Prospects for EMV

First post here guys. I'm a specialist doctor with an minor interest in stroke; that is, I see some patients with acute stroke, but not that many.

EMV's product, if it eventuates as forecast, will be a worldwide game-changer, at least if the in-ambulance units can be commercialised as predicted. The following is the critical point: if medics can (a) confirm the presence of a stroke and (b) distinguish between ischaemic and haemorrhagic lesions, then we can initiate appropriate management in a much more timely fashion than at present - this will save many lives and very substantially reduce long-term disability, with attendant huge financial as well as human benefits. The opportunity to administer thrombolytic ('clot-busting') drugs immediately in an ambulance setting, or if indicated to know that the patient has to be taken without delay to an appropriate centre for removal of an intra-arterial clot or extra-arterial haemorrhage, constitutes a revolutionary clinical development.

I saw the Kochie interviews with a couple of pundits being pretty negative about EMV. This negativity seemed to stem from a general view of biotech stocks as being risky (true of course) but more specifically that it's difficult to change doctors' behaviour and get them to invest in a new piece of tech; this conveys a lack of understanding of the clinical issues. We're not talking about a moderately more effective ultrasound or X-ray machine, but a completely new imaging modality that has the potential to completely change clinical management. If this works, it'll be essentially mandatory for every facility concerned with acute stroke care.

On the negative side, I note that initial use is likely to be for the monitoring of progression/recovery of stroke, which I presume is a temporising application whilst work on the ambulance-based units proceeds. However, from what I can glean I don't see any reason why the early units, which still seem to be highly portable, couldn't be used in hospital emergency departments to facilitate rapid diagnosis and management, especially at the likely price point and given the apparent ease of use. In my experience, this could easily knock half an hour or more off the delay to treatment initiation, as it takes time to get the patient onto a CT scanner, both because of the need to physically transport the patient and because there's almost always a patient already in the CT. Incredibly, it's still common for acute assessment and treatment of stroke to only be available during weekday business hours, even in some fairly large district hospitals, and there's a good chance that readily available high-quality diagnosis will provide the leverage to eliminate this.

A note on potential competitor tech:
Micro-X are proposing - as a 'future' development - a portable CT scanner that can be installed in ambulances. Whether they'll be able to develop this within a practical timeframe is very much open to question. Mobile 'stroke units' with CT already exist, but problems include the expense - an order of magnitude greater than the likely cost of EMV's microwave scanner, and the size - at present even the latest 'portable' CT is much larger and heavier than the EMV product. Potentially also, microwave imaging seems to be able to demonstrate subtle/early tissue effects so some superior aspects compared with CT and MRI, which only demonstrate established structural damage. The resolution of microwave imaging does seem to be lower, but this probably doesn't matter in the context. Oh, and a CT brain scan delivers a high dose of ionising radiation to the brain, a minor consideration when weighed against the acute effects of many strokes, but a consideration nevertheless; microwave imaging is non-ionising (mobile phone brain cancer arguments notwithstanding!).
Looking around at other centres developing microwave brain imaging, including via research published on PubMed, I couldn't find any centre at a similarly advanced stage, or even making substantial progress; unless they're keeping their cards very close to their chest, and I really can't see why that would be advantageous.

I'm very optimistic on this, all other factors being equal and barring a black swan event or concealed negative information. Best of luck....

Disclosure: I topped up to around a million AUD's worth last week after the haemorrhagic images were unveiled, and will almost certainly be buying more.