MRI image processing buffs low-field's image

Pretty pictures do not necessarily make a better diagnosis, butthey can attract referral business in MRI. Image Enhancement Systems,a company that branched out of an MRI center operating Toshiba's0.064-tesla Access MRI system, has developed a hardware and softwarepackage that reduces background noise in MRI images.

The Hayward, CA, company touts its product as an economicalway to extend the lifespan of low- and mid-field Toshiba scanners.IES maintains that the image processing product can keep centersprofitable in an increasingly difficult imaging center environment.

Low- and mid-field MRI scanners now on the market are capableof producing the same image quality available from high-fieldscanners only a few years ago. However, many low-field MRI serviceproviders have a hard time convincing referring physicians thatthe grainy images they are looking at contain the same diagnosticinformation as high-field-produced images. This makes referringphysicians reluctant to send patients to low-field centers, accordingto Peter Rothschild, president and CEO of Open MRI, parent companyof IES.

Open MRI is a Hayward, CA-based imaging center that uses anAccess magnet (SCAN 4/22/92).

"The reason referring doctors don't like mid- and low-fieldscanners is because the images are noisy, not because they areless diagnostic," Rothschild told SCAN. "That's onething that people get very confused about. There has never beena study that's shown that a high-field scanner is more diagnosticthan a mid- or low-field scanner."

IES software clears up the signal-to-noise ratios of ToshibaAccess and MRT-35 images, using algorithms initially developedby Context Vision of Stockholm for satellite data analysis. Thesoftware detects the high-contrast areas within an MRI image thatrepresent the edges between anatomical structures. The systemthen determines which areas within the image are noise and subtractsthe extraneous data.

The software runs on a Sun Microsystems workstation connectedto the Toshiba scanner's on-board computer. The workstation reconstructsan image in about 12 minutes and then sends it back to the Toshibasystem to be filmed.

Images become prettier, although not necessarily more diagnostic.The goal of the system, however, is not to increase the clinicalpower of low- and mid-field MRI but rather to give lower fieldimaging centers marketing leverage over their high-field competitionthat will help siphon off referrals.

"The images don't look any sharper, they look less noisy,"Rothschild said. "They look more like high-field images.That's the name of the game."

One IES user, Radiology Consultants of Omaha, purchased a systemalmost two years ago for its Access scanner. Since then the centerhas experienced a substantial increase in patient volume, accordingto Dr. Michael Collins, a radiologist at the center.

"We had reason to believe that before we got (IES), referringdoctors weren't happy (with our images)," Collins said. "Afterwe got IES, our volume went up significantly. Perhaps that wouldhave happened anyway, but we have the feeling that people whowere reluctant to send patients to our facility now are willing."

IES sells the package for $99,000, which includes a 1.2-gigabyteoptical disk for image archiving. The system costs $89,000 withoutthe optical disk option.

The IES package won Food and Drug Administration marketingclearance in December. Since then, the company has nearly saturatedthe Access market: 60% of Access scanners in the field are retrofittedwith IES packages, according to Rothschild. The MRT-35 is thenext niche market for the company. IES also has plans to adaptits system to low- and mid-field systems manufactured by othervendors.

Rothschild believes that an IES package can help imaging centerscope with sagging reimbursement levels by extending the lifespanof scanners that in many cases have already been paid for.

"A lot of centers and companies that are junking all the0.35-tesla magnets and buying high field now are having financialproblems," Rothschild said. "If you've got a magnetthat you've paid off and you're making money on, don't throw itaway. There's life left in these old MRT-35s."