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Posts Tagged ‘MRI’

People with back pain/problems can now skip an MRI Scan, and save the MRI Cost, a study report

MRI machine

In pain clinics, steroid shots are quite common for patients with back-pain; about the MRI cost back scans, with contrast-agent – the rates are high; in care-units, physicians routinely order an MRI scan, prior the therapy.

An MRI scanner uses powerful magnets for more detailed images, for internal anatomy and physiology; and therefore the MRI machine costs are high; would vary from one supplier to the other, per different product attributes; and, similarly for the procedures, about MRI cost brain scans, back, knee, or more – it would vary for, with and without contrast-enhanced procedures.

And, if you go through world-wide statistics, you would realize, be it MRI scan cost in US, and/or other countries, the figures may not be that pocket-friendly, for the patients; Dr. Steven Cohen (Johns Hopkins University School of Medicine) says, $1,500 each for the scans is not justified, and not necessary when the imaging offers a little chance to avoid a procedure (citing steroid injections from the doctors for back-pain patients), lessen complexities, or ameliorate outcomes.

Of the study results (led by Dr. Steven Cohen), the research team found that about 132 patients that have had an MRI before were being given steroid injections, by doctors, without even clarifying the test-results.

He added further that, by skipping the procedure (in advance), it could save patients significant MRI cost, and time; please refer the Archives of Internal Medicine, for more studies and observations of Dr. Steven Cohen in patients with sciatica and other.

We understand, the higher MRI cost for back, knee or brain scan definitely is a matter of concern for many out there; but then, the non-invasive imaging approach is safer than other imaging methods (X-ray, CT etc.) that use ionizing radiation.

It is like, ‘too-much’ of unneeded examinations (any) always add-up to medical bills, and that should be avoided, by the doctors.

So, be it MRI cost knee, brain, back or other: for the procedures, or information about new and refurbished equipment providers, MRI Machine Costs - people of the healthcare community can always be of good help, and you can join the MedicExchange community, for more knowledge and information.

The tremendous scope the non-invasive MRI technology has, is not new to any; let us take a quick peek, again, but then, for more detailed versions, in the coming year!

MRI Scanner

For people in the healthcare sector, the term MRI Scans or MRI Scanning (Magnetic Resonance Imaging scan) is not at all new; when the healthcare sector is growing like anything, with new booming technologies, for care and treatment, MRI screening definitely is preferred more than others of the slot (CT, X-Ray), to keep patients away from ionizing radiation effects.

And then, those who joined late, about the technology (during MRI screening), nuclear magnetic resonance/reverberations are being used to create two-dimensional/three-dimensional proton-density images, to visualize internal body structures, viz. muscles, bones, organs etc.

Well, we all know the power of magnet, and then superconducting magnets in MRI scanners are quite common, for various medical applications; gone are the days, when without knowing the main cause of diseases in people, the treatments were used to be given, and the results then were increased death rate; but, with the emerging need of the market, and with the upsurge of imaging technology, various medical imaging approaches in Radiology definitely have given a sign of hope for the patients, for early detection of disorders/diseases that patients are being affected with.

Be it human anatomy, or physiology, the non-invasive MRI scanning definitely helps; whether an MRI scan head/brain, knee, or MRI scan breast – everything is safe with/for a patient, with ‘no-ionizing’ radiations, involved.

Yes, be it for a complex human brain anatomy, ultra-high field MRI scan is always there, for subtle brain details; MRI scan brain – is common for patients with the following – dizziness, hearing loss, headaches etc.

And then, about MRI scan knee – for knee pain/osteoarthritis, joint injuries, and more; but, then, prior any MRI scan, you definitely will be checked for electronic devices/implants and other ferromagnetic devices, due to the super-conducting magnets, and associated electronic-magnetic fields.

The topic about magnetic resonance imaging MRI Scan Technology can never end, as we know well about the scope the domain has, in the healthcare sector.

So, stay tuned for more on MRI scans, and everything related with the magnetic resonance imaging technology!

Patients with implantable cardioverter defibrillator (ICD) and/or cardiac pacemakers should no longer worry going for MR imaging, for various medical conditions that they have: a study report

The study overruled following concerns: movement of device inside the body (due to MRI electromagnetic radiation/waves); device heating up, and affecting/burning tissues; device malfunctioning etc.!

Cardiac pacemaker

With specific procedures require to be followed – patients with newly implanted cardiac devices can definitely undergo MR imaging (securely), for cancer and other disorders/irregularities. (Courtesy: Johns Hopkins University)

Defibrillators help to restore normal rhythm of the heart, during fibrillation of heart muscles; on the other, the battery-powered cardiac pacemaker, embed under skin provides normal heartbeat (timed electrical pulses) stimulating the muscle, during specific heart conditions.

For specific MRI procedures – pacemakers produced in 1999 (or later), and defibrillator in 2000 (or later), with cardiologist and other skilled professionals to program the device, to make it MRI-safe, and observe the heart rhythm during the scan, will do!

Of various patients (with implanted cardiac devices – either cardiac pacemaker or defibrillator) that were studied by, no significant issues were reported after they have had MRI done (except for less than 1% of subjects).

Researchers did both during MRI examination: turned the device off, and turned down the sensitivity of the equipment to electromagnetic fields; study authors found the device being set again (reset to default settings), and/but this did not cause harm to any of the patients with implanted cardiac devices that were scanned through.

No patient was required cardiac device replacement, as the devices were re-programmed after the process (MRI) was successfully done on all of them.

Experts say, during an MRI, the study required skilled nurse and Electro-physiologists to tackle any emergency, and due to extra resources required for it, not all care facilities would be able to manage the process (MR imaging) on patients with implanted cardiac devices.

Heart devices compatible with MRI (nowadays) are widely available from various manufacturers; stay tuned with MedicExchange for details about companies/vendors with MRI-safe cardiac devices, and other related!

MRI evaluation of tumor regression grade and circumferential resection margin prefigure survival outcomes – for extra therapy options prior conclusive surgery.

MRI_Rectal Cancer

The medical research was contributed by Gina Brown (MBBS, MD, FRCR, Dept of Radiology, The Royal Marsden Hospital NHS Trust, Sutton, United Kingdom) and associates.

In neoadjuvant therapy (pre-surgery), therapeutic agents are administered before the main treatment; the research objective was to evaluate pathologic staging and MRI after neoadjuvant therapy for rectal cancer.  (Courtesy: Journal of Clinical Oncology)

About 111 patients with rectal cancer that were treated with therapeutic agents prior the main course enrolled this prospective cohort study; they were evaluated for pathology staging and MRI by T, N and circumferential resection margin status.

Tumor regression grade was even evaluated by MRI; through with Kaplan–Meier estimates, overall survival was appraised.

Cox model was put in use for affiliations amid staging of poor and good responders on survival outcomes and MRI/pathology, after checking for patient characteristics.

MRI-evaluated tumor regression grade hazard ratios were severally substantial for the endurance level, on multivariate analysis; pre-operative MR-indicated circumferential resection margin autonomously prefigured local recurrence; five-year survival for various stages were evaluated.

Conclusion: MRI evaluation of tumor regression grade and circumferential resection margin are imaging markers that prefigure survival outcomes for poor and good responders, for extra therapy options prior planning conclusive surgery.

The CNR and contrast enhancement ratio for hepatocellular carcinoma were not mutually related with histologic grades; contrast enhancement ratio was significantly lower in keratin 19–positive groups.

MRI_Hepatocellular Carcinoma

The medical research was conducted by Jin-Young Choi, Myeong-Jin Kim, Young Nyun Park, Jeong Min Lee, Sun Kook Yoo, Sun Young Rha and Jae Yeon Seok from Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System; Department of Pathology, Department of Medical Engineering, Department of Internal Medicine, Yonsei Cancer Center, Cancer Metastasis Research Center (Yonsei University College of Medicine); Department of Radiology, Institute of Radiation Medicine, Seoul National University Hospital, Seoul; Department of Pathology, Ajou University College of Medicine, Suwon, Republic of Korea.

The medical research objective was to evaluate if gadoxetate disodium intensified hepatobiliary phase magnetic resonance imaging could identify out the histological factors, of hepatocellular carcinoma/liver cancer in patients.

About 51 patients were retroactively assessed, of 53 hepatocellular carcinoma cases histopathologically affirmed by surgery; all the subjects were passed through gadoxetate disodium intensified magnetic resonance imaging, prior surgical removal/resection.

Kruskal wallis test was utilized for to equate deviations in contrast enhancement ratio of the lesions, with deviations in contrast-to-noise-ratio (CNR) among histologic grades of hepatocellular carcinoma. Spearman’s non-parametric method was put in use to establish relationship between cell density ratio, contrast enhancement, contrast to noise ratio, and incontrovertibility for anti-hepatocyte antibody, keratin 19, and keratin 7.

About the results, of 53 cases of hepatocellular carcinoma, 50 demonstrated low signal intensity on hepatobiliary phase images, pertain to liver and biliary ducts, but 3 showed hyperintensity on the same in contrast with neighboring hepatic parenchyma/liver tissue. Even though well discerned HCCs inclined to demonstrate higher contrast enhancement, no statistical significance could be established amongst histological grade and contrast enhancement ratio of the tumors; there was even no considerable deviation amongst histologic grade and contrast-to-noise-ratio (CNR); the contrast enhancement ratios (tumors) were considerably higher in keratin 19 negative group, than in keratin 19 positive group. There was no significant relation between subsequent: cell density ratio, contrast enhancement ratio, and positivity for anti-hepatocyte antibody and keratin 7.

Conclusion: for hepatocellular carcinoma – the CNR and contrast enhancement ratio were not mutually related with histologic grades; contrast enhancement ratio was substantially lower in keratin 19–positive HCCs.

In comparison to standard core biopsy procedure, cancer detection rate is higher through MR-guided biopsy.

MRI_Prostate

The clinical perspective was contributed by Andrew B. Rosenkrantz, Stephen M. Scionti, Savvas Mendrinos and Samir S. Taneja from Department of Radiology, New York University Langone Medical Center; Division of Urologic Oncology, Department of Urology; Department of Pathology, New York University Langone Medical Center, New York, NY.

The clinical perspective is available in American Journal of Roentgenology, and the objective was to examine possibilities of Magnetic resonance imaging in minimal-invasive focal ablative treatment for prostate cancer.

In union with biopsy, magnetic resonance imaging can affect patient selection for focal ablation, by aiding in to restrict clinically significant tumor foci. Some ablation can be executed through period-of-time MRI conduct. More to that, magnetic resonance imaging can be utilized for evaluation of degree of necrosis briefly after treatment, and for long-term supervision for recurring tumor.

For more on, how Magnetic Resonance imaging can reduce unnecessary prostate biopsies in men with persistently elevated PSA – please go through subsequent article:  MRI prostate

The tumors were desolate and well restricted of patients with surgicopathologic staging of nerve sheath tumor of the cervical vagus, over MR and CT studies.

On magnetic resonance imaging, the tumors were heterogeneously bright on T2WI, with strong inhomogeneous postgadolinium enhancement.

Nerve sheath tumor

The medical research study was conducted by Gopinathan Anil and Tiong-Yong Tan from Department of Radiology, Changi General Hospital, Singapore.

The study is available in American Journal of Roentgenology. Nerve sheath tumor is nervous system neoplasm – and emergence of it from the cervical vagus are uncommon. The research objective was to assess the role of Magnetic resonance imaging and Computed tomography in the diagnosis of these unusual neoplasms.

About 11 patients with surgicopathologic staging of nerve sheath tumor of the cervical vagus were selected had been referred to the institute from January 1999-2009, and their clinical data along with MR and CT studies were retroactively assessed. The tumors were appraised pertaining to: number, location, morphology, signal intensity/attenuation, patterns of mass effect and enhancement characteristics etc.

About the results, the tumors were desolate and well restricted. On computed tomography – 2 tumors were predominantly isodense, 8 were hypodense with poor enhancement; one had manifold cystic regions with enhancing solid components. On magnetic resonance imaging, the tumors in a heterogenous manner were bright on T2WI, with strong inhomogeneous postgadolinium enhancement. Subsequent were observed in some of patients: split fat sign, fascicular, entering and exiting nerve, hyperintense rim sign etc.

The common carotid artery was found anteriorly displaced in eight of the patients; except for a patient with posterolateral displacement, it maintained a neutral position for 2 of the patients. With exclusion of two, than other patients – the tumor acted as separation in between internal jugular vein and carotid artery.

Note: The spectrum of MRI and CT characteristics and patterns of mass effect of nerve sheath tumor of the cervical vagus were put forward as conclusion, along with observations for which we direct you more through http://www.ajronline.org

CSF shunt valve is not adversely affected by 3T MRI environment; agreeable to patients going through MRI at 3 Tesla or less, through conformity with manufacturer guidelines.

Programmable CSF Shunt Valves

The medical research study was conducted by Frank G. Shellock, Allison Bedwinek, Morgan Oliver-Allen and Stephen F. Wilson from Institute for Magnetic Resonance Safety, Education, and Research, Keck School of Medicine, University of Southern California, Los Angeles, CA; Product Development and Support Group, Codman, a Johnson & Johnson Company, Raynham, MA; Loyola Marymount University, Los Angeles, CA 90045.

The study is available in American Journal of Roentgenology. A newly evolved cerebrospinal fluid (CSF) shunt valve that integrates magnetically adaptable mechanism, crafted to withstand involuntary setting changes was assessed for problems during 3T MRI.

MRI associated heating, artifacts, field interactions and functional changes associated with manifold exposure and MRI conditions in varied samples at 3T were evaluated through standardized protocol.

About the results, the magnetic field interactions were not beyond normal limits. Results were in agreement with similar devices that had permanent magnets, even though artifacts were comparatively larger with respect to magnitude of programmable CSF shunt valve. MRI conditions and manifold exposures at 3T had no effect on functional aspects of the equipment; no involuntary developments to the valve setting were perceived.

Conclusion: CSF shunt valve is not disadvantageously affected by 3T MRI, and is agreeable to patients going through MRI at 3 Tesla or less, when particular rules are followed through, inclusive of verification of valve setting as per recommendations by manufacturer, instantly after the MRI procedure.

MR venography, and the mix of orbital and cranial MR imaging can be very specific and sensitive in distinct characterization of patients with intracranial hypertension.

MRI_intracranial hypertension

The medical research study was conducted by A.C. Rohra, C. Riedela, M.-C. Fruehaufd, A. van Baalenb, T. Bartschc, J. Hedderichd, K. Alfkea, L. Doernere and O. Jansena from the Departments of Neuroradiology; Neuropediatrics; Neurology; Medical Computer Science and Statistics; Neurosurgery (L.D.), University Schleswig-Holstein Campus Kiel, Germany.

The study is available in American Journal of Neuroradiology. Intracranial hypertension (Increased intracranial pressure) can change the arrangement of anatomic structures of the central nervous system. Researchers tried to establish the specificity and sensitivity of Magnetic Resonance Imaging to reveal developments in patients with secondary intracranial hypertension.

About 36 patients with intracranial hypertension were in a prospective manner examined with MRI, and matched to 36 controls. The images were assessed for optic nerve swelling and elongation, optic disc protrusion, posterior sclera flattening, height of the pituitary gland, and width of the optic nerve sheath. The team gauged the luminal width of the superior ophthalmic veins, and registered venous sinus abnormalities on MR venography. Grading score was brought in to determine cranial venous outflow obstruction.

About the results, optic hydrops (optic nerve sheath) and cranial venous outflow obstruction showed valid indication to intracranial hypertension with a specificity of 100% and 89%, and sensitivity of 94% and 92% respectively, in the given order.

For reduced pituitary height, the specificities and sensitivities were 97% and 56%; for flattening of the posterior sclera it were 78% and 64%; widening of the superior ophthalmic veins – 97% and 31%; for optic disc protrusion – 100% and 33%; optic nerve edema – 100% and 14%, and for elongation of the optic nerve – 100% and 6% respectively. At the minimum two-MR findings could be evinced in each patient, except for any of the controls; positive MR imaging findings showed mutual relation with cerebrospinal fluid pressure.

Conclusion: MR venography, and the mix of orbital and cranial MR imaging can be very specific and sensitive in diagnosis of patients with intracranial hypertension.

Apparent diffusion coefficient can be an effective MRI tool for distinction of inflammatory/benign lesions from malignant tumors, in the sinonasal region.

MRI_sinuses

The medical research study was conducted by M. Sasakia, S. Eidaa, M. Sumia and T. Nakamuraa from the Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan.

The study is available in American Journal of Neuroradiology. Computed Tomography, and Magnetic Resonance Imaging aspects of malignant and benign sinonasal lesions are in many cases not detailed, and researchers tried to assess the apparent diffusion coefficient (ADC) based distinction of these lesions.

They retroactively evaluated apparent diffusion coefficients of about 61 patients, with histologically proven sinonasal tumors and lesions resembling a tumor: 14 inflammatory lesions, 28 malignant tumors, and 19 benign lesions. Through 2 b-values (500 and 1000 s/mm2), apparent diffusion coefficients of total tumor region with extremely low, low, intermediate, high ADCs were evaluated by.

About the results, apparent diffusion coefficients of malignant tumors were remarkably lower than that of inflammatory and benign lesions. On apparent diffusion coefficient mapping, the proportions of total tumor region within malignant tumors with low or extremely low ADCs were notably greater than that within inflammatory and benign lesions. Cutoff points for apparent diffusion coefficient mapping efficaciously discerned inflammatory/benign lesions and malignant tumors with 85% accuracy, 94% specificity, 75% sensitivity, and 82% negative and 91% positive predictive values, in the order given. Apparent diffusion coefficients even effectively discerned squamous cell carcinoma and lymphomas from other malignant tumors.

Conclusion: Apparent diffusion coefficient can be an effective MRI tool for distinction of inflammatory/benign lesions from malignant tumors, in the sinonasal region.