Medical imaging has come a long way, having endured many trials and tribulations over time. Since Wilhelm Röntgen won the Nobel Prize in 1901 for his expansive contributions to physics and the eventual development of X-rays, radiology and imaging technology has grown to be a sophisticated and essential component of modern medicine. Today, the practice of healthcare is incomplete without the intricate value provided by various imaging methods, including Computerized Tomography (CT) scans, Ultrasound, and Magnetic Resonance Imaging (MRI).
The MRI specifically has been a relatively recent imaging technique, and utilizes powerful magnets to produce detailed anatomical images. MRI has many advantages; according to Radiopedia, “MRI images demonstrate superior soft-tissue contrast as compared to CT scans and plain radiographs making it the ideal examination of the brain, spine, joints, and other soft tissue body parts.” However, one disadvantage is that MRI scans often take longer to acquire than CT scans, and can’t be done in a portable manner, like portable X-rays.
More importantly, the FDA describes the risk of the strong magnetic field that is involved in MRI technology: “patients with implanted medical devices should not receive an MRI exam unless the implanted medical device has been positively identified as MR Safe or MR Conditional. An MR Safe device is nonmagnetic, contains no metal, does not conduct electricity and poses no known hazards in all MR environments. An MR Conditional device may be used safely only within an MR environment that matches its conditions of safe use. Any device with an unknown MRI safety status should be assumed to be MR Unsafe.”
The FDA also warns that the surrounding environment is also at risk: “The strong, static magnetic field will attract magnetic objects (from small items such as keys and cell phones, to large, heavy items such as oxygen tanks and floor buffers) and may cause damage to the scanner or injury to the patient or medical professionals if those objects become projectiles. Careful screening of people and objects entering the MR environment is critical to ensure nothing enters the magnet area that may become a projectile.”
However, a new venture may help reshape the way MRI is used and its future applications. Last week, Massachusetts General Hospital (MGH) announced the potential viability of a “portable, low-field magnetic resonance imaging (MRI) device.” In the press release, W. Taylor Kimberly, MD, PhD, Chief of the division of Neurocritical Care at MGH, explains: “How can a portable low-field device that operates on a standard electrical plug change the paradigm? It can bring the MRI to the bedside, and it can do so in a hospital environment where there is metallic material nearby, and can do it safely because the magnetic field strength is lower.”
According to the release, the investigators behind the study have reported their preliminary findings in the prestigious medical journal, JAMA Neurology. In the paper, the authors state: “In patients without COVID-19 (n = 30), neuroimaging findings were detected in 29 cases (97%). Twenty-nine patients (97%) also received conventional imaging (computed tomography, 6 patients; MRI, 23 patients). All POC [point-of-care] MRI findings were in agreement with available conventional radiology reports, except that 1 patient had a diffuse subarachnoid hemorrhage that was not observed on POC MRI(κ = 0.65; P < .001).” They also go on to provide findings in patients with Covid-19.
Regarding the overall study, the authors state that “[t]hese findings demonstrate for the first time (to our knowledge) the deployment of a portable MRI to the bedside of patients with critical illness. In acute neurological settings, it is well established that noninvasive, time-sensitive neuroimaging is the cornerstone of triage and treatment pathways.”
They conclude that “this experience demonstrates that low-field, portable MRI can be deployed successfully into intensive care settings. This approach may hold promise for portable assessment of neurological injury in other scenarios, including the emergency department, mobile stroke units, and resource-limited environments.”
Ultimately, only time and more evidence-based investigation will truly tell what the viability, accuracy, feasibility, and potential problems will be with the use of this new technology.
Indeed, the world is moving towards more portable modalities of imaging. For example, in the last few years, the use of ultrasound technology has exponentially grown, with more companies offering portable solutions and promoting the use of point-of-care ultrasounds (“POCUS”). Even formalized fellowship training programs are now available for physicians to gain more specialized clinical acumen and experience in these areas. This is also all in the context of artificial intelligence technology, which is slowly gaining traction in the field of radiology.
However, just as with anything else that impacts patient care, clinicians, consumers, regulatory leaders, and the scientific community must maintain a high level of scrutiny to ensure that these new and emerging technologies have been thoroughly tested, supported, and proven, in order to ultimately maintain the highest standard of patient safety.
The content of this article is not implied to be and should not be relied on or substituted for professional medical advice, diagnosis or treatment by any means, and is not written or intended as such. This content is for information and news purposes only. Consult with a trained medical professional for medical advice.