The microembolic signal (MES) working group of the World Organization of Neurosonology (WON) has organized the MESOMEGA trial. The overall goal of MESOMEGA is to foster the use of MES detection in daily clinical practice.

This trial has the following goals:

1. to define criteria for MES that will be easily yet reliably implemented in daily clinical practice
2. to evaluate a possible MES using standardized criteria, independent of the TCD device that was used to record the signal. The second goal has become feasible due to the program called TCD Player, a universal and publicly available software interface for the evaluation of Doppler signals that was developed by Rune Aaslid, PhD.

Donors of real-world microembolic signals needed!
The purpose of the study is to reflect the actual detection of MES in the clinical setting as close as possible. Therefore, we are seeking MES study files from a variety of sources i.e. from colleagues who have recorded MES signals using a TCD machine. 
With the help of Rune Aaslid, multiple TCD manufacturers (DWL, Atys, Delica / Multigon, and Dolphin machines) have provided a method that allows for exporting an anonymized MES studies that can be analyzed by TCD Player.

If you have MES studies, please consider becoming a donor to MESOMEGA. Donors will be asked to use their MES studies and TCD player to create 20 second clips of MES (“.mes file”) that will be contributed to the MESOMEGA study database. We encourage the donors to supply signals that contain either obvious MES, doubtful MES, or clear artefacts. Since we want to establish clear-cut criteria for the identification of solid MES, gaseous emboli are not eligible.

Experts of microembolic signals needed!

The MESOMEGA study will utilize a panel of 18 experts to analyze a database of ~700-800 MES files contributed by donors. The task of an expert is to evaluate individual MES files and decide whether it is an MES, an artefact, or just a normal Doppler signal. Each MES file will be independently evaluated by two experts.

The final goal of the MESOMEGA study is to establish a decision tree for an unambiguous identification of MES stemming from a solid particle, irrespective of the TCD device used. Considering the time it takes to evaluate each MES file, we anticipate that each expert will need approximately one to one and a half days to analyze all the MES files that are assigned to them.

If you are interested in being a part of this project, i.e. serving as a donor or an expert, please contact the chairperson of the working group, Werner Mess MD, PhD for further information.

Sincerely,

The WON MES Working Group