Publication for the Philips MRI Community

Transcription

1 FieldStrength Publication for the Philips MRI Community Issue 38 Summer 2009 Hospitals deploy Panorama HFO as an all purpose MRI scanner Panorama High Field Open scanner serves all MRI needs of both Community Memorial Hospital and Porter Hospital. FieldStrength Publication for the Philips MRI Community Issue 38 Summer 2009 Pediatric neuro, MSK, whole body imaging Tokai University reports on benefits of Achieva 3.0T TX with MultiTransmit University of Michigan praises Elite Breast solution for biopsies SmartExam for efficient, reproducible shoulder imaging at PAMF Maastricht performs MRA of spinal cord blood vessels FreeWave upgrade for Intera 1.5T boosts throughput This article is part of Field Strength issue 38, Summer 2009

2 Hospitals deploy Panorama HFO as an all purpose MRI scanner Panorama High Field Open scanner serves all MRI needs of both Community Memorial Hospital and Porter Hospital. Community Memorial Hospital and Porter Hospital are two very different facilities. However, both use Panorama HFO as their only MRI system. The Panorama s wide-open patient space makes it a good choice for patients of all sizes and MR needs. Panorama High Field Open MRI appeals to both patients and referring physicians alike with its 360º panoramic viewing angle and spacious 160 cm-wide patient aperture ensuring a comfortable, relaxing MRI experience for anxious, elderly, obese or claustrophobic patients. The large space allows sideways positioning for any patient, assuring that any anatomy (including knee, wrist and shoulder) is always at the isocenter for best image quality. Solenoid Technology coils offer superb coverage and comfort, high SNR and excellent homogeneity. The images benefit from the minimal susceptibility and distortion as well as uncompromised fat saturation at the 1.0T field strength, while providing SNR comparable to 1.5T. Since the majority of patients prefer the open Panorama over any cylindrical system, this helps when marketing a practice directly to the patients. Panorama HFO helps Community Memorial Hospital grow quality MR exams on about 70 patients a month. Many of the patients are referred from the hospital s pain management clinic, orthopedic department and family practice physicians. Rich Wharton (Philips) and MRI technologists Robin Morhart, Angel Stevens, Lori Peglow. Located in a city of about 5,700 residents, Community Memorial Hospital (Hicksville, Ohio, USA) is a critical access hospital with 25 beds. The Panorama was installed in June 2008, and is used to perform high The Panorama s large patient aperture is a plus at Community Memorial. Sue Fowler, RT, Radiology Manager at Community Memorial, says, There are a significant number of patients in our demographic area who are too large for a closed system or who are claustrophobic. If patients are claustrophobic, the technologists can take them to see the unit, which helps to dispel any negative perceptions they might have about closed MR systems and puts them at ease. Our Panorama is the only high field open system available to them in our service area. We re not doing conscious sedation, but we ve had some pediatric patients whose parents have stayed in the room with them, and that has been very calming for the children. 36 FieldStrength Issue 38 Summer 2009

3 Subacute subdural bleeding T1-weighted An 81-year-old female with history of diabetes presented with headaches, tinnitus. T1-weighed image shows increase in subdural fluid. FLAIR demonstrates small amounts of fluid in the subdural space along the convexity of the brain, consistent with subacute subdural bleeding without mass effect, with reactive meningeal enhancement. FLAIR FLAIR Post contrast T1-weighted T2-weighted PD-weighted T1-weighted Large disc extrusion 40-year-old male with low back pain and right-sided foot drop for several months. Sagittal images demonstrate a large disc extrusion at L4-L5 with spinal stenosis. The axial images demonstrate right paracentral disc hernation compressing the thecal sac and impinging on the right L5 nerve root. T1-weighted T2-weighted The community members overwhelmingly wanted an open MR system. When Community Memorial began the search for an MR system, hospital administrators surveyed their physicians and members of the community. The physicians wanted a 1.5T closed-bore system, citing image quality issues with open-bore systems, says Gregg Harpel, Vice President of Ancillary Services. The community members overwhelmingly wanted an open MR system. When Philips presented the Panorama as a high field open, I was a bit skeptical, as sales representatives claims of image quality can sometimes be a bit inflated. But when we saw it in action, I knew we had the right fit. FieldStrength 37

4 Next, Mr. Harpel and the team discussed it with the hospital s radiology group and medical staff. Once they were on board, we presented the numbers to the Board of Governors and the Township Trustees to get their approval, he says. The success of the project relied heavily on the continued growth of the hospital, so they were a bit apprehensive, but their faith in us has paid off. The high field open system fulfills its promises The Panorama is the Community Memorial s only MRI scanner, and serves all its MR needs. In a small, rural area, two MR systems would be cost-prohibitive. Even with refurbished units, the cost of purchase, maintenance, training and regulatory oversight would not be costeffective, explains Mr. Harpel. More importantly, there would be no added value in having two different machines; we have not run into anything that we cannot do on this magnet. We have not run into anything that we cannot do on this magnet. We have nothing but great things to say about our Panorama, agrees Ms. Fowler. We were very pleased with the entire process from beginning to end. We decided on a turnkey approach, whereby Philips was also in charge of putting together the modular building that would be attached to our hospital, and we believe that was money well spent. One of the highlights was when the huge building for the MR suite came through the streets of our small town to arrive at the hospital. Mr. Harpel says the Panorama has turned out to be a marketing tool for the hospital. We have people coming to our hospital that didn t know we had a hospital a year ago. Not only are they coming for the MRI, but also for other services. The marketing campaign had a residual effect of getting our name out and building our image. Being in Hicksville, many people get an instant mental image of someplace lost in time. The MRI campaign let everyone in the extended area know that we are here and we have top-notch technology. We are very happy with the choice that we made, says Ms. Fowler. With the Panorama we have the best of both worlds: we have a system that s both high field and open. Panorama meets all MR needs at Porter Hospital Nancy Babich Porter Hospital (Valparaiso, Indiana, USA), in comparison, is a large hospital with 250 beds. Nancy Babich, Director of Imaging for Porter Hospital, says Porter has imaged about 7,000 patients on its Panorama HFO since it was installed in late Brain and cardiac imaging is fairly common here, as is imaging of extremities. Because of the openness of the Panorama, and the fact that we work through a central scheduling department, we also get claustrophobic patients who won t or can t go to other facilities. Especially in brain imaging, where the head must be held still, the open sides of the Panorama are a welcome addition to MR exams. For pediatric patients, it s reassuring to have a parent or family member in the MR room with them. In fact at one point we had a mother come and lie next to her child during the scan, says Ms. Babich. Porter has had MR scanners in its facilities for a long time and appreciated both the image quality, and the service on Philips equipment. We needed an open MR, says Ms. Babich, and when we saw the capabilities of the Panorama the removable table, the cardiac capabilities, the high quality images we decided it would answer our needs for both a high field and an open scanner. We decided Panorama HFO would answer our needs for both a high field and an open scanner. 38 FieldStrength Issue 38 Summer 2009

5 T2-weighted PD-weighted T2 TSE T1 FFE post-contrast Brain Total spine A 33-year-old female complaining of bilateral upper & lower extremity weakness and dizziness. No abnormalities were identified. SENSE.Flex M coil is used for cervical area and Integrated Body coil for thoracic and lumbar areas. Voxel size 1.15 x 1.76 x 4.0 mm in all stations. Panorama HFO exam of a 44-year-old male complaining of dizziness and inability to focus shows a normal brain. Voxel size 0.8 x 100 x 5 mm, scan times 2:58 min. for T2 TSE and 2:12 min. for T1 FFE. The open nature of the scanner and the superb images it creates have differentiated Porter Hospital from others in the area. Panorama is fully capable The Panorama efficiently serves all the hospital s MR needs, she adds. We have not had to turn any patients away or ambulance any patients to a high field scanner, because we haven t encountered any limitations on the Panorama. The open nature of the scanner and the superb images it creates have differentiated Porter Hospital from others in the area, says Dr. Alkadri. People no longer have to travel outside of Porter County to have an open MR exam, he says. A competing hospital recently installed an open scanner, but it s not high field. Amjad Alkadri, MD Amjad Alkadri, MD, Chairman of Imaging at Porter Hospital says that, in his opinion, the quality of the images created with the Panorama is comparable to those from a 1.5T system. The combination of the high field strength and Philips improved coil technology have finally made it possible to create high quality images in an open magnet. A high field open is really an advantage for all patient services in MR, says Dr Alkadri. Before the HFO magnet was introduced, radiologists had to choose between quality and how open the magnet could be. With the HFO magnet, we are now able to offer an open magnet without compromising on image quality. FieldStrength 39