Better Than HDTV

June 16, 2008
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GRAND RAPIDS — This is your brain.

This is your brain on Spectrum Health’s new 3T magnetic resonance imaging machine.

“Cost of the exam is the same as the other scan, and yet the images are just stunning,” said Dr. Brad Betz, a pediatric radiologist who was involved in bringing the advanced technology to Grand Rapids. “The anatomic detail we have with 3T is just amazing.”

MRI has been around for about 30 years. It uses high-strength magnetic fields and radio waves to capture a digital view of soft tissue inside the body, unlike X-rays or CT scans, which use radiation and give the best view of bones. Early MRIs started out at 0.6 tesla, the unit that measures magnetic field strength. Technological improvements eventually made 1.5T the industry standard.

In the past several years, 3T MRIs have been moving out of research and into clinical use, as health care providers replace older machines. This month, one of the $2.77 million Signa HDx 3T machines from GE Healthcare has taken up residence in a copper-lined, ground floor room in Spectrum’s Butterworth Hospital. It will be joined by a twin in the fall, said Larry Genzink, director of radiology services.

The digital images are read and manipulated using GE’s complex software that can turn the 3T images into a 3D view, and spin and rotate them as needed, said Steve Zomberg, clinical application coordinator.

Betz said the 3T is especially useful for brain studies, breast cancer and studies of muscles and bones, particularly in cases of trauma to large joints such as knees and ankles. Zomberg said functional MRI studies can be combined with enhanced MRI, in which a solution has been used in the patient to increase contrast between different types of tissue, and the resulting images are then relayed to a computer in the operating room during surgery.

“We can use it to map out areas of the brain that control movement, language and memory activities, and that really has been shown to have a positive impact in neurosurgical outcomes,” Betz said.

With the powerful magnet’s greater speed, doctors can see brain function and blood flow, Betz said. That is a better tool in many cases, such as stroke management, epilepsy and vascular overgrowth in the brain seen in children, he said.

“Because the magnet has more power, we can use that for greater speed. It lets us go beyond just seeing how the brain looks; it lets us evaluate how the brain functions,” he said. “So we have a developing program here to take advantage of that speed with functional MRI.”

It can even be used to analyze the chemical content of an abnormality, which could save a patient from surgery, he added.

The greater clarity not only provides a clearer view for radiologists to identify abnormalities, it also gives greater assurance in ruling out a potential problem, Betz said.

“MRI has really revolutionized the way breast evaluations are done with known cancer,” he said. “It’s the best test we have to determine if there are other areas of involvement.”

It’s also useful in screening for breast cancer in certain cases, he added.

Imaging of all sorts is a significant source of income for hospitals today. According to an analysis by Alliance for Health, MRI procedures alone produce 3.6 percent of hospital revenues, and are responsible for 1.8 percent of operating costs.

In the first review under the Certificate of Need process, the Alliance for Health found the average charge for each of the 32,000 MRIs done at the seven locations in Spectrum Health’s system is $1,561. Spectrum Health expected to receive an average of $850 per procedure from various insurance companies and government programs, according to the analysis.

Spectrum Health’s MRI machines, located at Butterworth, Blodgett and the South and West pavilions, plus one being moved from an Advanced Radiology location to the Lemmen-Holton Cancer Pavilion, are operated around the clock Monday through Friday and 16 hours per day on weekends, with personnel of more than 20 full-time equivalents.

A typical study requires the patient to lay still for 45 minutes, Zomberg said.

Still, some medical imaging is better left to 1.5T MRIs, CT scans and X-rays, Betz said. Nonspecific complaints that may involve the brain, broken bones and many abdominal cases can adequately be seen with the older — and cheaper — technology, he said. Patients with metal in their bodies, such as a pacemaker, are not good candidates for MRIs, he said. On the other hand, use of an MRI minimizes exposure to radiation, which could be important for some patients.

“This really is a tremendous opportunity for us to improve the health care of our community in West Michigan,” Betz added.

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