When it debuted, industry experts hailed MR technology as an imaging advancement that provided high-resolution images without exposing patients to radiation. Now a new set of improvements rolling out is positively impacting not only image quality and patient comfort, but also the efficiency of your workflow.
With so many enhancements on the market, determining which ones are right for your practice or department can be overwhelming. Before making any purchasing decisions, analyze your needs, as well as your budget, said William Bradley, MD, PhD, FACR, chair of the University of California-San Diego radiology department.
“I always advise radiologists to buy the very best technology that they can afford,” said Bradley, who has published 180 studies and authored 20 textbooks on MRI. “With the looming reimbursement cuts to health care for radiologists, any magnet that you buy now, you’re going to have for 10 to 20 years.”
From 1.5T to 3T
One of the biggest MRI shifts is the migration from the 1.5T machine to the 3T models that have twice the magnetic field strength. Originally approved by the FDA in 2002, 3T is a trend that is picking up momentum — or, at least in this economy, holding steady.
According to John Metellus, product manager at Siemens Healthcare, roughly one-third of the company’s new MRI sales are 3T models. To meet the needs of cost-conscious customers, Siemens introduced its MAGNETOM Spectra, a more economical 3T machine, he said.
Currently, 3T MRIs cost between $2 million and $2.3 million compared to the average $1.5 million cost of a 1.5T machine.
“We see customers looking for opportunities for referral growth as facilities consolidate and try to find better ways to utilize the equipment they have,” he said. “We’re starting to see people wanting to put what they have at facilities to better, more efficient use. They want more diagnostic confidence in what they have in order to provide better patient care.”
The popularity of these machines is well-founded, he said. The biggest clinical advantage is the improved field strength that provides for better signal, improved image quality, and better throughput. From a workflow perspective, 3T machines can accommodate more patients with faster scans and obviate the need for a second system. They can also open the door to more advanced applications, such as neurology, oncology, or improved soft tissue scans. Overall, 3T machines make it easier to view abnormalities through saturated fats in the body, and they enhance the effectiveness of contrast agents.
Some practices or departments opt to purchase 3T models just so they can either keep pace with or out-do their competition, Metellus said.
“Some practices are starting to look at who else is in their neighborhood – who could they be losing referrals to because that someone might have a 3T machine,” he said. “Or some might be trying to get into a new clinical segment or add a new practice at their facility. Getting a 3T machine can be something that makes you different from the other guy on the block.”
But even though 3T’s magnet strength and speed benefits are preferable in the long term, switching out all your 1.5T machines now isn’t necessary, said UCSD’s Bradley, who is also past president of the International Society of Magnetic Resonance in Medicine.
“With 3T, you know you’re getting thinner slices that produce better and faster images,” he said. “However, you don’t always need 3T, especially in this economy. If money is a factor, you can maximize what your 1.5T machines offer.”
For example, rather than upgrade all UCSD’s MRIs to 3T, Bradley opted to pair a 3T with a 1.5T at each site. This way, the 3T technology is still available throughout the health system, but 1.5T machines can also produce images more quickly when you use parallel imaging, he said.
Through parallel imaging, you use spatial information gathered through radio-frequency coils to achieve some spatial encoding usually accomplished by gradient fields.
Anne Arundel Diagnostics Imaging Experience
In September, Anne Arundel Diagnostics Imaging (AADI) announced its move from 1.5T MR machines to 3T. Despite the higher price tag associated with 3T equipment, the practice determined the advanced technology would benefit both their providers and patients.
“The real push for us was the image quality from the 3T. It’s better than 1.5T in several different areas, especially in musculoskeletal imaging where we can get better definition of cartilage lesions or evaluate small parts, like the foot, ankle, hand, and wrist, with better detail,” said John Park, MD, an AADI radiologist. “MRI is our workhorse, and it’s incredibly helpful to get better quality images in half the time.”
The main challenge to implementing a 3T machine is scheduling, Park said. Office staff accustomed to scheduling appointments around the time needed for exams in 1.5T machines must now learn how to organize patient visits based on faster scan times. In addition, a 3T scan isn’t appropriate for all patients. For example, an older patient facing knee surgery for arthritis will benefit less from a 3T scan than a child with a cartilage lesion.
Park cautioned, however, that purchasing a 3T machine does require some additional room preparation. Make sure your space is configured correctly to accommodate a 3T MR, and if necessary, reinforce the room’s floor to sustain the heavier weight machine.
Diagnostic Imaging polled hospital-based imaging directors and managers on the The MarkeTech Group's imagePRO panel. The panel accurately represents the U.S. hospital market by bedsize and geographic areas.
Just 13 percent of respondents said their facility considers 3T MRI to be the standard of care and use it for all patients. The majority, 65 percent, said the technology is still too expensive and limited to special cases.