Opening Minds to Open MRI

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How do you acquire the high–field-strength open MRI unit of your dreams in a tough economy? Unless you had already budgeted a cool million before the economy tanked, it may be difficult. David Nelson, director of outpatient imaging for BayCare Health System, Clearwater, Fla, overcame his lack of comfort with open systems last year and did just that.

“We get the best of both worlds, and we can accommodate claustrophobic patients as well as patients who can’t fit into the closed MRI. We are definitely in a society where people are getting larger, and I don’t see that trend slowing down at all.”
--Michael R. Foreman

It was a long time coming, since most open MRI magnets hovered around the 0.3T–0.7T range—a strength rating that Nelson believes is less than ideal. Nelson, who oversees multiple BayCare Health System locations throughout the Tampa region, says, “When I first got here in Florida, there was a 0.3T magnet on every other street corner. It probably took me 5 years to change the thought processes of the local community that open was not better, especially at the typical magnet strength. The only option we had for high-field imaging was a conventional unit. I have now gone from being the arch enemy of open configurations, however, to being an advocate of having open units in your portfolio.”

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Erin Butler, RTR

The debut of the 1.2T magnet ultimately changed Nelson’s mind, motivating him to allocate precious budget dollars to the new OASIS™ high-field open MRI from Hitachi, Twinsburg, Ohio, which is currently the most powerful open system on the market. Prior to purchasing the unit, BayCare Health System’s top radiologist went to Cleveland to look at the equipment. At that time, no OASIS had yet been installed in the United States. Like Nelson, the radiologist was not a big fan of mid-strength magnets. The trip went exceedingly well, though, and it wasn’t long before BayCare Health System was on the waiting list for a July 2009 installation.

The team at Saint Joseph Mercy Health System, Howell, Mich, got on the bandwagon in September 2008, in a move that has already led to almost 2,000 successful scans using the new unit. Erin Butler, RTR, is MRI service delivery leader at Saint Joseph Mercy Health System, a system with 30 facilities and 13,000 employees. She says, “We are now able to serve a patient population that we could not in the past, and we are doing that. Rather than having to reschedule patients, we are now able to proceed within our own facility.”

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Jim Knauf

Many MRI veterans have endured the embarrassing task of telling obese patients that closed, conventional MRI units are just not adequate. For the most part, open systems eliminate this problem. “Sometimes, when patients and even physicians hear open, they anticipate wide open,” Butler warns, “but these magnets, regardless of the field strength, have a top and a bottom, so there are still some criteria for being able to fit between the top and the bottom.”

Fortunately, these limitations are rarely a concern, and the open unit is usually perfect for obese or claustrophobic patients. “We get the best of both worlds, and we can accommodate claustrophobic patients as well as patients who can’t fit into the closed MRI,” Michael R. Foreman, MRI manager at Lakeshore Bone and Joint Institute, a private facility in Chesterton, Ind, explains. “We are definitely in a society where people are larger, and I don’t see that trend slowing down at all.”

According to Jim Knauf, business line leader at Saint Joseph Mercy Health System, his department has been able to accommodate a patient weighing nearly 272 kg (600 pounds) on the OASIS with little difficulty. “We would never have been able to scan this patient prior to having the new open MRI unit,” Knauf says.

As a general rule, about 10% of patients are claustrophobic, and a small percentage of those are so severely affected that even an open MRI is out of the question. For these patients, anesthesia is an option, although that is never ideal, due to safety issues. Knauf estimates that fewer patients at Saint Joseph Mercy Health System are requiring anesthesia—which he believes is a direct result of having the new system.

While it’s been only six months since he started using his new 1.2T open unit, Foreman can’t help anticipating new developments on the horizon. Fortunately, new software can be added to the system, which helps to keep things up to date. “Any software changes, we get automatically,”