From Massachusetts General Hospital
By Terri Janos, September 10, 2020
- MRI
is unparalleled as an imaging technology for detecting disease or injury
to the brain and central nervous system
- Traditional
MRI units are immobile behemoths containing large, heavy magnets
- New
portable MRI device can be safely used at bedside in complex clinical care
settings to evaluate critically-ill patients
“This is an enabling
technology to bring non-invasive neuroimaging with the soft-tissue contrast and
all of those things neurologists have been relying on for years to environments
where it otherwise would not be possible.”
Matthew S. Rosen, PhD
Athinoula A. Martinos Center for Biomedical Imaging
Massachusetts General Hospital
A portable, low-field magnetic resonance imaging (MRI)
device can be safely used at bedside in complex clinical care settings to
evaluate critically-ill patients for suspected stroke, traumatic brain injury
(TBI), or other neurological problems, results of a proof-of-concept study
show.
“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,” says W. Taylor Kimberly, MD, PhD, chief of the division of
Neurocritical Care at Massachusetts General Hospital (MGH).
Among 30 patients in a the Yale Neuroscience intensive care unit (ICU), the bedside MRI system produced important neuroimaging findings in 29, and the findings jibed with conventional radiology findings in all but one case, found Kimberly, Matthew S. Rosen, PhD, director of the Low Field MRI and Hyperpolarized Media Lab and co-Director of the Center for Machine Learning at the Athinoula A. Martinos Center for Biomedical Imaging at MGH, and colleagues at Yale University in New Haven, Connecticut.
In addition, the bedside MRI detected abnormal neurologic
findings in eight of 20 patients with altered mental status in a COVID-19 ICU.
The investigators report their finding online in the
journal JAMA Neurology..
MRI is unparalleled as an imaging technology for detecting
disease or injury to the brain and central nervous system, but traditional MRI
units are immobile behemoths containing large, heavy magnets made of
super-conducting material that requires super-cooling with liquid nitrogen or
helium. In addition, the high magnetic field strengths of standard MRI units –
1.5 to 3 Tesla – require careful screening of patients to ensure that there are
no ferrous metals in or on their bodies (such as medical implants, insulin
pumps, or shrapnel fragments) that could cause serious injury during imaging,
and any medical equipment containing ferromagnetic components must be kept out
of the MRI room.
In contrast, the mobile MRI system trades some of the
high-resolution imaging quality of a fixed MRI for portability and lower cost.
The device contains a 0.064 Tesla permanent magnet that does not require
cooling, and can be plugged into a single 110 volt, 15 amp outlet, making it
suitable for use in settings such as emergency departments, mobile stroke
units, and regions with limited medical resources. The lower strength magnetic
field does not interfere with metal-containing equipment in patient care units.
The system grew out of work Rosen began more than a decade
ago at the request of the U.S. Department of Defense (DoD). DoD staff were
concerned that soldiers with battlefield injuries might have shrapnel in their
heads that could cause serious injury or death if they were placed into a
high-field scanner.
“This is an enabling technology to bring non-invasive
neuroimaging with the soft-tissue contrast and all of those things neurologists
have been relying on for years to environments where it otherwise would not be
possible,” Rosen says.
Co-authors of the study are Kevin N. Sheth, MD, Mercy H.
Mazurek, BS, Matthew M. Yuen, BA, Bradley A. Cahn, BS, Jill T. Shah, BA,
Adrienne Ward, RN, Jennifer A. Kim, MD, PhD, Emily J. Gilmore, MD, Guido J.
Falcone, MD, ScD, MPH, Nils Petersen, MD, PhD, Kevin T. Gobeske, MD, PhD, MPH,
Firas Kaddouh, MD, David Y. Hwang, MD, Joseph Schindler, MD, Lauren Sansing,
MD, MS, Charles Matouk, MD, Jonathan Rothberg, PhD, Gordon Sze, MD, Jonathan
Siner, MD, and Serena Spudich, MD, MA, all of Yale and/or Yale New Haven
Hospital.
The study was supported by funding from the American Heart
Association. The portable MRI system is made by Hyperfine Research Inc. Rosen
and Rothberg co-founded the company, which licenses some technology from MGH.
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