Portable Magnetic Resonance Imaging for ICU Patients

Turpin, Justin; Unadkat, Prashin; Thomas, Justin G.; Kleiner, Nick; Khazanehdari, Shahab; Wanchoo, Sheshali; Samuel, Kenia; Moclair, Betsy O; Black, Karen; Dehdashti, Amir R.; Narayan, Raj K.; Temes, Richard E.; Schulder, Michael

doi:10.1097/cce.0000000000000306

Cited by 36 publications

(46 citation statements)

References 20 publications

(19 reference statements)

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“…It should be noted that the FDA 510k-cleared Hyperfine Swoop™ device ( Fig. 1b ) has already been introduced to acquire structural MRI in clinical use and research studies in multiple U.S. hospitals ( Sheth et al, 2020 ), and to scan COVID-19 patients in multiple hospitals ( Kremer et al, 2020 ; Turpin et al, 2020 ). In addition, Hyperfine scanners will be used to acquire structural MRI scans in children for research on infant asphyxia and nutritional brain development in remote and resource-limited settings, in a partnership with the Bill and Melinda Gates Foundation (Gates Foundation 2020).…”

Section: Identifying and Addressing Elsi Issues: Project Methods And Survey Resultsmentioning

confidence: 99%

Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings

et al. 2021

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Smaller, more affordable, and more portable MRI brain scanners offer exciting opportunities to address unmet research needs and long-standing health inequities in remote and resource-limited international settings. Field-based neuroimaging research in low- and middle-income countries (LMICs) can improve local capacity to conduct both structural and functional neuroscience studies, expand knowledge of brain injury and neuropsychiatric and neurodevelopmental disorders, and ultimately improve the timeliness and quality of clinical diagnosis and treatment around the globe. Facilitating MRI research in remote settings can also diversify reference databases in neuroscience, improve understanding of brain development and degeneration across the lifespan in diverse populations, and help to create reliable measurements of infant and child development. These deeper understandings can lead to new strategies for collaborating with communities to mitigate and hopefully overcome challenges that negatively impact brain development and quality of life. Despite the potential importance of research using highly portable MRI in remote and resource-limited settings, there is little analysis of the attendant ethical, legal, and social issues (ELSI). To begin addressing this gap, this paper presents findings from the first phase of an envisioned multi-staged and iterative approach for creating ethical and legal guidance in a complex global landscape. Section 1 provides a brief introduction to the emerging technology for field-based MRI research. Section 2 presents our methodology for generating plausible use cases for MRI research in remote and resource-limited settings and identifying associated ELSI issues. Section 3 analyzes core ELSI issues in designing and conducting field-based MRI research in remote, resource-limited settings and offers recommendations. We argue that a guiding principle for field-based MRI research in these contexts should be including local communities and research participants throughout the research process in order to create sustained local value. Section 4 presents a recommended path for the next phase of work that could further adapt these use cases, address ethical and legal issues, and co-develop guidance in partnership with local communities.

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Section: Identifying and Addressing Elsi Issues: Project Methods And Survey Resultsmentioning

confidence: 99%

Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings

et al. 2021

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“…In the past 15 years several groups have shown significant progress in the design of low field (<100 mT) MRI systems [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Several different magnet geometries have been used, and each system contains a unique combination of custom-built and commercial components.…”

Section: Introductionmentioning

confidence: 99%

“…The system operates at 64 mT, has a 30 cm vertical opening and uses an 8-channel receive only head coil. Their bi-planar gradient coils create a gradient field with a maximum strength of 26 mT 1 m −1 [11,12].…”

Section: Introductionmentioning

confidence: 99%

Design, Characterisation and Performance of an Improved Portable and Sustainable Low-Field MRI System

et al. 2021

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Low-field permanent magnet-based MRI systems are finding increasing use in portable, sustainable and point-of-care applications. In order to maximize performance while minimizing cost many components of such a system should ideally be designed specifically for low frequency operation. In this paper we describe recent developments in constructing and characterising a low-field portable MRI system for in vivo imaging at 50 mT. These developments include the design of i) high-linearity gradient coils using a modified volume-based target field approach, ii) phased-array receive coils, and iii) a battery-operated three-axis gradient amplifier for improved portability and sustainability. In addition, we report performance characterisation of the RF amplifier, the gradient amplifier, eddy currents from the gradient coils, and describe a quality control protocol for the overall system.

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“…The copyright holder for this preprint this version posted July 5, 2021. ; https://doi.org/10.1101/2021.07.02.21259789 doi: medRxiv preprint studies. ULF MRI systems may be suitable for hospitalized patients, such as those in intensive care units or isolation wards, for whom transport to a standard clinical scanner carries unacceptable risk [7][8][9]. More broadly, ULF MRI units could potentially be used in ambulances, emergency departments, physician's offices or rural clinics [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…Such devices could decrease healthcare expenditures, improve availability in underserved areas, and provide a convenient and ionizing-radiation-free modality for routine or monitoring studies. ULF MRI systems may be suitable for hospitalized patients, such as those in intensive care units or isolation wards, for whom transport to a standard clinical scanner carries unacceptable risk [7][8][9]. More broadly, ULF MRI units could potentially be used in ambulances, emergency departments, physician's offices or rural clinics [10,11].…”

Section: Introductionmentioning

confidence: 99%

Simulated Diagnostic Performance of Ultra-Low-Field MRI: Harnessing Open-Access Datasets to Evaluate Novel Devices

Arnold

Baldassano

Litt

et al. 2021

Preprint

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The purpose of this study is to demonstrate a method for virtually evaluating novel imaging devices using machine learning and open-access datasets, here applied to a new, ultra-low-field strength (ULF), 64mT, portable MRI device. Paired 3T and 64mT brain images were used to develop and validate a transformation converting standard clinical images to ULF-quality images. Separately, 3T images were aggregated from open-source databases spanning four neuropathologies: low-grade glioma (LGG, N=76), high-grade glioma (HGG, N=259), stroke (N=28), and multiple sclerosis (MS, N=20). The transformation method was then applied to the open-source data to generate simulated ULF images for each pathology. Convolutional neural networks (DenseNet-121) were trained to detect pathology in axial slices from either 3T or simulated 64 mT images, and their relative performance was compared to characterize the potential diagnostic capabilities of ULF imaging. Algorithm performance was measured using area under the receiver operating characteristic curve. Across all cohorts, pathology detection was similar between 3T and simulated 64mT images (LGG: 0.97 vs. 0.98; HGG: 0.96 vs. 0.95; stroke: 0.94 vs. 0.94; MS: 0.90 vs 0.87). Pathology detection was further characterized as a function of lesion size, intensity, and contrast. Simulated images showed decreasing sensitivity for lesions smaller than 4 cm2 (~2.25 cm in diameter). While simulations cannot replace prospective trials during the evaluation of medical devices, they can provide guidance and justification for prospective studies. Simulated data derived from open-source imaging databases may facilitate testing and validation of new imaging devices.

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Portable Magnetic Resonance Imaging for ICU Patients

Abstract: Supplemental Digital Content is available in the text.

Cited by 36 publications

References 20 publications

Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings

Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings

Design, Characterisation and Performance of an Improved Portable and Sustainable Low-Field MRI System

Simulated Diagnostic Performance of Ultra-Low-Field MRI: Harnessing Open-Access Datasets to Evaluate Novel Devices

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