Acute ischemic stroke represents the vast majority of strokes. The priority in mitigating the impact is getting to hospital quickly. Once at the hospital we use medical imaging to determine the type of stroke and type of treatment. Medical imaging provides many measurements of brain tissue for the assessment of stroke. These measurements provide insight about tissue that we can save with treatment. As well as the amount of tissue that could die without treatment. Currently we determine the outer boundary of the tissue-at-risk by measuring cerebral blood flow.

Recent research in animals has shown cerebral blood flow doesn’t reveal the tissue-at-risk as well as pH mapping. This is because pH mapping shows the state of the tissue as either aerobic or anaerobic. If the tissue is aerobic it may have reduced flow but is still receiving enough nutrients. To date, pH mapping is not used in human stroke centres because it is not yet available on modern MRI scanners.

In this project, we will create a pH mapping tool and show it’s use for acute ischemic stroke patients. The ability to detect the tissue-at-risk compared with cerebral blood flow is the primary outcome. We expect the pH mapping will detect the tissue-at-risk better than cerebral blood flow. This will lead to more accurate assessment of stroke with medical imaging and better guide treatment decisions. pH mapping provides a more direct measurement of tissue nutrient supply. pH mapping will show which tissues are receiving enough nutrients and which are not. pH mapping will become an important tool for the assessment of stroke.