Hospitals deploy Panorama HFO as an all purpose MRI ... - Philips

FieldStrength
Publication for the Philips MRI Community
FieldStrength
Publication for the Philips MRI Community Issue 38 – Summer 2009
This article is part of
Field Strength issue 38,
Summer 2009
Pediatric neuro,
MSK, whole
body imaging
Tokai University reports on benefits of
Achieva 3.0T TX with MultiTransmit
University of Michigan praises
Elite Breast solution for biopsies
SmartExam for efficient, reproducible
shoulder imaging at PAMF
Maastricht performs MRA of spinal
cord blood vessels
FreeWave upgrade for Intera 1.5T
boosts throughput
Issue 38 – Summer 2009
Hospitals deploy Panorama HFO
as an all purpose MRI scanner
Panorama High Field Open scanner serves all MRI needs of both Community Memorial Hospital
and Porter Hospital.

Hospitals deploy Panorama HFO
as an all purpose MRI scanner
Panorama High Field Open scanner serves all MRI needs of both Community Memorial Hospital
and Porter Hospital.
36
FieldStrength – Issue 38 – Summer 2009
Community Memorial Hospital and Porter Hospital are two very different facilities. However,
both use Panorama HFO as their only MRI system. The Panorama’s wide-open patient space
makes it a good choice for patients of all sizes and MR needs.
Panorama High Field Open MRI appeals to both patients
and referring physicians alike with its 360º panoramic
viewing angle and spacious 160 cm-wide patient aperture
ensuring a comfortable, relaxing MRI experience for
anxious, elderly, obese or claustrophobic patients.
The large space allows sideways positioning for any
patient, assuring that any anatomy (including knee,
wrist and shoulder) is always at the isocenter for best
image quality.
Panorama HFO helps Community Memorial Hospital grow
Rich Wharton (Philips) and MRI technologists Robin Morhart, Angel Stevens,
Lori Peglow.
Located in a city of about 5,700 residents, Community
Memorial Hospital (Hicksville, Ohio, USA) is a critical
access hospital with 25 beds. The Panorama was
installed in June 2008, and is used to perform high
Solenoid Technology coils offer superb coverage and
comfort, high SNR and excellent homogeneity. The images
benefit from the minimal susceptibility and distortion as
well as uncompromised fat saturation at the 1.0T field
strength, while providing SNR comparable to 1.5T.
Since the majority of patients prefer the open Panorama
over any cylindrical system, this helps when marketing a
practice directly to the patients.
quality MR exams on about 70 patients a month. Many
of the patients are referred from the hospital’s pain
management clinic, orthopedic department and family
practice physicians.
The Panorama’s large patient aperture is a plus at
Community Memorial. Sue Fowler, RT, Radiology
Manager at Community Memorial, says, “There are
a significant number of patients in our demographic
area who are too large for a closed system or who
are claustrophobic. If patients are claustrophobic, the
technologists can take them to see the unit, which
helps to dispel any negative perceptions they might
have about closed MR systems and puts them at ease.
Our Panorama is the only high field open system
available to them in our service area. We’re not doing
conscious sedation, but we’ve had some pediatric
patients whose parents have stayed in the room with
them, and that has been very calming for the children.”

Subacute subdural bleeding
An 81-year-old female with history of diabetes presented with headaches,
tinnitus. T1-weighed image shows increase in subdural fluid. FLAIR
demonstrates small amounts of fluid in the subdural space along
the convexity of the brain, consistent with subacute subdural bleeding
without mass effect, with reactive meningeal enhancement.
FLAIR
FLAIR
T2-weighted PD-weighted T1-weighted
T1-weighted T2-weighted
“The community members
overwhelmingly wanted an
open MR system.”
Post contrast T1-weighted
Large disc extrusion
T1-weighted
40-year-old male with low back pain
and right-sided foot drop for several
months. Sagittal images demonstrate
a large disc extrusion at L4-L5 with
spinal stenosis. The axial images
demonstrate right paracentral disc
hernation compressing the thecal
sac and impinging on the right L5
nerve root.
When Community Memorial began the search for an
MR system, hospital administrators surveyed their
physicians and members of the community. “The
physicians wanted a 1.5T closed-bore system, citing
image quality issues with open-bore systems,” says
Gregg Harpel, Vice President of Ancillary Services.
“The community members overwhelmingly wanted
an open MR system. When Philips presented the
Panorama as a high field open, I was a bit skeptical,
as sales representatives’ claims of image quality can
sometimes be a bit inflated. But when we saw it in
action, I knew we had the right fit.”
FieldStrength 37

“ We have not run into anything that
we cannot do on this magnet.”
Panorama meets all MR needs at Porter Hospital
Nancy Babich
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FieldStrength – Issue 38 – Summer 2009
Next, Mr. Harpel and the team discussed it with the
hospital’s radiology group and medical staff. “Once
they were on board, we presented the numbers to the
Board of Governors and the Township Trustees to get
their approval,” he says. “The success of the project
relied heavily on the continued growth of the hospital,
so they were a bit apprehensive, but their faith in us
has paid off.”
The high field open system fulfills its promises
The Panorama is the Community Memorial’s only MRI
scanner, and serves all its MR needs. In a small, rural area,
two MR systems would be cost-prohibitive. “Even with
refurbished units, the cost of purchase, maintenance,
training and regulatory oversight would not be costeffective,”
explains Mr. Harpel. “More importantly,
there would be no added value in having two different
machines; we have not run into anything that we cannot
do on this magnet.”
Porter Hospital (Valparaiso, Indiana, USA), in
comparison, is a large hospital with 250 beds. Nancy
Babich, Director of Imaging for Porter Hospital, says
Porter has imaged about 7,000 patients on its Panorama
HFO since it was installed in late 2007. “Brain and
cardiac imaging is fairly common here, as is imaging of
extremities. Because of the openness of the Panorama,
and the fact that we work through a central scheduling
department, we also get claustrophobic patients who
won’t or can’t go to other facilities.”
Especially in brain imaging, where the head must be held
still, the open sides of the Panorama are a welcome
addition to MR exams. For pediatric patients, it’s
reassuring to have a parent or family member in the MR
room with them. “In fact at one point we had a mother
come and lie next to her child during the scan,” says
Ms. Babich.
“We have nothing but great things to say about our
Panorama,” agrees Ms. Fowler. “We were very pleased
with the entire process from beginning to end. We
decided on a turnkey approach, whereby Philips was also
in charge of putting together the modular building that
would be attached to our hospital, and we believe that
was money well spent. One of the highlights was when
the huge building for the MR suite came through the
streets of our small town to arrive at the hospital.”
Mr. Harpel says the Panorama has turned out to be a
marketing tool for the hospital. “We have people coming
to our hospital that didn’t know we had a hospital a year
ago. Not only are they coming for the MRI, but also for
other services. The marketing campaign had a residual
effect of getting our name out and building our image.
Being in Hicksville, many people get an instant mental
image of someplace lost in time. The MRI campaign let
everyone in the extended area know that we are here
and we have top-notch technology.”
“We are very happy with the choice that we made,”
says Ms. Fowler. “With the Panorama we have the best
of both worlds: we have a system that’s both high field
and open.”
Porter has had MR scanners in its facilities for a long time
and appreciated both the image quality, and the service
on Philips equipment. “We needed an open MR,” says
Ms. Babich, “and when we saw the capabilities of the
Panorama – the removable table, the cardiac capabilities,
the high quality images – we decided it would answer our
needs for both a high field and an open scanner.”
“ We decided Panorama HFO
would answer our needs for
both a high field and an
open scanner.”

T2-weighted PD-weighted
Total spine
A 33-year-old female complaining of
bilateral upper & lower extremity
weakness and dizziness. No abnormalities
were identified. SENSE.Flex M coil is used
for cervical area and Integrated Body coil
for thoracic and lumbar areas. Voxel size
1.15 x 1.76 x 4.0 mm in all stations.
Amjad Alkadri, MD
T2 TSE T1 FFE post-contrast
Brain
Panorama is fully capable
The Panorama efficiently serves all the hospital’s MR
needs, she adds. “We have not had to turn any patients
away or ambulance any patients to a high field scanner,
because we haven’t encountered any limitations on
the Panorama.”
Amjad Alkadri, MD, Chairman of Imaging at Porter
Hospital says that, in his opinion, the quality of the
images created with the Panorama is comparable to
those from a 1.5T system. “The combination of the high
field strength and Philips’ improved coil technology have
finally made it possible to create high quality images in an
open magnet.”
Panorama HFO exam of a 44-year-old male complaining
of dizziness and inability to focus shows a normal brain.
Voxel size 0.8 x 100 x 5 mm, scan times 2:58 min. for T2 TSE
and 2:12 min. for T1 FFE.
“ The open nature of the scanner
and the superb images it creates
have differentiated Porter Hospital
from others in the area.”
“The open nature of the scanner and the superb images
it creates have differentiated Porter Hospital from
others in the area,” says Dr. Alkadri. “People no longer
have to travel outside of Porter County to have an open
MR exam,” he says. “A competing hospital recently
installed an open scanner, but it’s not high field.”
A high field open is really an advantage for all patient
services in MR, says Dr Alkadri. “Before the HFO
magnet was introduced, radiologists had to choose
between quality and how open the magnet could be.
With the HFO magnet, we are now able to offer an
open magnet without compromising on image quality.”
FieldStrength 39