The essential role of neuroimaging in diagnosing and managing cerebrovascular disease in Africa: a review

Figures & data

Table 1. Comparison of neuroimaging modalities for cerebrovascular disease management in Africa.

Neuroimaging Modality	Cost	Use	Accessibility	Effectiveness
CT Scan	Low	High	High	Effective for acute stroke diagnosis, but not as useful for monitoring stroke progression and recurrence. More widely available than MRI.
MRI	High	Low	Low	More effective than CT for diagnosis and monitoring of cerebrovascular disease, but more expensive and less accessible.
X-ray	Low	Low	High	Limited in diagnostic capabilities, but effective for screening and monitoring cerebrovascular disease, especially in resource-limited settings.
PET Scan	High	Low	Low	Useful for research purposes but limited clinical applications due to high cost and limited accessibility.
SPECT Scan	High	Low	Low	Limited clinical applications due to high cost and limited accessibility.
MRA	High	Low	Low	More accessible and less invasive than angiography, but less effective in visualizing small vessels.
Angiography	High	Low	Low	Highly effective for visualizing blood vessels in the brain, but invasive and expensive. Not widely available in Africa.

^Cost:.

• ^{Low: The cost of the neuroimaging modality is relatively affordable and within the financial means of healthcare institutions or patients}.

• ^{High: The cost of the neuroimaging modality is relatively expensive, requiring significant financial resources for acquisition, operation, and maintenance}.

^Use:.

• ^{Low: The neuroimaging modality is not frequently used or has limited applications in clinical practice}.

• ^{High: The neuroimaging modality is extensively used in clinical practice and has a wide range of applications}.

^{Accessibility:}.

• ^{Low: The neuroimaging modality has limited availability or is not easily accessible to a significant portion of the population}.

• ^{High: The neuroimaging modality is widely accessible and available to a large proportion of the population}.

Figure 1. Diagnostic process for cerebrovascular disease in Africa with neuroimaging.

Table 2. Challenges and policy recommendations for neuroimaging in cerebrovascular disease management in Africa.

Challenge	Description	Policy Recommendation
Limitations in Healthcare Infrastructure	Limited healthcare infrastructure in many African countries hinders the implementation of neuroimaging technologies. Access to specialized facilities and qualified personnel is insufficient, particularly in rural and low-income areas. This impacts timely and accurate diagnoses of cerebrovascular disease, affecting patient outcomes.	Expand and upgrade healthcare infrastructure to provide specialized neuroimaging facilities, focusing on both urban and rural areas. Develop programs to train healthcare professionals in neuroimaging techniques, with emphasis on rural areas. Implement telemedicine and remote imaging initiatives for extended access to neuroimaging services in remote regions.
Need for Specialized Imaging Facilities and Qualified Personnel	The scarcity of specialized facilities and qualified personnel poses a challenge in implementing neuroimaging technologies in Africa. Limited workforce proficiency and long wait times for imaging procedures impact diagnostic quality.	Establish educational programs and partnerships for training healthcare professionals in neuroimaging. Support mentorship programs and continuing education initiatives for healthcare professionals in neuroimaging. Strengthen recruitment strategies and provide incentives to attract and retain qualified personnel in neuroimaging.
High Cost of Neuroimaging Equipment and Maintenance	The high cost of neuroimaging equipment and maintenance hinders widespread implementation. Affordability issues limit access to these technologies, affecting the diagnosis and management of cerebrovascular disease.	Explore cost-sharing models and international collaborations to reduce the financial burden of acquiring neuroimaging equipment. Advocate for financial support and grants from governments, philanthropic organizations, and international agencies. Prioritize cost-effectiveness studies to assess the value of neuroimaging technologies on patient outcomes and healthcare costs.
Dearth of Knowledge and Capacity Building	The lack of knowledge and capacity building in neuroimaging presents challenges in Africa. Limited training programs, resources, and experienced trainers hinder the acquisition and dissemination of expertise. This impacts patient care and outcomes.	Develop and expand educational programs and training opportunities in neuroimaging. Improve accessibility to up-to-date resources and guidelines in neuroimaging through online platforms and collaborations. Establish mentorship programs for knowledge transfer and skill development in neuroimaging. Encourage research initiatives focused on neuroimaging within the African context.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the reviews.