TIME IS BRAIN – Accelerating Brain Bleed Treatment

By: Keren Nachmias, Senior Product Manager, Head CT products
Zebra Medical Vision

On May 14, 2015, Dr. Derek Shepherd (aka McDreamy), a brilliant neurosurgeon, died following a road traffic accident due to a missed brain bleed having not undergone a head CT scan, in one of the most memorable episodes of Gray’s Anatomy (forgive my guilty pleasure). Besides being heartbroken, I kept wondering if his life would have been saved if he underwent a CT scan? If you have a clinical background, or if like me you are a fan of theatrical medical dramas, you already understand that every minute counts and a head CT scan should have been performed urgently. However, Dr. Shepherd was rushed to a non trauma center, likely without expert radiology services available.

Removing the Hollywood bells and whistles, McDreamy’s scenario is a reality on a daily basis at hospitals across the world. Of course, in reality most centers will have rapid access to CT scanning, but the burden facing radiology departments from the increasing workload and imaging complexity means fast and accurate diagnosis of time-critical conditions such as intracranial hemorrhage (ICH) can suffer. In addition, centers without on-call radiology services will often rely overnight on a resident to report the scan, where the potential to miss a finding might be greater.

Intracranial hemorrhage (ICH) is the second most common subtype of stroke and a time-critical disease, often leading to significant morbidity and mortality. For these patients where every minute counts, the phrase “time is brain” is literal. We at Zebra Medical Vision echo the words of McDreamy that “every day is a beautiful day to save lives” and we are delighted that the FDA has cleared our HealthICH solution to automatically identify brain bleeds on head CTs, part of the first FDA approved multi-modality triage solution.

HealthICH automatically identifies and alerts the physician of suspected internal brain bleeds based on commonly acquired non-contrast head CTs. HealthICH can provide early indication of people at high risk of brain bleeding, allowing rapid review and clinical management by the team. The unique algorithm, based on deep learning models and trained on over 250,000 head CTs, is comprised of a unique tailor-made neural network architecture designed to identify intracranial hemorrhage while tackling several challenges such as relatively small bleed size and high variance within the brain.

McDreamy also would have benefited from Zebra’s revolutionary AI1 (All in one) solution, whereby HealthICH and all our current and future algorithms are available, fulfilling our vision of providing high quality, affordable and accessible care to the world’s population. For example, following McDreamy’s road traffic accident, our HealthPNX algorithm may have identified a pneumothorax on a chest X-ray, whilst the HealthICH algorithm would have picked up a bleed on a head CT. As we continue to develop our head CT package, we will identify more head CT findings augmenting our radiologists day-to-day practice and ensuring patients receive the best care, driven by Zebra’s AI1 solutions. Our AI1 solution also provides healthcare institutions with non-acute algorithms to risk stratify populations, for example identifying compression fractures on CT to assess for osteoporosis or scoring the level of coronary calcium, an indicator of cardiovascular risk.

I am incredibly proud to be part of the research, development, clinical and operational team that made it possible to achieve this FDA clearance and I look forward to sharing our next Zebra announcements very soon, perhaps though without my dear McDreamy!