Alexandra S. Reynolds, Jimmy Suh, Ahmedyar Hasan, Parth Upadhyaya, Venkatakrishna Rajajee, Mohammad I. Hirzallah, David M. Greer, Aarti Sarwal, American Society of Neuroimaging Brain Death Task force
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We aimed to consolidate the technical considerations related to the use of TCD as an ancillary test in the evaluation of BD/DNC.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We performed a scoping review of the available literature from inception to December 2024. Articles describing TCD as an ancillary test for BD/DNC were included using appropriate Medical Subject Headings terms. The focus was on technical details and clinimetric properties of TCD (e.g., signal quality, frequency, gate, probe location, etc.). Technical categories were curated as full-text reviews were completed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We reviewed 181 articles to extract technical descriptions of TCD under several categories. Image acquisition was divided into machine-related factors (59 studies, four questions), exam-related aspects (82 studies, 13 questions), and patient anatomical factors (19 studies, three questions). Image interpretation concerns were addressed in 50 studies (three questions). Patient-related clinical factors affecting TCD utility were addressed in 44 studies (seven questions). Legislative priorities were discussed in 19 studies; in 13 studies, authors commented on their recommendations for research priorities.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>We found significant inconsistencies and a lack of technical details described in the literature. Next steps include a national survey of current TCD protocols for BD/DNC evaluation, and an expert consensus guidelines report on the technical use of TCD as an ancillary test.</p>\n </section>\n </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70021","citationCount":"0","resultStr":"{\"title\":\"Technical Considerations in the TCD Evaluation of Cerebral Circulatory Arrest in Death by Neurological Criteria\",\"authors\":\"Alexandra S. Reynolds, Jimmy Suh, Ahmedyar Hasan, Parth Upadhyaya, Venkatakrishna Rajajee, Mohammad I. Hirzallah, David M. Greer, Aarti Sarwal, American Society of Neuroimaging Brain Death Task force\",\"doi\":\"10.1111/jon.70021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and Purpose</h3>\\n \\n <p>Ancillary testing is essential for diagnosing brain death/death by neurologic criteria (BD/DNC) when clinical determination (neurologic exam and apnea testing) cannot be fully or safely performed. Transcranial Doppler ultrasound (TCD) has been recommended as an ancillary test; however, the technical descriptions have been heterogeneous. We aimed to consolidate the technical considerations related to the use of TCD as an ancillary test in the evaluation of BD/DNC.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We performed a scoping review of the available literature from inception to December 2024. Articles describing TCD as an ancillary test for BD/DNC were included using appropriate Medical Subject Headings terms. The focus was on technical details and clinimetric properties of TCD (e.g., signal quality, frequency, gate, probe location, etc.). Technical categories were curated as full-text reviews were completed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>We reviewed 181 articles to extract technical descriptions of TCD under several categories. Image acquisition was divided into machine-related factors (59 studies, four questions), exam-related aspects (82 studies, 13 questions), and patient anatomical factors (19 studies, three questions). Image interpretation concerns were addressed in 50 studies (three questions). Patient-related clinical factors affecting TCD utility were addressed in 44 studies (seven questions). 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Technical Considerations in the TCD Evaluation of Cerebral Circulatory Arrest in Death by Neurological Criteria
Background and Purpose
Ancillary testing is essential for diagnosing brain death/death by neurologic criteria (BD/DNC) when clinical determination (neurologic exam and apnea testing) cannot be fully or safely performed. Transcranial Doppler ultrasound (TCD) has been recommended as an ancillary test; however, the technical descriptions have been heterogeneous. We aimed to consolidate the technical considerations related to the use of TCD as an ancillary test in the evaluation of BD/DNC.
Methods
We performed a scoping review of the available literature from inception to December 2024. Articles describing TCD as an ancillary test for BD/DNC were included using appropriate Medical Subject Headings terms. The focus was on technical details and clinimetric properties of TCD (e.g., signal quality, frequency, gate, probe location, etc.). Technical categories were curated as full-text reviews were completed.
Results
We reviewed 181 articles to extract technical descriptions of TCD under several categories. Image acquisition was divided into machine-related factors (59 studies, four questions), exam-related aspects (82 studies, 13 questions), and patient anatomical factors (19 studies, three questions). Image interpretation concerns were addressed in 50 studies (three questions). Patient-related clinical factors affecting TCD utility were addressed in 44 studies (seven questions). Legislative priorities were discussed in 19 studies; in 13 studies, authors commented on their recommendations for research priorities.
Conclusion
We found significant inconsistencies and a lack of technical details described in the literature. Next steps include a national survey of current TCD protocols for BD/DNC evaluation, and an expert consensus guidelines report on the technical use of TCD as an ancillary test.
期刊介绍：
Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on:
MRI
CT
Carotid Ultrasound and TCD
SPECT
PET
Endovascular Surgical Neuroradiology
Functional MRI
Xenon CT
and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!
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