When referring physicians in Southington, Connecticut, grew weary of sending patients out of town to the nearest open MRI unit, they asked the board of directors at the Bradley Memorial campus of the Hospital of Central Connecticut to recommend a new open MRI system for the hospital’s MRI center. As director of imaging services, Michael Perrone was given that assignment directly by the board—and with a sizable amount allocated from the budget, the purchasing decision had long-range clinical and financial ramifications.
“At the end of the day, we based our decision on the ability to market the strongest open scanner available to patients,” Perrone says. The 22-year imaging veteran settled on the 1.2T boreless Oasis system from Hitachi Medical Systems America (Twinsburg, Ohio), which offers high-field imaging combined with boreless architecture.
Marketing to the community—patients and referring physicians alike—took the form of advertising in newspapers, on television, on radio, and in physicians’ trade magazines. Professional marketing agencies wrote the scripts, but not before Perrone approved every word. Claustrophobic and/or obese adult patients also spread the word to friends, family members, and primary-care physicians.
While the power of the magnet cinched the deal, other design elements were factored in as Perrone narrowed down the choice to two prominent brands. “We considered a clamshell-style magnet, where the table went in and out sideways, and you did not have access to both sides of the table as easily as with the other scanner,” he says. “We ended up going with Hitachi’s more traditional design, where the table is just sticking out from the scanner and you have easy access to both sides.”
Community Needs
Bradley Memorial campus in Southington (served by MRI of New Britain) is a small community hospital with 50 beds, but it is no stranger to MRI, having started the service line in the mid-1990s with a mobile 1.5T system that was present two days a week. When open architecture began to gain traction, the team at the hospital was particularly impressed by Hitachi’s 0.7T Altaire system, primarily due to its design: The tabletop allowed for easier movement of patients on and off the table.
The need to perform advanced studies such as diffusion-weighted imaging and contrast-enhanced MR angiography, however, made the hospital more interested in a system with a higher field strength. In the end, it settled on the 1.2T Oasis system, which can perform these types of advanced studies.
Despite its record of strong performance, people who were not familiar with the boreless Oasis technology still had some preconceived notions. “Some radiologists believe it can’t do the work of certain high-field closed scanners,” Perrone says. “After they get a chance to see the images, they definitely change their minds. If you put the images next to the other work we do, you usually can’t tell the difference.”
Radiologists might find it difficult to tell the difference, but in an era of patient-centered imaging, patients can tell the difference. Claustrophobic or large people, in particular, are spared the anxiety of closed MRIs. These patients report their satisfaction, and word inevitably spreads; that satisfaction adds up to high utilization, and heavy use means that routine maintenance is crucial.
“We like to go with the OEM for our service contracts,” Perrone explains. “Especially when you are buying new, you can negotiate up front and do pretty well. You always get a third party wanting to come in, and initially, it may seem less expensive. Over time, however, you are better off with the OEM.”
The new magnet would need to meet ACR® standards with little or no effort. Good abdominal imaging, adequate accommodation of large patients, and highest field strength were all on the wish list. The Oasis offers a TIGRE™ sequence for abdominal imaging, which produces excellent images with a shorter breath-holding time; for neurological exams, scan times are similar to those of a conventional 1.5T system. Another sequence, dubbed RADAR™, is a motion-suppression technique unique to Hitachi. It is helpful for many diagnostic studies, but especially for patients who can’t hold their breath well.
Additional Considerations
Compatibility with the hospital’s existing PACS added up to seamless networking and little or no IT headache. “This stuff is boilerplate now,” Perrone says. “The images are usually compatible. You just have to tell the images where to go.” With technical matters less of a concern, choosing the right open MRI system often comes down to specific needs. Crucial questions include where the unit will be located and what type of clients you are serving. “Here in the Northeast, we see a lot of people who are overweight,” Perrone notes.
Space constraints are always critical, since the typical MRI system usually requires a room measuring 20 by 24 feet. In the case of Bradley Memorial, no additional room modifications were necessary. “We were able to give a strong marketing message that included the widest opening and the highest table weight capacity, and the Oasis could fit in the existing space with existing shielding, which the others could not,” Perrone notes.
Other benefits of the Oasis include a reduced need for sedation and anesthesia when imaging anxious patients. As a result, productivity goes up, in many cases, and better patient throughput improves scheduling and boosts workflow efficiency. Combine these factors with great service, Perrone says, and word of mouth will quickly spread among patients and referring physicians. “The equipment is only 50% of how good your center is going to be,” he observes. “The other 50% depends on staff members.”
Greg Thompson is a contributing writer for ImagingBiz.com