A timely and thoughtful opinion essay published by the Journal of the American College of Radiology on November 1, 2021, urges radiologists to embrace the use of low-cost low-field MRI scanners. Dr. Jeffrey C. Weinreb, Director of the MRI Service at Yale-New Haven Hospital and Professor in the Department of Radiology and Biomedical Imaging at the Yale School of Medicine, highlights the renewed interest in low-cost low-field MRI scanners and addresses the potential impact of this disruptive technology. Dr. Weinreb is a respected voice on this topic and has been a thought leader and innovator in MRI for decades.
Dr. Weinreb describes portable, bedside MRI as a "disruptive technology." While these technologies initially may underperform established products in mainstream markets, they offer lower cost, greater simplicity of use, smaller size, and improved convenience. They start by gaining a foothold in the low-end (and less demanding) part of the market and successively move upmarket through performance improvement, finally displacing the incumbent’s product.
Dr. Weinreb notes a number of immediate and valuable uses of this new disruptive technology in radiology, including:
- point-of-service brain MRI in the intensive care unit, emergency department, stroke unit, and ambulance;
- serial examinations in the intensive care unit;
- guidance for radiotherapy, biopsies in the interventional radiology suite, and surgery in any operating room;
- bedside focused MRI of the abdomen, pelvis, and extremities;
- outpatient imaging in non-radiologist offices; and
- mobile screening of patients at risk for neurovascular disease.
He notes that low-field MRI might even have some inherent clinical advantages, such as fewer artifacts from metallic implants, better contrast enhancement on T1-weighted images, and in the assessment of the lungs.
Earlier this year, we wrote about the possible benefits of portable low-cost MRI devices designed to be moved and positioned within even the most crowded health care environments to deliver point-of-care scans at the patient’s location, rather than requiring the patient to travel to the device’s location. These portable MRI devices can help bring MRI to underserviced areas of the United States and around the world.
The JACR opinion essay notes a number of practical considerations -- such as payment/financial and legal implications -- as a disruptive technology like low-cost portable MRI units are brought fully into the health system. Other key considerations include patient safety, including performance and documentation of examination screening, as well the current requirement that all advanced diagnostic imaging devices must be accredited in order to provide services to Medicare beneficiaries. Additionally, we need to consider IT issues, such as integration of images produced on the portable units into existing picture archiving and communication system (PACS) and electronic medical records.
Dr. Weinreb wants to take lessons from other industries and use them to help the radiology field benefit from disruptive technologies. He urges that strategies be developed to help radiology practices, academic departments, and the ACR succeed through -- rather than become victims of -- this disruptive technology. He concludes, " We can fight it, but that is almost guaranteed to be a losing long-term strategy. Rather, we need to put our collective minds together and address these issues with our eyes wide open and a sense of urgency so that our patients benefit, and perhaps radiology does as well."