Space the final frontier. The greatest challenge to MRI is the interior space inside the scanner. The newest technology is the 70 cm bore. This is almost 30 inches inside and truly is the greatest advance in MRI since phased array surface coils and parallel imaging. I think the three newest software advances are BLADE which is a revolutionary way to freeze patient motion. Even if you are moving inside the scanner we can get sharp pictures. This changes everything! Most doctors have no clue about the advantage of BLADE. Ask your physician about BLADE.
The second advantage is NATIVE - which is a revolutionary new way to get pictures of the artery without contrast. Pioneered by the Toshiba corporation and Dr. Miyazaki Siemens perfected this sequence on their scanner and it is a godsend. I prefer to do my studies without contrast injection as much as possible. Already we use safe MR contrast (www.safecontrast.com) in less than 20% of cases. I prefer to do all studies without contrast first and only do them with contrast when I think we need it. When we do angiography we used contrast for peripheral angiography 100% of the time with the older technology. With this new sequence we can first try non contrast methods in the body. If we get a good picture without contrast - we save the patient the use of unnecessary contrast. Software is the difference. It also saves money. In the brain and neck we can always do non contrast MRA first. I highly recommend that if you can do a test without contrast - this is the way we should do it. I want the patients to benefit from new technology. This is an example where new technology actually saves time, money and patient lives.
The last new sequence is REVEAL - which reveals cancers by making them stand out like lightbulbs. It is about 85% sensitive so it is not 100% - no test is, but when added to the 90%-95% sensitivity of MRI it helps us be more accurate in the separation of benign from malignant tumors. A recent study from HOPKINS about REVEAL and breast MR shows that it significantly improves the specificity of the exam. Ask if your facility has REVEAL. It is very helpful in liver and pacreas and other GI small bowel tumors as well.
Please ask your facility these three questions.
What year was your magnet installed ?- the older the magnet - the more likely it will not be up to date. Ours went live in 2007 (3t) and Dec 24th 2008 (Espree).
What contrast do they use? Only go to them if they use Multihance at 1.5T or Prohance at 3T. The contrast they inject into you is a direct indication how much the doctor cares about you. If your doctor uses anything else it means he is not totally informed about contrast. www.safecontrast.com
Does the facility have a doctor on site to monitor your scan? Most facilities will possibly lie to you about this. When you get there ask to see the doctor. check his credentials. At our facility Dr. Philip W Chao monitors all the scans as your are being scanned. Once is a while he is called away but he makes a very significnat attempt to be there for every scan performed. We can give you your MRI results as your leave our facility. You might have to wait 15 minutes. He has a double fellowship in MRI. He was the body MRI fellow at University of Pennsylvania and also a neuroradiology fellow there. He is one of the few double MRI fellowship physicians in the world. He is an expert on musculoskeletal MRI. He has read 380000 MRI studies. Most of them in Delaware.
We installed our scanner for the claustrophobic and large patient, Finally REALLY OPEN MRI. Most OPEN MRIs are narrow and not OPEN at all. They are much more narrow than our truly OPEN MRI system. Our OPEN MRI is the world's most spacious. SPACE IS THE FINAL FRONTIER for MRI.
According to the Centers for Disease Control and Prevention (CDC), more than 60 million Americans are obese — a significant statistic considering that research has linked obesity to more than 15 serious health conditions.
Obesity is a growing healthcare epidemic in the United States, but it’s also causing a serious problem in medical imaging by interfering with a doctor’s ability to obtain accurate, informative diagnostic images.
Obese patients, who often require diagnostic imaging procedures to determine proper treatment, cannot fit through the restrictive opening of traditional MRI scanners. As a result, their physicians send them to “open” MRI scanners, which feature a wider opening, or bore, believeing that they can accommodate larger patients. But this is actually untrue. Many large patients go to the OPEN MRI and get rejected due to size.
In addition, open MRI scanners often sacrifice magnet strength to provide more space for patients. The more space open MRI scanners provide, the weaker the magnet becomes. The images suffer and the patient also gets false reassurance.
The result is a serious dilemma that frustrates both doctors and patients. Although obese patients can fit into an open MRI scanner, the weaker magnet often produces images that are significantly less effective in assisting the physician’s diagnosis. We have seen (unfortunately) many instances where the OPEN MRI missed fractures, breast cancer, brain aneurysms, brain tumors and lesions all because of inferior image quality. So quality does matter. SIZE DOES MATTER in MRI. And if you are a large patient you must go to a facility that is properly equipped to image large and small patients.
The Siemens Espree scanner is 1.5T. It is not a dumbed down weaker magnet for larger patients. It is the most comfortable and least claustrophobic scanner in the world. It is the largest widest OPEN BORE magnet in the world. OPEN BORE MRI is the best OPEN MRI. OPEN BORE is 70 cm. The space in front of the patient is about 12 inches. This is compared to about 3-4 inches in most other scanners. That extra seven inches makes a huge difference. Also when we scan the lumbar spine your head can be outside the magnet if you are taller than 5'2". This is a significant advantage. Head and lumbar studies are the two most common CNS procedures. For knee, foot, pelvis and ankle MRI studies your head will be outside the scanner and in our system you can watch a plasma TV mounted above the scanner. Our office is disgned to be the least claustrophobic MRI experience possible. We also think this scanner is ideal for the claustrophobic or anxious patient or small child that might need an MRI. This scanner has all of the new advanced pulse sequences offered by Siemens. REVEAL diffusion weight imaging shows more pancreas and liver or abdominal cancers. It is particularly good to detect colon or small bowel cancers. 4D Twist and ASL and allow us to create MRA (magnetic resonance angiograms) with little or no contrast. In the past year the use of contrast has been tempered by the possibility of nepgrogenic system sclerosis. In our attempts to protect our patients we always screen the BUN and Creatinine in all patient above the age of 60. We actually do it for free using our ISTAT-1 device which gives an instant result. We are the onl;y facility that cares enough to do this for free. We can also check the glomerular filtration rate using a 24 hour unirne collection but this is really not necessary. Any patient with reduced renal function should let us know. We use Prohance which is the only cyclical Gadolinium based contrast sold in the U.S. (www.safecontrast.com) Our facility combines the OPEN BORE ESPREE with an advanced Siemens 3T Trio scanner. The two scanners combined is the best MRI facility in Delaware. On the 3T scanner we prefer to use 1/2 dose contrast for those patients. Using 4D Twist we can still get a good angiogram using 1/2 dose contrast. On our 3T scanner we can use 1/2 dose contrast and get the same results as full dose contrast because 3T is twice as sensitive to the contrast material. At 1.5T we have to use single dose. But I always recommend to all patients that we consider why we are using contrast and if it will help us. On the new scanner we purchased the NATIVE angiography option which lets us get MR angiograms without any injected contrast. The only drawback is that it might fail to give us diagnostic pictures once in a while. I am estimating about 90-% success rate and not giving contrast. Please check our sister websites: www.3t-mri.net www.mriconsultants.net www.3tbreastmri.com www.safecontrast.com
Now obese patients have access to the quality imaging services they need. Siemens’ MAGNETOM Espree™ 1.5T open-bore MRI delivers a new approach to open MRI.
Taking its inspiration from the blueprint of a CT scanner, Siemens engineers designed the first open-bore MRI that provides true comfort and quality. The Siemens 3T Verio came a few years later. Both scanners have the advanced 70 cm OPEN BORE DESIGN.
The opening of the Espree, almost 30 inches in diameter, provides a full foot of space above the patient’s head — much more than traditional MRI scanners or even the best open MRI scanners. And its extremely short bore enables many exams to be performed with the patient’s head completely outside the magnet bore. This is the least claustrophobic scanner in the world.
Obese patients find the extra space comfortable. However, doctors find the Espree’s powerful “high-field” magnet comforting. At 1.5 Tesla, the magnet provides the strength needed to obtain quality diagnostic images. The image quality on our 18 channel Espree is impressive.
Drawing on Siemens’ innovative Tim™ (Total imaging matrix) technology, the Espree delivers high quality whole-body images while reducing exam times.
A New Level of Comfort and Speed
More Headroom
· Patients enjoy generous face space – about a foot above their nose.
· There’s also more elbow room – more than 27 inches from side to side for a more comfortable shoulder, chest or upper abdomen scan.
Friendly for Everyone
· Starting and finishing the exam is as easy as lying down and getting up from your couch.
· Bodily contact during the scan is possible, for example, holding a child’s hand for comfort and assurance.
Shorter Exam Times
· The more powerful 1.5 Tesla magnet offers shorter exam times, which means you’re in and out in no time.
· Thanks to revolutionary Tim technology, time consuming head-to-toe exams can be performed in a single pass. And revolutinary BLADE software makes sure the images are sharp.
Better Quality for More Patients
· For obese patients, the Espree now offers the quality exam they require, but could not get before. With up to four times more power over low-field open magnets, obese patients now have access to a full-service MRI.
· Also the Espree's table is now capable of handling 550 lbs. in both the horizontal and vertical direction.
We also pride ourself on patient care. People have no idea about MRI or the contrast we use. We use the safest contrast for MRI - Prohance. There are 5 gadolinium based contrasts marketed in the US. We use the one which is the most stable and both theoretically and in practice has the least cases of Nephrogenic Systemic Sclerosis (Fibrosis) - abbreviated as NSF. NSF is a debilitating skin thickening which occurs in patients with renal failure and Gadolinium use. It has not yet been shown to occur in patients with normal renal function. However, NSF has never been described using Prohance alone. Prohance has the tighest bound Gadolinium ion of all the contrasts we use. It is a bit more costly but we think your safety is worth it and we use Prohance for our patients. There is one documented case of NSF with Prohance plus Magnevist. So the blame is being placed on Magnevist in that patient. But clearly Prohance has a better safety profile and has the highest thermal stability of marketed MRI contrasts. We do this because we care!
Call us - 302-472-2378 (BEST) The Best OPEN MRI in Delaware. The widest MRI in the world. The least claustrophobic MRI in the world. 94% of patients prefer the Siemens Espree to any other MRI system. If you have had a scan on our MRI system you will not want to have a scan on any other. WATCH TV DURING YOUR SCAN 60% of the time.
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