Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
avneesh.chhabra
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
graemevthompson
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
janfritz777
It depends on your practice:
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
_____
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I agree with all the comments.
All the vendors’ machines work – GE is very good, but Siemens is best
overall.
For MSK, getting a full range of top end surface coils is absolutely
crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of
in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get
one 1.5T and three 3T.
Another consideration is that many MR conditional devices have different specifications for 1.5T and 3T. We scan a lot of patients with these devices and this can sometimes limit the studies that can be done with 3T. Especially if you are trying to perform more complicated studies.
Best,
Kevin
Ajay.Kohli
Great discussions but I’m surprised no one brought up the Siemens Low Field MRIs. Siemens has a 0.55T MR that uses deep learning to significantly improve image quality. The additional benefit is that these costs are much lower w 0.55T at about $850,000 versus twice that for the 1.5T (approx costs that have been quoted) Maintenance costs are supposedly lower too. It doesn’t have the bells and whistles to make the surgeons happy and likely not a replacement for the 3T outpatient scanners but perhaps good enough for inpatient/ED workflow with a wider bore (80cm) I’ve only analyzed demo cases at RSNA but would love to hear if anyone has used it in practice.
I agree with all the comments.
All the vendors’ machines work – GE is very good, but Siemens is best overall.
For MSK, getting a full range of top end surface coils is absolutely crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get one 1.5T and three 3T.
Cheers,
Rob
Great points!
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
[gallery]
racdan
Hi All.
I work on 1.5T GE, 3T Siemens, 3T Phillips, 3T GE.
The Siemens and the Philips are both excellent.
1.5 T GE is excellent.
3T GE not in the same league as Siemens or Philips.I would avoid, even if cheaper.
Would only have a 1.5T MRI for inside hospital, if only one magnet.
I am not sure our referrers would tolerate low field images.
Great discussions but I’m surprised no one brought up the Siemens Low Field MRIs. Siemens has a 0.55T MR that uses deep learning to significantly improve image quality. The additional benefit is that these costs are much lower w 0.55T at about $850,000 versus twice that for the 1.5T (approx costs that have been quoted) Maintenance costs are supposedly lower too. It doesn’t have the bells and whistles to make the surgeons happy and likely not a replacement for the 3T outpatient scanners but perhaps good enough for inpatient/ED workflow with a wider bore (80cm) I’ve only analyzed demo cases at RSNA but would love to hear if anyone has used it in practice.
All the vendors’ machines work – GE is very good, but Siemens is best overall.
For MSK, getting a full range of top end surface coils is absolutely crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get one 1.5T and three 3T.
Cheers,
Rob
Great points!
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
_____
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
[gallery]
scotcampbell1
Many good points brought up on both sides in this discussion.
For 1.5T, I agree with Siemens > GE > Philips > other (Hitachi way down the
list). For 3T, I agree with Siemens > GE. No experience with 3T Philips.
For metal artifact, Siemens SEMAC is better than Siemens WARP for slice
distortion and overall metal artifact reduction but worse for blurring. GE
MAVRIC also provides very good metal artifact reduction. Even with these
multispectral techniques, if doing arthroplasty MRI routinely, 1.5T is
better than 3T. If only occasionally, maybe not a big issue.
You can easily obtain images as high spatial resolution with 1.5T as most
people are getting with 3T with good contrast resolution.
True, MRI safety profile is better with 1.5T if you will do any cases on
patients with non conditional pacemakers.
The extra available signal at 3T is very nice for doing acceleration
techniques that drop SNR or amping up the spatial resolution.
Higher spatial resolution can make tissue mapping techniques more accurate,
advantage 3T on that.
3T sells well – good for advertising.
Will your hospital be buying new or refurbished? Then you may be deciding
between a “lower level” new (like Siemens Lumina) and a slightly older
model refurb (like Siemens Skyra).
Siemens 3T Lumina has significantly lower peak gradient amplitude but the
same slew rate as Siemens Vida (36/200 vs 60/200). Some examples of where
the difference may be visible include high BW imaging like joint
replacement cases, or if you do diffusion, perfusion, or UTE imaging.
Mostly for day to day MSK work you won’t see a difference on the images
with those gradients having the same slew rate.
Siemens Lumina uses SMS on 2D joint imaging, compressed sense on 3D.
Make sure you go through the documents so that you know which coils will be
part of the deal, and ask for the ones you need. Sometimes the people in
charge of purchasing don’t adequately consider the MSK studies that will
need to be performed.
-Scot
On Thu, Mar 10, 2022 at 11:32 PM Dr Colin Turner <doccolin@mweb.co.za>
wrote:
janfritz777
That’s another very interesting discussion!
Check out our SSR poster on lumbar spine MRI at 0.55T versus 1.T b Dr. Samim:
An an article about metal reduction MRI at 0.55T versus 1.5T using high-BW, SEMAC, and Compressed Sensing (CS) SEMAC hot off the press here by Dr. Khodarahmi: 1drv.ms/b/s!AlETWJQhV6-YtfF0nBIxvnbQecnktg
0.55T offers some intriguing opportunities (metal implants without and with, excellent T1 marrow contrast, AI/DL, devices as Kevin pointed out) and challenges for MSK (SNR, fluid brightness, spectral fat suppression, coils, acquisition time).
Transmission and signal processing have improved, but 0.55T is 0.55T and some physics don’t change. 0.55T requires about 4-5 times longer acquisition times than 1.5T (with adequately similar coils).
Who remembers 0.2T Open and Concerto scannrs? I did my thesis with those scanners before the millennium.
The above 4-sequence spine porotocol is 6 min @ 1.5T and 25 min @ 0.55T. The spine work well. But peripheral joints right now need dedicated coils, like this one here by Dr. Want and Brown:
It has its place, e.g. for sites where total cost of ownership or space of 1.5T and 3.0T systems is prohibitive. It will be interesting to see how it fits into high volume practices.
Looking forward “see” everyone in San Diego!
Jan
———————————-
Jan Fritz, M.D., P.D., R.M.S.K.
Associate Professor of Radiology
Division Chief, Musculoskeletal Radiology
New York University Langone Health
Grossman School of Medicine
Department of Radiology
660 1st Ave, 3rd Floor, Rm 313
New York, NY 10016
Phone: 646-501-0328
Email: jan.fritz@nyulangone.org
———————————-
Great discussions but I’m surprised no one brought up the Siemens Low Field MRIs. Siemens has a 0.55T MR that uses deep learning to significantly improve image quality. The additional benefit is that these costs are much lower w 0.55T at about $850,000 versus twice that for the 1.5T (approx costs that have been quoted) Maintenance costs are supposedly lower too. It doesn’t have the bells and whistles to make the surgeons happy and likely not a replacement for the 3T outpatient scanners but perhaps good enough for inpatient/ED workflow with a wider bore (80cm) I’ve only analyzed demo cases at RSNA but would love to hear if anyone has used it in practice.
Warmly, Ajay Ajay Kohli, MD
Assistant Professor
Departments of Radiology and Orthopaedic Surgery
UTSouthwestern Medical Center
Deputy Medical Informatics Officer, Parkland Enterprise Cell: 630.677.4534
Great points!
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
Best! AC
Avneesh Chhabra, M.D. M.B.A. Professor, Radiology & Orthopedic Surgery Chief, Musculoskeletal Radiology Department of Radiology 5323 Harry Hines, Blvd. Dallas, Tx-75390-9316 Office: 214-648-2122 http://www.utsouthwestern.edu/radiology
It depends on your practice: If predominately MSK and Neuro – 3T all the way If high volume – 3T all the way If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way If none of the above, then it may not matter. See attached our papers about the value of 3.0 T for MSK: 3T images 4-times faster than 1.5T at baseline Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T Cost differences between 1.5T and 3.0T have narrowed over time Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T. We have very few 1.5T left in our fleet, and we don’t miss any. From: ocad-msk@googlegroups.com < ocad-msk@googlegroups.com > On Behalf Of Graeme Thompson
Sent: Friday, March 11, 2022 8:42 AM
Cc: peter.young@uhhospitals.org ; OCAD_MSK < ocad-msk@googlegroups.com >; avneesh.chhabra@utsouthwestern.edu
Siemens is the only MRI for me.
G Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Best! AC
Avneesh Chhabra, M.D. M.B.A. Professor, Radiology & Orthopedic Surgery Chief, Musculoskeletal Radiology Department of Radiology 5323 Harry Hines, Blvd. Dallas, Tx-75390-9316 Office: 214-648-2122 http://www.utsouthwestern.edu/radiology
EXTERNAL MAIL Never have a 3T as the *only* MRI for an inpatient hospital setting. Been there, done that. pete Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon. We will be initially looking at 3 new machines. Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc. Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine? I look forward to your insights. Thanks in advance Kind regards Colin —
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[gallery]
avneesh.chhabra
Congratulations on the poster!
0.5T has its role..
– claustrophobic patients with 89cm more open bore
– low cost of operation
– For MSK- black structures look better. Intermeniscal/obl meniscomeniscal lig / plica / synachiae, etc m. are very well seen in the background of good fat contrast and marrow fat contrast
-Read a lot of arthrograms on 0.5T as that would provide the needed contrast. I presume newer 0.5T would do fs image in 5 min
An an article about metal reduction MRI at 0.55T versus 1.5T using high-BW, SEMAC, and Compressed Sensing (CS) SEMAC hot off the press here by Dr. Khodarahmi: 1drv.ms/b/s!AlETWJQhV6-YtfF0nBIxvnbQecnktg
0.55T offers some intriguing opportunities (metal implants without and with, excellent T1 marrow contrast, AI/DL, devices as Kevin pointed out) and challenges for MSK (SNR, fluid brightness, spectral fat suppression, coils, acquisition time).
Transmission and signal processing have improved, but 0.55T is 0.55T and some physics don’t change. 0.55T requires about 4-5 times longer acquisition times than 1.5T (with adequately similar coils).
Who remembers 0.2T Open and Concerto scanners? I did my thesis with those scanners before the millennium.
The above 4-sequence spine porotocol is 6 min @ 1.5T and 25 min @ 0.55T. The spine work well. But peripheral joints right now need dedicated coils, like this one here by Dr. Want and Brown:
It has its place, e.g. for sites where total cost of ownership or space of 1.5T and 3.0T systems is prohibitive. It will be interesting to see how it fits into high volume practices.
Looking forward “see” everyone in San Diego!
Jan
———————————-
Jan Fritz, M.D., P.D., R.M.S.K.
Associate Professor of Radiology
Division Chief, Musculoskeletal Radiology
New York University Langone Health
Grossman School of Medicine
Department of Radiology
660 1st Ave, 3rd Floor, Rm 313
New York, NY 10016
Phone: 646-501-0328
Email: jan.fritz@nyulangone.org
———————————-
Great discussions but I’m surprised no one brought up the Siemens Low Field MRIs. Siemens has a 0.55T MR that uses deep learning to significantly improve image quality. The additional benefit is that these costs are much lower w 0.55T at about $850,000 versus twice that for the 1.5T (approx costs that have been quoted) Maintenance costs are supposedly lower too. It doesn’t have the bells and whistles to make the surgeons happy and likely not a replacement for the 3T outpatient scanners but perhaps good enough for inpatient/ED workflow with a wider bore (80cm) I’ve only analyzed demo cases at RSNA but would love to hear if anyone has used it in practice.
I agree with all the comments.
All the vendors’ machines work – GE is very good, but Siemens is best overall.
For MSK, getting a full range of top end surface coils is absolutely crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get one 1.5T and three 3T.
Cheers,
Rob
Great points!
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
doccolin
Wow so many responses with so many great points and valuable insight.
It’s really wonderful to be able to receive so many opinions in such a short space of time.
Overall I think the Siemens 1.5T will probably be the best fit for us so will have to discuss with other relevant parties in our group going forward.
Thank you all for your advice and input.
Kind regards
Colin
Sent: 11 March 2022 08:32 AM
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
marcelvn
One late insight, if you let me. No conflicts of interest here.
Philips top of the line 1.5 offer includes an interesting magnet that works
with less then 10l sealed helium, so there is no need for helium refuel
(simpler maintanance down the road), no need for a quench tube (those thing
sometimes can be an issue to deal depending on the installation site), and
for safety situations, the magnet can be quenched and come back to
operation in less the 12h.
I have been working with two of those, different sites. Some issues about
image consistency, but I believe the point is the operator…
Marcel
Em segunda-feira, 14 de março de 2022 às 03:30:26 UTC-3, Colin Turner
escreveu:
mrimaging
Learnt a lot from the discussion !
We have a range of units with 2 x 3T (both Siemens), mostly Siemens 1.5T
with 1 GE and 1 Hitachi. Our extremity 1.5T GE MR430s just got taken out
cos no more service support, otherwise it was a great lil’ magnet for MSK,
esp claustro patients. Being replaced with a 1.5T Philips.
Agree with the general feeling that Siemens is consistent across all our
sites. One other consideration is that with magnet life-spans getting
longer, both Siemens and GE are offering mid-life upgrades to many of their
units. From the vendor’s point, better to upgrade and keep my customer
base, rather than it being replaced with a competitor’s magnet.
For the customer (us in radiology), the advantage is a shorter downtime and
familiarity with the user interface and capabilities. GE calls it the
“Lift” and Siemens “Fit”. So we’ve upgraded our GE Hdxt to an Explorer_lift
and Siemens Trio to Prisma_fit, both about 4 years ago, both working well
with no issues. Considering doing the same to 1 or 2 of our oldest Aera to
get a Sola_fit.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
EXTERNAL MAIL
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
Siemens is the only MRI for me.
G
Sent from my iPhone
It depends on your practice:
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Sent: Friday, March 11, 2022 8:42 AM
Cc: peter.young@uhhospitals.org; OCAD_MSK <ocad-msk@googlegroups.com>; avneesh.chhabra@utsouthwestern.edu
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/> http://www.utsouthwestern.edu/radiology
EXTERNAL MAIL
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
_____
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
2021-InvRad-The-Value-of-3-Tesla-Field-Strength-for-Musculoskeletal-MRI.pdf
2021-AJR-Rapid-Musculoskeletal-MRI-in-2021-Value-and-Optimized-Use-of-Widely-Accessible-Techniques.pdf
2021-AJR-Rapid-Musculoskeletal-MRI-in-2021-Clinical-Application-of-Advanced-Accelerated-Techniques.pdf
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
It depends on your practice:
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Sent: Friday, March 11, 2022 8:42 AM
Cc: peter.young@uhhospitals.org; OCAD_MSK <ocad-msk@googlegroups.com>; avneesh.chhabra@utsouthwestern.edu
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
EXTERNAL MAIL
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
All the vendors’ machines work – GE is very good, but Siemens is best
overall.
For MSK, getting a full range of top end surface coils is absolutely
crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of
in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get
one 1.5T and three 3T.
Cheers,
Rob
On Fri, Mar 11, 2022 at 7:44 AM Avneesh Chhabra < Avneesh.Chhabra@utsouthwestern.edu> wrote:
Another consideration is that many MR conditional devices have different specifications for 1.5T and 3T. We scan a lot of patients with these devices and this can sometimes limit the studies that can be done with 3T. Especially if you are trying to perform more complicated studies.
Best,
Kevin
More details here:
[Image.jpeg]
http://www.magnetomworld.siemens-healthineers.com/hot-topics/lower-field-mri
Warmly,
Ajay
Ajay Kohli, MD
Assistant Professor
Departments of Radiology and Orthopaedic Surgery
UTSouthwestern Medical Center
Deputy Medical Informatics Officer, Parkland Enterprise
Cell: 630.677.4534
________________________________
Sent: Friday, March 11, 2022 9:52 AM
Cc: Jan Fritz <janfritz777@gmail.com>; graemevthompson@gmail.com <graemevthompson@gmail.com>; doccolin@mweb.co.za <doccolin@mweb.co.za>; peter.young@uhhospitals.org <peter.young@uhhospitals.org>; OCAD_MSK <ocad-msk@googlegroups.com>
I agree with all the comments.
All the vendors’ machines work – GE is very good, but Siemens is best overall.
For MSK, getting a full range of top end surface coils is absolutely crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get one 1.5T and three 3T.
Cheers,
Rob
Great points!
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
It depends on your practice:
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Sent: Friday, March 11, 2022 8:42 AM
Cc: peter.young@uhhospitals.org<mailto:peter.young@uhhospitals.org>; OCAD_MSK <ocad-msk@googlegroups.com<mailto:ocad-msk@googlegroups.com>>; avneesh.chhabra@utsouthwestern.edu<mailto:avneesh.chhabra@utsouthwestern.edu>
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
EXTERNAL MAIL
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
________________________________
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
[gallery]
I work on 1.5T GE, 3T Siemens, 3T Phillips, 3T GE.
The Siemens and the Philips are both excellent.
1.5 T GE is excellent.
3T GE not in the same league as Siemens or Philips.I would avoid, even if cheaper.
Would only have a 1.5T MRI for inside hospital, if only one magnet.
I am not sure our referrers would tolerate low field images.
Regards
Daniel
Sent: Saturday, March 12, 2022 7:49 AM
Cc: Jan Fritz <janfritz777@gmail.com>; graemevthompson@gmail.com; doccolin@mweb.co.za; peter.young@uhhospitals.org; OCAD_MSK <ocad-msk@googlegroups.com>
Great discussions but I’m surprised no one brought up the Siemens Low Field MRIs. Siemens has a 0.55T MR that uses deep learning to significantly improve image quality. The additional benefit is that these costs are much lower w 0.55T at about $850,000 versus twice that for the 1.5T (approx costs that have been quoted) Maintenance costs are supposedly lower too. It doesn’t have the bells and whistles to make the surgeons happy and likely not a replacement for the 3T outpatient scanners but perhaps good enough for inpatient/ED workflow with a wider bore (80cm) I’ve only analyzed demo cases at RSNA but would love to hear if anyone has used it in practice.
More details here:
http://www.magnetomworld.siemens-healthineers.com/hot-topics/lower-field-mri
Warmly,
Ajay
Ajay Kohli, MD
Assistant Professor
Departments of Radiology and Orthopaedic Surgery
UTSouthwestern Medical Center
Deputy Medical Informatics Officer, Parkland Enterprise
Cell: 630.677.4534
_____
Sent: Friday, March 11, 2022 9:52 AM
Cc: Jan Fritz <janfritz777@gmail.com <mailto:janfritz777@gmail.com> >; graemevthompson@gmail.com <mailto:graemevthompson@gmail.com> <graemevthompson@gmail.com <mailto:graemevthompson@gmail.com> >; doccolin@mweb.co.za <mailto:doccolin@mweb.co.za> <doccolin@mweb.co.za <mailto:doccolin@mweb.co.za> >; peter.young@uhhospitals.org <mailto:peter.young@uhhospitals.org> <peter.young@uhhospitals.org <mailto:peter.young@uhhospitals.org> >; OCAD_MSK <ocad-msk@googlegroups.com <mailto:ocad-msk@googlegroups.com> >
I agree with all the comments.
All the vendors’ machines work – GE is very good, but Siemens is best overall.
For MSK, getting a full range of top end surface coils is absolutely crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get one 1.5T and three 3T.
Cheers,
Rob
Great points!
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology <http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
It depends on your practice:
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Sent: Friday, March 11, 2022 8:42 AM
Cc: peter.young@uhhospitals.org <mailto:peter.young@uhhospitals.org> ; OCAD_MSK <ocad-msk@googlegroups.com <mailto:ocad-msk@googlegroups.com> >; avneesh.chhabra@utsouthwestern.edu <mailto:avneesh.chhabra@utsouthwestern.edu>
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology <http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
EXTERNAL MAIL
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
_____
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
[gallery]
For 1.5T, I agree with Siemens > GE > Philips > other (Hitachi way down the
list). For 3T, I agree with Siemens > GE. No experience with 3T Philips.
For metal artifact, Siemens SEMAC is better than Siemens WARP for slice
distortion and overall metal artifact reduction but worse for blurring. GE
MAVRIC also provides very good metal artifact reduction. Even with these
multispectral techniques, if doing arthroplasty MRI routinely, 1.5T is
better than 3T. If only occasionally, maybe not a big issue.
You can easily obtain images as high spatial resolution with 1.5T as most
people are getting with 3T with good contrast resolution.
True, MRI safety profile is better with 1.5T if you will do any cases on
patients with non conditional pacemakers.
The extra available signal at 3T is very nice for doing acceleration
techniques that drop SNR or amping up the spatial resolution.
Higher spatial resolution can make tissue mapping techniques more accurate,
advantage 3T on that.
3T sells well – good for advertising.
Will your hospital be buying new or refurbished? Then you may be deciding
between a “lower level” new (like Siemens Lumina) and a slightly older
model refurb (like Siemens Skyra).
Siemens 3T Lumina has significantly lower peak gradient amplitude but the
same slew rate as Siemens Vida (36/200 vs 60/200). Some examples of where
the difference may be visible include high BW imaging like joint
replacement cases, or if you do diffusion, perfusion, or UTE imaging.
Mostly for day to day MSK work you won’t see a difference on the images
with those gradients having the same slew rate.
Siemens Lumina uses SMS on 2D joint imaging, compressed sense on 3D.
Make sure you go through the documents so that you know which coils will be
part of the deal, and ask for the ones you need. Sometimes the people in
charge of purchasing don’t adequately consider the MSK studies that will
need to be performed.
-Scot
On Thu, Mar 10, 2022 at 11:32 PM Dr Colin Turner <doccolin@mweb.co.za>
wrote:
That’s another very interesting discussion!
Check out our SSR poster on lumbar spine MRI at 0.55T versus 1.T b Dr. Samim:
An an article about metal reduction MRI at 0.55T versus 1.5T using high-BW, SEMAC, and Compressed Sensing (CS) SEMAC hot off the press here by Dr. Khodarahmi: 1drv.ms/b/s!AlETWJQhV6-YtfF0nBIxvnbQecnktg
0.55T offers some intriguing opportunities (metal implants without and with, excellent T1 marrow contrast, AI/DL, devices as Kevin pointed out) and challenges for MSK (SNR, fluid brightness, spectral fat suppression, coils, acquisition time).
Transmission and signal processing have improved, but 0.55T is 0.55T and some physics don’t change. 0.55T requires about 4-5 times longer acquisition times than 1.5T (with adequately similar coils).
Who remembers 0.2T Open and Concerto scannrs? I did my thesis with those scanners before the millennium.
The above 4-sequence spine porotocol is 6 min @ 1.5T and 25 min @ 0.55T. The spine work well. But peripheral joints right now need dedicated coils, like this one here by Dr. Want and Brown:
It has its place, e.g. for sites where total cost of ownership or space of 1.5T and 3.0T systems is prohibitive. It will be interesting to see how it fits into high volume practices.
Looking forward “see” everyone in San Diego!
Jan
———————————-
Jan Fritz, M.D., P.D., R.M.S.K.
Associate Professor of Radiology
Division Chief, Musculoskeletal Radiology
New York University Langone Health
Grossman School of Medicine
Department of Radiology
660 1st Ave, 3rd Floor, Rm 313
New York, NY 10016
Phone: 646-501-0328
Email: jan.fritz@nyulangone.org
———————————-
Great discussions but I’m surprised no one brought up the Siemens Low Field MRIs. Siemens has a 0.55T MR that uses deep learning to significantly improve image quality. The additional benefit is that these costs are much lower w 0.55T at about $850,000 versus twice that for the 1.5T (approx costs that have been quoted) Maintenance costs are supposedly lower too. It doesn’t have the bells and whistles to make the surgeons happy and likely not a replacement for the 3T outpatient scanners but perhaps good enough for inpatient/ED workflow with a wider bore (80cm) I’ve only analyzed demo cases at RSNA but would love to hear if anyone has used it in practice.
More details here:
http://www.magnetomworld.siemens-healthineers.com/hot-topics/lower-field-mri
Warmly, Ajay Ajay Kohli, MD
Assistant Professor
Departments of Radiology and Orthopaedic Surgery
UTSouthwestern Medical Center
Deputy Medical Informatics Officer, Parkland Enterprise Cell: 630.677.4534
Sent: Friday, March 11, 2022 9:52 AM
Cc: Jan Fritz <janfritz777@gmail.com>; graemevthompson@gmail.com <graemevthompson@gmail.com>; doccolin@mweb.co.za <doccolin@mweb.co.za>; peter.young@uhhospitals.org <peter.young@uhhospitals.org>; OCAD_MSK <ocad-msk@googlegroups.com>
I agree with all the comments.
All the vendors’ machines work – GE is very good, but Siemens is best overall.
For MSK, getting a full range of top end surface coils is absolutely crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get one 1.5T and three 3T.
Cheers,
Rob
Great points!
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
Best! AC
Avneesh Chhabra, M.D. M.B.A. Professor, Radiology & Orthopedic Surgery Chief, Musculoskeletal Radiology Department of Radiology 5323 Harry Hines, Blvd. Dallas, Tx-75390-9316 Office: 214-648-2122 http://www.utsouthwestern.edu/radiology
It depends on your practice: If predominately MSK and Neuro – 3T all the way If high volume – 3T all the way If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way If none of the above, then it may not matter. See attached our papers about the value of 3.0 T for MSK: 3T images 4-times faster than 1.5T at baseline Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T Cost differences between 1.5T and 3.0T have narrowed over time Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T. We have very few 1.5T left in our fleet, and we don’t miss any. From: ocad-msk@googlegroups.com < ocad-msk@googlegroups.com > On Behalf Of Graeme Thompson
Sent: Friday, March 11, 2022 8:42 AM
Cc: peter.young@uhhospitals.org ; OCAD_MSK < ocad-msk@googlegroups.com >; avneesh.chhabra@utsouthwestern.edu
Siemens is the only MRI for me.
G Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Best! AC
Avneesh Chhabra, M.D. M.B.A. Professor, Radiology & Orthopedic Surgery Chief, Musculoskeletal Radiology Department of Radiology 5323 Harry Hines, Blvd. Dallas, Tx-75390-9316 Office: 214-648-2122 http://www.utsouthwestern.edu/radiology
EXTERNAL MAIL Never have a 3T as the *only* MRI for an inpatient hospital setting. Been there, done that. pete Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon. We will be initially looking at 3 new machines. Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc. Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine? I look forward to your insights. Thanks in advance Kind regards Colin —
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[gallery]
0.5T has its role..
– claustrophobic patients with 89cm more open bore
– low cost of operation
– For MSK- black structures look better. Intermeniscal/obl meniscomeniscal lig / plica / synachiae, etc m. are very well seen in the background of good fat contrast and marrow fat contrast
-Read a lot of arthrograms on 0.5T as that would provide the needed contrast. I presume newer 0.5T would do fs image in 5 min
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
That’s another very interesting discussion!
Check out our SSR poster on lumbar spine MRI at 0.55T versus 1.5T by Dr. Samim:
An an article about metal reduction MRI at 0.55T versus 1.5T using high-BW, SEMAC, and Compressed Sensing (CS) SEMAC hot off the press here by Dr. Khodarahmi: 1drv.ms/b/s!AlETWJQhV6-YtfF0nBIxvnbQecnktg
0.55T offers some intriguing opportunities (metal implants without and with, excellent T1 marrow contrast, AI/DL, devices as Kevin pointed out) and challenges for MSK (SNR, fluid brightness, spectral fat suppression, coils, acquisition time).
Transmission and signal processing have improved, but 0.55T is 0.55T and some physics don’t change. 0.55T requires about 4-5 times longer acquisition times than 1.5T (with adequately similar coils).
Who remembers 0.2T Open and Concerto scanners? I did my thesis with those scanners before the millennium.
The above 4-sequence spine porotocol is 6 min @ 1.5T and 25 min @ 0.55T. The spine work well. But peripheral joints right now need dedicated coils, like this one here by Dr. Want and Brown:
It has its place, e.g. for sites where total cost of ownership or space of 1.5T and 3.0T systems is prohibitive. It will be interesting to see how it fits into high volume practices.
Looking forward “see” everyone in San Diego!
Jan
———————————-
Jan Fritz, M.D., P.D., R.M.S.K.
Associate Professor of Radiology
Division Chief, Musculoskeletal Radiology
New York University Langone Health
Grossman School of Medicine
Department of Radiology
660 1st Ave, 3rd Floor, Rm 313
New York, NY 10016
Phone: 646-501-0328
Email: jan.fritz@nyulangone.org
———————————-
Great discussions but I’m surprised no one brought up the Siemens Low Field MRIs. Siemens has a 0.55T MR that uses deep learning to significantly improve image quality. The additional benefit is that these costs are much lower w 0.55T at about $850,000 versus twice that for the 1.5T (approx costs that have been quoted) Maintenance costs are supposedly lower too. It doesn’t have the bells and whistles to make the surgeons happy and likely not a replacement for the 3T outpatient scanners but perhaps good enough for inpatient/ED workflow with a wider bore (80cm) I’ve only analyzed demo cases at RSNA but would love to hear if anyone has used it in practice.
More details here:
[Image.jpeg]
http://www.magnetomworld.siemens-healthineers.com/hot-topics/lower-field-mri
Warmly,
Ajay
Ajay Kohli, MD
Assistant Professor
Departments of Radiology and Orthopaedic Surgery
UTSouthwestern Medical Center
Deputy Medical Informatics Officer, Parkland Enterprise
Cell: 630.677.4534
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Sent: Friday, March 11, 2022 9:52 AM
Cc: Jan Fritz <janfritz777@gmail.com>; graemevthompson@gmail.com <graemevthompson@gmail.com>; doccolin@mweb.co.za <doccolin@mweb.co.za>; peter.young@uhhospitals.org <peter.young@uhhospitals.org>; OCAD_MSK <ocad-msk@googlegroups.com>
I agree with all the comments.
All the vendors’ machines work – GE is very good, but Siemens is best overall.
For MSK, getting a full range of top end surface coils is absolutely crucial and is more important than tesla or gradient strength.
If you only have 1 MRI, and it is a busy hospital setting with lots of in-patients, I would get 1.5T. If the facility had 4 MRIs then I would get one 1.5T and three 3T.
Cheers,
Rob
Great points!
We are doing isotropic 3D capri space on newer 1.5T for joints- sola etc. with similar quality as 3T in 6 min
The issue is vendors wont bring newer enhancements on 1.5T as fast as 3T otherwise people wont buy 3T
Its like MR spectroscopy wasnt made available by siemens on 1T for a while as 1.5T wouldn’t sell in 1997-2000 time frame. Although, 1 T was the most homogeneous magnet and required v little shimming.
The guy who developed cyclotron was giving a futuristic talk and said MRI magnet will be in everyone’s house as magnetic energy is cheap -in less than 20 years
We are buying a high end 1.5T Siemens for our offsite sports practice. I hope to get compressed sense on that magnet so that we can do 3-D in 3 minutes. Our surgeons love 3D for preop planning.
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
It depends on your practice:
* If predominately MSK and Neuro – 3T all the way
* If high volume – 3T all the way
* If advanced MSK and neuro application (MRN, 3D MRI, quant imaging, DTI) – 3T all the way
If none of the above, then it may not matter.
See attached our papers about the value of 3.0 T for MSK:
* 3T images 4-times faster than 1.5T at baseline
* Very difficult with 1.5T to get enough SNR for advanced MSK and Neuro applications
* The effect of gradient performance is over-estimated for most MSK applications. RF coil performance, surface coils, and receiver chain/channel count make a bigger difference -> decision between midlevel and high-end 3T
* Cost differences between 1.5T and 3.0T have narrowed over time
* Metal: with advanced metal suppression sequences (e.g., CS SEMAC), almost all cases come out well at 3T.
We have very few 1.5T left in our fleet, and we don’t miss any.
Sent: Friday, March 11, 2022 8:42 AM
Cc: peter.young@uhhospitals.org<mailto:peter.young@uhhospitals.org>; OCAD_MSK <ocad-msk@googlegroups.com<mailto:ocad-msk@googlegroups.com>>;avneesh.chhabra@utsouthwestern.edu<mailto:avneesh.chhabra@utsouthwestern.edu>
Nothing a 3T can do that a 1.5 with top end gradients and could can’t.
Siemens is the only MRI for me.
G
Sent from my iPhone
I have no COI
In my opinion- Siemens is the best for multiple reasons..
– most consistent image quality
– less human intervention- most reproducible
– less bulky coils
– industry leader therefore more advancements come quicker
– current compressed sense provides 3 min 3D scans- beautiful images
– SMS Dixon is excellent
– resolve/motion corrected beautiful moci DWI and DTI scans and T2 / T1 VIBE Dixon images
There is a reason that it is more expensive …
Philips is a more open platform- if you want your magnet to be your lab- go for Philips- cheaper magnet, bulkier coils, mostly copies other vendors for advancements which tend to arrive later; requires a lot of maintainance and is a headache for our techs due to lack of reproducibility and inconsistent image quality. I have to intervene frequently to teach them and get a good image quality
Thats been my experience working with both vendors and their high-end advancements
GE is coming back after a hiatus but has a longer way to go
Their air coil is great!!
Toshiba- gave us a presentation recently and on the face of it, it looked good
But I would like to stay with industry leader and focus on more patient care and outcomes rather than spend my time to make the routine images look good
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
EXTERNAL MAIL
Never have a 3T as the *only* MRI for an inpatient hospital setting.
Been there, done that.
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology
University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
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Sent: Friday, March 11, 2022 1:32 AM
Dear Ocader’s I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
It’s really wonderful to be able to receive so many opinions in such a short space of time.
Overall I think the Siemens 1.5T will probably be the best fit for us so will have to discuss with other relevant parties in our group going forward.
Thank you all for your advice and input.
Kind regards
Colin
Sent: 11 March 2022 08:32 AM
Dear Ocader’s
I work in a hospital with one MRI machine (currently Philips 1.5T which is now nearing end of life) but am also part of a practice with other branches that are also requiring new MRI machines very soon.
We will be initially looking at 3 new machines.
Please might I ask what everyone would recommend and advise with respect to their own experiences with new machines. Philips, Siemens, Toshiba, uMR etc.
Also, is it inadvisable to purchase a 3.0T machine if that machine will be a stand alone machine?
I look forward to your insights.
Thanks in advance
Kind regards
Colin
Philips top of the line 1.5 offer includes an interesting magnet that works
with less then 10l sealed helium, so there is no need for helium refuel
(simpler maintanance down the road), no need for a quench tube (those thing
sometimes can be an issue to deal depending on the installation site), and
for safety situations, the magnet can be quenched and come back to
operation in less the 12h.
I have been working with two of those, different sites. Some issues about
image consistency, but I believe the point is the operator…
Marcel
Em segunda-feira, 14 de março de 2022 às 03:30:26 UTC-3, Colin Turner
escreveu:
We have a range of units with 2 x 3T (both Siemens), mostly Siemens 1.5T
with 1 GE and 1 Hitachi. Our extremity 1.5T GE MR430s just got taken out
cos no more service support, otherwise it was a great lil’ magnet for MSK,
esp claustro patients. Being replaced with a 1.5T Philips.
Agree with the general feeling that Siemens is consistent across all our
sites. One other consideration is that with magnet life-spans getting
longer, both Siemens and GE are offering mid-life upgrades to many of their
units. From the vendor’s point, better to upgrade and keep my customer
base, rather than it being replaced with a competitor’s magnet.
For the customer (us in radiology), the advantage is a shorter downtime and
familiarity with the user interface and capabilities. GE calls it the
“Lift” and Siemens “Fit”. So we’ve upgraded our GE Hdxt to an Explorer_lift
and Siemens Trio to Prisma_fit, both about 4 years ago, both working well
with no issues. Considering doing the same to 1 or 2 of our oldest Aera to
get a Sola_fit.
Ian Tsou
Singapore