A better MRI experience is here

A few years ago, I took a bad tumble and injured my back. My primary care doctor ordered an MRI to see if surgery would be necessary. Luckily it wasn’t, but my MRI experience is one I will never forget. The machine was loud and made me feel claustrophobic. I left hoping I would never need another MRI.

Patients today have a much different and greatly improved experience, now that Cape Cod Healthcare is using the new Shields MRI. The new machine, which is the first Voyager MRI system and the third AI-enabled MRI system on Cape Cod, is faster, quieter and has a roomier opening than previous models.

The new MRI is located at three locations on the Cape: Cape Cod Hospital in Hyannis, Fontaine Medical Center in Harwich and Cape Cod MRI/CT in West Yarmouth.

The new MRI improves the patient and physician experience in three main ways, according to Shawn Rayder, MD, the chief of radiology at Cape Cod Hospital:

• The experience is more comfortable and faster.
• Improved imaging and resolution leads to better patient care.
• Hospital scheduling is easier and smoother.

“This machine has a wider bore, so your shoulders fit in better, your hips fit in better, there is space in front of your nose so when you open your eyes the bore is not right against your nose,” he said. “As far as patient comfort goes, it’s great.”

And there’s another bonus, he said. Given the machine’s configuration and physics, it’s also faster. “We can do similar series and imaging techniques in less than half the time,” he said.

Saving time is better for both the patient and the hospital. Patients don’t have to wait as long to get an MRI because the hospitals and outpatient clinics can schedule more MRIs in a day.

“For the radiologist, there are a lot of advantages,” Dr. Rayder said. “Because it’s faster, there are imaging studies that you can do now that you couldn’t possibly do before. You wouldn’t even try them on the old scanner. Those are perfusion studies or blood flow studies to organs in the body.”

Perfusion studies of the brain allow radiologists to not only look for a stroke, but also determine the exact volume of brain that’s involved. If it is a stroke, the exam gives physicians a more accurate prediction on recoverability from the stroke It also means patients can be moved to rehab sooner.

With perfusion studies of the heart, radiologists can tell if a patient has had a heart attack and, if so, how much of the heart muscle is affected. That knowledge helps the surgeons determine the potential for revascularization of the cardiac muscle they are going to operate on.

The Future of Biopsies

The Shields MRI can also do cerebral spinal fluid flow studies without having to put in a dye or contrast. With the older MRIs, anything involving movement meant blurry images. The Shields MRI is capable of doing dynamic imaging of things in motion that are crisp and sharp images. It also, overall, has better image resolution.

With the old MRI, radiologists used to have to make measurements manually. Now, the Shields MRI uses artificial intelligence to do that work, which makes it more accurate.

“We can also do something called ‘MR spectroscopy’ which is basically a long word that means fingerprint,” Dr. Rayder said.

MR spectroscopy allows radiologists to find the chemical fingerprints of different tumors and diseases in a less invasive way.

“As we move forward and we recognize more fingerprints from different tumors and different diseases, hopefully what we do is we eliminate the need to do (surgical) biopsies on patients,” he said. “We can biopsy them chemically by their magnetic fingerprint as it comes out of the machine. That’s why everybody is excited about it.”

AI will do the chemical analysis of the tumor, which will speed things up and hopefully eliminate radiation exposure by eventually replacing CT scans. That isn’t going to happen right away, but Dr. Rayder foresees it occurring in the future.

It has already happened with cases of appendicitis. In adults, appendicitis is primarily diagnosed with a CT scan, which not everyone can have, especially pregnant women, for which an ultrasound is used.  In children and young adults, an ultrasound is used for diagnosis, but if the radiologist cannot see the appendix, instead of going to a CT scan, they can go to an MRI scan, he said.

Improvements Continue

As much as he is thrilled with the new MRI, Dr. Rayder doesn’t think the improvements to MRI technology will stop with the Shields MRI.

“Right now, we scan everybody lying down, but we do chest X-rays standing up,” he said. “We do a lot of images with people in different positions, and I think that in the future we’ll see some upright MRIs for orthopedics, particularly because you want to get some weight-bearing images as opposed to non-weight bearing.”

The company that makes Shields MRIs is based in Brockton, MA. Cape Cod Healthcare benefits from being so close to the Boston area, where a lot of the newer medical technology is developed, Dr. Rayder said.

“We’re not only close to the high-tech companies developing the latest in medical imaging and medical care, we’re also close to the academic institutions which do the initial testing on them. And when they are ready for prime time and they get rolled out to the public, we’re right down the street,” he said.

That means it’s easier to acquire the machines without onerous shipping. It also means that doctors and hospital administrators can easily drive up to see the latest technology at work and assess whether it would be something beneficial for the patient population on Cape Cod, he said.