MRI is gaining ground in the imaging world thanks to technological innovations that make it a more patient-friendly exam.
Left: Philips Medical Systems? Gyroscan Intera CV
The widespread acceptance of open MRI has been a key factor in the modality?s growth. That trend has been fueled further by a corporate-style marketing philosophy at many hospitals and imaging centers that have purchased open MRI scanners. Facilities are touting their new open MRI systems to potential patients in advertising campaigns, bypassing physicians with the pitch.
Frost & Sullivan (Mountain View, Calif.) pegs MRI with a 20 percent share of the imaging market at $1.88 billion. By 2004, that share is expected to climb to nearly 25 percent, producing sales of approximately $3.64 billion.
Cost has always been an issue with MRI in its battle to steal ground from other modalities, but list prices of MRIs are becoming more manageable with short-bore magnets are making systems more accessible to healthcare facilities.
The consolidation of the hospital market could be a thorn in the side of MRI sales growth. When two or three facilities combine, they often consolidate imaging equipment and extend the time between purchases. Growing interest in refurbished equipment also may limit the sales of new, higher-caliber MRIs.
Toshiba America Medical Systems (TAMS of Tustin, Calif.) debuted its 1.5-Tesla Excelart (left) MRI scanner at RSNA. Excelart?s short-bore design has a 655 mm opening to achieve a greater feeling of openness and reduce a patient?s sensation of being enclosed.
The system soon may offer Pianissimo, a works-in-progress technology designed to reduce examination noise by as much as 90 percent in the closed MRI. Pianissimo uses a solid foundation for gradient support and special insulators to reduce the acoustic noise from the vibration of the gradient coil. Noise is reduced additionally through a gradient vacuum vessel and independent support direct from the ground, which shields against air vibration.
The Excelart is optimized for advanced imaging techniques to perform studies such as MR angiography, as well as abdominal, liver and spine imaging. The system also features works-in-progress SuperFASE for imaging vascular structures in the abdomen and chest. With this technique, MRA images of venous and arterial vessels can be simultaneously visualized without the use of contrast agents.
TAMS also displayed a works-in-progress series of enhancements for its Opart MRI system, a superconducting, 0.35-Tesla cryogenless open magnet. New features include a fully motorized, multi-directional table, which also is a works-in-progress. The open design of Opart makes it suitable for interventional procedures.
Philips Medical Systems North America (Shelton, Conn.) rolled out its new Gyroscan Intera general-purpose MRI system, which offers three fields of strength ? 0.5 Tesla, 1.0 Tesla and 1.5 Tesla.
?We have shortened the size of the magnet by 10 cm from our previous system,? said Scott Yohe, Philips? MRI marketing manager. ?We also have added air flow through the bore, lighting changes to make it more appealing and reduced the gradient noise the patient hears.?
Philips also has increased the reconstruction rate to 196 images per second ? standard on all Intera models ? and offers a new in-room operator console.
The Intera also features Syncrascan, which increases the acquisition speed by the same factor as the number of coils in use. For example, a traditional 10-minute scan would become a five-minute exam with the use of two coils, while a 20-second breath-hold exam would be reduced to 10 seconds with two coils. Philips plans to begin deliveries in May. The Gyroscan Intera ranges in list price from $1 million to $1.7 million, based in part on different gradient and field strengths.
Hitachi Medical Systems America Inc. (Twinsburg, Ohio) unveiled its Celeris MRI scanner, a whole-body, high-field imaging system. The 1.5-Tesla short bore MRI includes a solid-state RF amplifier and a full complement of quadrature and phased-array coils. The system is pending FDA clearance.
The advanced platform of the Celeris is designed for diffusion-weighted imaging and perfusion imaging, as well as future applications, such as high-speed cardiac imaging. Hitachi is positioning Celeris as its platform to move into cardiac and neurological imaging.
Hitachi also debuted new software for its Airis and MRP-7000 open MRI scanners at RSNA. New Version 6.0 software introduces pulse sequencing capabilities, such as contrast enhanced MR angiography, to better visualize structures throughout the body and dual echo gradient echo to acquire dual contrast in a single acquisition. Version 6.0 is pending FDA clearance. Hitachi is targeting commercial release for the summer of 2000.
New features on Hitachi?s Airis II scanner include echoplanar imaging for rapid T1 and T2 weighted images, EPI-based diffusion weighted imaging and the XP workstation.
GE Medical Systems? (GEMS of Waukesha, Wis.) new high-field OpenSpeed (left) open MRI system made its RSNA debut. The company says the system ? launched in October ? allows doctors to scan patients three times faster than any other commercially available open MRI system.
Beyond standard MRI capabilities ? such as knee, shoulder, ankle, spine and brain ? OpenSpeed may be used in pediatric care, monitoring stroke therapy, trauma patients and minimally invasive procedures.
GEMS projects installations of approximately 100 OpenSpeed systems worldwide by the end of this year. The company had received 20 orders as of RSNA.
At RSNA, GEMS also showed a new gradient platform to increase the power of its 1.0 Tesla and 1.5 Tesla Signa LX MR systems and optimize image quality, drive advanced applications and improve productivity. The initiative includes a program to upgrade existing 1.0 Tesla and 1.5 Tesla Signa LX systems to the new gradient technology.
Fresh off its 1999 acquisition of Surrey Medical Imaging Systems Ltd. (SMIS of Guildford, U.K.), Marconi Medical Systems (Highland Heights, Ohio) is working with SMIS? personnel to bring very-high-field MRI technology into the fold as quickly as possible.
SMIS has developed technology for whole body imaging systems of 3.0 Tesla and 4.7 Tesla strength for research applications.
?Our plan is to take the high-field program and the Eclipse and Polaris and build on that platform up to a 3T machine,? said Robert Gylling, vice president and general manager of Marconi?s global MR business. ?We are targeting a clinical machine with FDA approval, which will a whole body system, but optimized for newer applications.?
Applications for the 3T system – dubbed Orion ? would include functional MRI, spectroscopy and angiography. ?We?re talking about 12 months delivery time for the first machine,? said Gylling.
Marconi is targeting two markets ? oncology and interventional MRI. Clinical institutions, which concentrate heavily on research, are likely to order high-field MRI initially, Gylling said.
?Then it will trickle down to the bigger hospitals,? he added. ?That will take three to five years. It will be an important international market, because the top institutions everywhere will follow the lead.?
Siemens? Magnetom Open viva
RSNA attendees also were the first to see the early results from Siemens Medical Systems? (Iselin, N.J.) new 1.0-Tesla Magnetom open MRI scanner. The works-in-progress carries the highest field strength of any open MRI system.
The unit is designed to improve patient comfort without affecting gradient performance or advanced applications with its high magnetic field strength.
The 1.0-Tesla open MRI system will feature gradient performance that enables advanced whole-body applications, such as spectral fat saturation, diffusion for stroke imaging, perfusion, contrast-enhanced MR angiography, and blood oxygenation level dependent imaging. A full set of integrated panoramic array coils will also be offered, including head, neck, spine and body. 
