Reducing MRI waiting lists: Aperto Lucent Affordable open ... · -PhD.-Quantitative MRI in...

Mihály Aradi MD., Ph.D

Reducing MRI waiting lists:

Aperto Lucent

Affordable open MRI

under diagnostic pressure

Introduction: the speaker

Me and the MRI:

-MD., radiologist fellow in County Hospital Of Zala (Hungary)

-PhD.-Quantitative MRI in experimental and applied clinical research

-operator level experience with 0.3T-9.4T MR machines

-most publications on 3T, Matlab® software basic level programming

-recently using 0.4T(Aperto Lucent) and 1.5T on daily basis

-head of a small private Diagnostic Center -Integrity MRI :

Aperto Lucent 0.4T MRI, Arietta V70 US, XGEO GU60 Xray

Myriad tissue contrast variations

Structural, functional and metabolical information

High resolution 2/3D

Non ionizing -”nil nocere”

Expensive Not enough capacity Long waiting lists Missed timeframe Missed diagnosis

Possibilities vs. reality

Advanced therapies need advanced diagnostics

The most advanced Imaging tool: MRI

More MRI capacity needed more MRI machine

The problem of the 21st century medicine

Balancing cost, quality, reality

More MRI machines, how?

closed

superconducting

permanent magnet

gradient system

comfort

maintenance

- What do I want/have to do?

NHS/private, expected patient number

special imaging purposes,image quality etc.

Buying MRI:

the money I have / will have

the reputation I have / will have

- What can I do?

Think! The decision is yours

and so are the consequences

A feasible alternative

Aperto Lucent: Balanced cost and quality in reality.

The balance of Aperto Lucent

Comfort Cost Quality

- 320°open gentry - low noise - motorized patient table - friendly GUI

- permanent magnet - no helium - no water cooling - low intallation and maintenance cost - low power consumption

- 0.4T advanced magnet - powerful gradient system - superShim - dedicated coils - dedicated sequences - advanced signal processing

Easy installation,easy maintenance. .

Low running costs

230V power line

Permanent magnet technology

No helium – cryogen free

No extended building works needed

Return on investment.

NHS patients

Scan 14 patients per day and yield

a return of £ 310,000 profit a year

Example based on APERTO Lucent: calculated on 220 working days with a reimbursement fee of £145 per patient

(includes capital costs, electricity, service costs and 1 FTE radiographer)

Return on investment.

NHS + private patients

Scan 14 patients per day and yield

a return of £ 750,000 profit a year

Example based on APERTO Lucent: calculated on 220 working days with a reimbursement fee of £250 per patient

(includes capital costs, electricity, service costs and 1 FTE radiographer)

Reality

How does Aperto Lucent perform in real practice?

Can image quality really live up to the mark?

Was it for worth for Integrity MRI to buy an Aperto Lucent? (If we could go back in time would we buy it again?)

Ok, enough of the money,

Image quality

1,5T or 0,4T Which one?

? T ? T 1.5T 0.4 T

Brain 5mm gapless protocol- The Hitachi 0.4T Aperto Lucent in action

T2 w T1 w FLAIR

DWI TOF PC

Brain coronal 3D T1 w contrast - The Hitachi 0.4T Aperto Lucent in action

After Multi Planar reconstruction

Coronal 2mm

T2 w FLAIR

Brain: White matter lesion- The Hitachi 0.4T Aperto Lucent in action

Neck – Retropharyngeal abscess (4y)- The Hitachi 0.4T Aperto Lucent in action

T2w -RADAR STIR-RADAR STIR-RADAR

DWI –ADC map

Cervical spine - The Hitachi 0.4T Aperto Lucent in action

T2w T1w

GRE –T2(*)w

Thoraco-Lumbar spine The Hitachi 0.4T Aperto Lucent in action

T2w T1w T2w

Knee – LCL lesion - The Hitachi 0.4T Aperto Lucent in action

T1w STIR PD FS

Shoulder – Supra/infraspinatal tear- The Hitachi 0.4T Aperto Lucent in action

Wrist –SLD (scapholunate dissociation) -The Hitachi 0.4T Aperto Lucent in action

T2*w T2w

STIR T1w

Hip, ankle,elbow The Hitachi 0.4T Aperto Lucent in action

Tibia – Non ossifying fibroma (9y)- The Hitachi 0.4T Aperto Lucent in action

T1 w PD FS

PD FS T1 w

DWI-ADC

Prostate - The Hitachi 0.4T Aperto Lucent in action

T2w T2w

T1w WFS T1 ce.

Female pelvis- The Hitachi 0.4T Aperto Lucent in action

T2w T2w

Rectal cancer –gel distension The Hitachi 0.4T Aperto Lucent in action

WFS T1 ce.

Abdomen /Liver- The Hitachi 0.4T Aperto Lucent in action

T1w T2w T1w

WFS T1w MRCP MRCP

Breast implant The Hitachi 0.4T Aperto Lucent in action

T2w - normal STIR- 1mm rupture

Breast – Fibroadenomatosis - The Hitachi 0.4T Aperto Lucent in action

Type I enhancement

Dynamic contrast enhanced T1w

All the MR images presented were obtained on our 0.4 T Aperto Lucent at the Integrity MRI Diagnostic Center in Hungary. It reflects one year experience with the machine. Protocols were fine tuned by us, and still advancing.

Integrity MRI Hungary - The Hitachi 0.4T Aperto Lucent in action

Does image quality of 0.4T Aperto Lucent live up to the mark or not?

Thank you for your kind attention!

Reducing MRI waiting lists: Aperto Lucent Affordable open ... · -PhD.-Quantitative MRI in...

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