• The Voice of Your Colleague

How Dedicated MRI impacts an Imaging Center needs - the Radiologist’s Experience

Richard J. Rolfes

Please give us a short overview of your Imaging/Radiology department.
As one of the most experienced teleradiology providers in the USA,Proscan Imaging operates 29 Imaging Centers in seven states with primary focus on MR Imaging. Proscan Imaging also provides imaging supervision of all modalities and reading services for several hundred specialty physician practices in all 50 states and beyond. We are every-thing but the average radiology department!

You already have Conventional MRI within your facility – why did you introduce Esaote Dedicated MRI to your installed base?

Adding Esaote Dedicated MRI to our existing imaging centers gave us access to novel imaging capabilities and enhanced imaging center throughput. Specifically, we added an Esaote Dedicated Weight-Bearing G-scan MRI to one of our markets that already had all other modalities, further increasing our competitiveness in that market as the only provider of Weight-Bearing MR Imaging. Additionally, adding an Esaote O-scan to one of our backlogged high-field MRI centers allowed us to improve weekly throughput while maintaining near high-field image quality on our Musculoskeletal (MSK) extremity exams, while minimizing capital expenditure by avoiding the expense of a second high field system with cryogens, or a major facility buildout & remodel.

Once you decided for a Dedicated MRI system, how did you go about to choosing a suitable system, and what were the main requirements?

After reading exams from our customers’ Esaote O-scan Extremity MRI images for years, we already knew that the O-scan had the perfect combination of near-high field image quality, small footprint with uncomplicated siting, and attractive price point. We really did not look at other vendors. And of course, the Esaote G-scan is best in class for Weight-Bearing MR Imaging. Image quality was the main requirement for both, which Esaote’s state of the art software & coil technology delivers.

How long did it take from the idea of installing an MRI to have it operational?

About 9 months.

How easy, or difficult, was the installation process?

Very easy. The magnet and imaging suite were sited relatively quickly within the existing building space, with only relatively minor building changes.

What has been the impact to your practice since you installed the dedicated MRI?

With the O-scan absorbing much of the Extremity MSK MRI, our scheduled case backlog in that center was eliminated in short order, while freeing up our high-field MRI for Neuro, Body & Spine work. Our excess capacity now allows us to resume marketing efforts to further increase overall scan volume for our center. The G-scan has allowed us to offer novel imaging capabilities and focus on our spine providers, including spine surgeons, physiatrists and chiropractors, as a new niche of business for our imaging center in that market.

What are the main areas of Clinical impact that the Dedicated MRI can fulfil?

The G-scan, of course, has greatest impact in spine imaging, and is increasingly preferred for practices focusing on personal injury work due to the increased sensitivity of weight-bearing imaging over standard supine imaging for certain types of pathology. The O-scan is the perfect solution for offloading extremity MSK imaging from a full or overloaded high field scanner, having near-high field image quality and virtually zero issues with claustrophobia. In most instances, there is no meaningful difference in image quality. This is true for all types of extremity exams.
For example, in upper extremity, we perform many high-quality finger, thumb and wrist exams on the O-scan, and we also read for many hand specialists, some of whom have this equipment in their own office which further attests to the excellent image quality. Similarly, in the lower extremity, we read dozens of forefoot/toe O-scan exams daily, including many from podiatrists and orthopaedic foot surgeons having in-office equipment and confidently using these images and our reports as a reliable roadmap for surgery including plantar plate repairs.

We have touched several important arguments, maybe some points of advice to your colleagues that are evaluating this option as a clinical solution?

Although low field strength, the coil technology and software on these Esaote MRI systems is state of the art, and dramatically improved over low field systems from the 1990’s and early 2000’s.
In particular, the 3D isotropic imaging is exceptional and serves to level the playing field of image quality between high and low field equipment. Before committing to the purchase of high field equipment with cryogen costs and build out requirements, it behooves any group to consider Esaote’s systems.

You opted for a dedicated MRI system instead of a traditional MRI. After extensive use, why does the Esaote O-scan dedicated MRI system meet your needs and what is your opinion on the image quality and ease of use?

The exceptional, near-high field image quality of the O Scan is the perfect extremity scanner to offload MSK exams from a high field scanner, eliminating backlog and increasing daily case throughput with the low capital expenditure and ongoing fixed costs. The system is extremely easy to use. In a specialist practice with in-office imaging, an X-ray tech or MA can be trained on the system in just a few days.

Coming to the economics part of the equation, I think that many of your colleagues would be very interested to have MRI in-house, but they probably are worried about the return on investment. How did this work out for your practice?

After installation, we were able to exceed the break even point immediately and at a much lower volume threshold than a more expensive high field system. In retrospect, keeping our center costs down was extremely valuable during the COVID shutdowns. One should always consider worst case scenarios, but no one saw that coming!

What one thing would you tell anyone unsure of why to invest in Dedicated MRI?

With the Esaote O-scan, field strength is no longer an issue when considering equipment for extremity imaging. Every business savvy radiology group or specialist should consider adding this equipment to their arsenal.

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