
Summary of 2nd VWI Study Group Meeting - ASNR Montreal 2014
Approximately 50 attendees were present for the session. After group introductions, the session was kicked off by showing cases that included:
- moyamoya showing focal wall enhancement of the MCA associated with ipsilateral acute infarction,
- bilateral distal internal carotid stenosis,
- VWI-guidance for biopsy of an inflamed vessel with histologic confirmation of vasculitis,
- VWI for monitoring response to medical treatment in a basilar plaque, and
- symptomatic, low-grade cervical carotid plaque with intra-plaque hemorrhage and large lipid core treated by endarterectomy.
Lively discussion ensued over pathophysiology, imaging protocols, image interpretation, and future needs. Specific attention was made to appropriate resolution constraints for intracranial wall imaging and to pitfalls in image interpretation. Dissemination of standard imaging protocols was high on the list of needs.
The Protocol Committee (David Saloner - Chair) has succeeded in garnering the interest of Siemens (Gerhard Laub) and GE (Ajit Shankaranarayanan) who are working on protocol development. Both vendors are close to providing these to users. Philips (Liesbeth.Geerts@philips.com) is behind in this regard despite attempts by to engage the vendor’s attention to this issue.
The Education and Networking Committee (Michelle Johnson and Charles Matouk, co-chairs) is working to establish a web presence via a link to the ASNR website in order to coordinate teaching, research, protocols, and webinar case materials. A literature database on vessel wall imaging is being compiled and submissions to Neurographics and ASNR electronic exhibits will be coordinated.
The Research Committee (Bruce Wasserman and David Mikulis, co-chairs) are vetting drafts on wall imaging of intra-cranial arteries (Danny Mandell, Toronto) and extra-cranial carotid arteries (Luca Saba, University of Cagliari, Italy). Tom Hatsukami and Chun Yuan, international leaders in cervical carotid wall imaging, have joined the group and have agreed to help direct the carotid arm of the committee. Since carotid wall imaging is further advanced than intracranial wall imaging, the research focus would be somewhat different. Imaging protocols are relatively well-established and analysis of plaque components is mature. Research questions will therefore focus on randomized controlled trials to assess the roll of wall imaging metrics and decision-making in managing patients with this disease. Developing collaborative multi-institutional projects was discussed. The intent is to first identify research questions for investigation with PIs assigned to begin collecting cases submitted by institutional collaborators.
The Program Committee (Bruce Wasserman and David Mikulis co-chairs) discussed the overall plan to work with the ASNR to develop program activities, but also to work with other societies (ISC, ICAS, ISMRM) to secure time on their meeting agendas. A session on Vessel Wall Imaging sponsored by the group was been proposed for presentation at next year’s International Stroke Conference. The Committee will continue to work during the upcoming year on establishing its presence in these other societies.