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© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Mihály Aradi MD., Ph.D
Reducing MRI waiting lists:
Aperto Lucent
Affordable open MRI
under diagnostic pressure
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
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
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
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
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Balancing cost, quality, reality
More MRI machines, how?
open
closed
0,2T
superconducting
permanent magnet
gradient system
coils
1,5T
3T
noise
comfort
maintenance
DTI
money
etc.
fMRI
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
- 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
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
A feasible alternative
Aperto Lucent: Balanced cost and quality in reality.
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
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
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Easy installation,easy maintenance. .
Low running costs
230V power line
Permanent magnet technology
No helium – cryogen free
No extended building works needed
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
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)
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
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)
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
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,
but:
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Image quality
1,5T or 0,4T Which one?
? T ? T 1.5T 0.4 T
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Brain 5mm gapless protocol- The Hitachi 0.4T Aperto Lucent in action
T2 w T1 w FLAIR
DWI TOF PC
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Brain coronal 3D T1 w contrast - The Hitachi 0.4T Aperto Lucent in action
After Multi Planar reconstruction
Coronal 2mm
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
T2 w FLAIR
DWI
Brain: White matter lesion- The Hitachi 0.4T Aperto Lucent in action
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Neck – Retropharyngeal abscess (4y)- The Hitachi 0.4T Aperto Lucent in action
T2w -RADAR STIR-RADAR STIR-RADAR
DWI –ADC map
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Cervical spine - The Hitachi 0.4T Aperto Lucent in action
T2w T1w
STIR
GRE –T2(*)w
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Thoraco-Lumbar spine The Hitachi 0.4T Aperto Lucent in action
T2w T1w T2w
T2w
STIR
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Knee – LCL lesion - The Hitachi 0.4T Aperto Lucent in action
T1w STIR PD FS
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Shoulder – Supra/infraspinatal tear- The Hitachi 0.4T Aperto Lucent in action
STIR
T2w
T1w
STIR
PD FS
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Wrist –SLD (scapholunate dissociation) -The Hitachi 0.4T Aperto Lucent in action
T2*w T2w
STIR T1w
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Hip, ankle,elbow The Hitachi 0.4T Aperto Lucent in action
T2w
PD FS
T2*
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Tibia – Non ossifying fibroma (9y)- The Hitachi 0.4T Aperto Lucent in action
T1 w PD FS
PD FS T1 w
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
STIR
DWI-ADC
Prostate - The Hitachi 0.4T Aperto Lucent in action
T2w T2w
T1w WFS T1 ce.
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Female pelvis- The Hitachi 0.4T Aperto Lucent in action
T2w T2w
STIR
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Rectal cancer –gel distension The Hitachi 0.4T Aperto Lucent in action
STIR
T2w
STIR
WFS T1 ce.
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Abdomen /Liver- The Hitachi 0.4T Aperto Lucent in action
T1w T2w T1w
WFS T1w MRCP MRCP
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Breast implant The Hitachi 0.4T Aperto Lucent in action
T2w - normal STIR- 1mm rupture
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Breast – Fibroadenomatosis - The Hitachi 0.4T Aperto Lucent in action
Type I enhancement
Dynamic contrast enhanced T1w
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
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?
© Hitachi Medical Systems Europe 2015. All rights reserved. Hitachi Medical Systems America, Inc. 2014 97334v1
Thank you for your kind attention!
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