1
|
Ghotra SS, Champendal M, Flaction L, Ribeiro RT, Sá Dos Reis C. Approaches to reduce medical imaging departments' environmental impact: A scoping review. Radiography (Lond) 2024; 30 Suppl 1:108-116. [PMID: 39146889 DOI: 10.1016/j.radi.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024]
Abstract
INTRODUCTION Global warming stands as a paramount public health issue of our time, and it is fundamental to explore approaches to green medical imaging departments/(MID). This study aims to map the existing actions in the literature that promote sustainable development in MID towards the promotion of environmental impact reduction. METHODS Following the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), this literature search was conducted on MEDLINE, Embase and CINAHL to encompass studies published after 2013. Combinations of keywords and relevant terms related to environmental sustainability, recycling, medical waste, and greening radiology were applied for this review. Three independent reviewers screened abstracts, titles, and eligible full-text. Disagreement was solved through consensus. RESULTS 38 out of 4630 articles met all inclusion criteria, and four additional articles were identified and added through reference search. A third of the studies included were published after 2022, and most were conducted in developed countries (36/41). Articles focused on computed tomography (9/41), magnetic resonance imaging (6/41), interventional radiology (4/41), conventional radiography (4/41), ultrasound (2/41), mixed modalities (10/41), or not applicable to an imaging modality (6/41). Four principal categories were identified to decrease ecological footprint: energy consumption, waste management, justification and environmental pollution. CONCLUSION To minimise the environmental impact of MIDs raising awareness and promoting education is fundamental. Examinations must be justified adequately, energy consumption must be reduced, and waste management practices need to be implemented. Further studies are required to prioritise the most effective strategies, supporting decision-making among stakeholders. IMPLICATIONS FOR PRACTICE Several strategies are already possible to implement to reduce the environmental impact of MIDs and improve the healthcare outcomes for patients.
Collapse
Affiliation(s)
- S S Ghotra
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland; Department of Radiology, Hospital of Yverdon-les-Bains (eHnv), 1400, Yverdon-les-Bains, Switzerland.
| | - M Champendal
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - L Flaction
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - R T Ribeiro
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - C Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| |
Collapse
|
2
|
Balaji S, Wiley N, Poorman ME, Kolind SH. Low-field MRI for use in neurological diseases. Curr Opin Neurol 2024; 37:381-391. [PMID: 38813835 DOI: 10.1097/wco.0000000000001282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW To review recent clinical uses of low-field magnetic resonance imaging (MRI) to guide incorporation into neurological practice. RECENT FINDINGS Use of low-field MRI has been demonstrated in applications including tumours, vascular pathologies, multiple sclerosis, brain injury, and paediatrics. Safety, workflow, and image quality have also been evaluated. SUMMARY Low-field MRI has the potential to increase access to critical brain imaging for patients who otherwise may not obtain imaging in a timely manner. This includes areas such as the intensive care unit and emergency room, where patients could be imaged at the point of care rather than be transported to the MRI scanner. Such systems are often more affordable than conventional systems, allowing them to be more easily deployed in resource constrained settings. A variety of systems are available on the market or in a research setting and are currently being used to determine clinical uses for these devices. The utility of such devices must be fully evaluated in clinical scenarios before adoption into standard practice can be achieved. This review summarizes recent clinical uses of low-field MR as well as safety, workflows, and image quality to aid practitioners in assessing this new technology.
Collapse
Affiliation(s)
- Sharada Balaji
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neale Wiley
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Shannon H Kolind
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine (Neurology)
- Department of Radiology
- International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
3
|
Samardzija A, Selvaganesan K, Zhang HZ, Sun H, Sun C, Ha Y, Galiana G, Constable RT. Low-Field, Low-Cost, Point-of-Care Magnetic Resonance Imaging. Annu Rev Biomed Eng 2024; 26:67-91. [PMID: 38211326 DOI: 10.1146/annurev-bioeng-110122-022903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Low-field magnetic resonance imaging (MRI) has recently experienced a renaissance that is largely attributable to the numerous technological advancements made in MRI, including optimized pulse sequences, parallel receive and compressed sensing, improved calibrations and reconstruction algorithms, and the adoption of machine learning for image postprocessing. This new attention on low-field MRI originates from a lack of accessibility to traditional MRI and the need for affordable imaging. Low-field MRI provides a viable option due to its lack of reliance on radio-frequency shielding rooms, expensive liquid helium, and cryogen quench pipes. Moreover, its relatively small size and weight allow for easy and affordable installation in most settings. Rather than replacing conventional MRI, low-field MRI will provide new opportunities for imaging both in developing and developed countries. This article discusses the history of low-field MRI, low-field MRI hardware and software, current devices on the market, advantages and disadvantages, and low-field MRI's global potential.
Collapse
Affiliation(s)
- Anja Samardzija
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
| | - Kartiga Selvaganesan
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
| | - Horace Z Zhang
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
| | - Heng Sun
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
| | - Chenhao Sun
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Yonghyun Ha
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Gigi Galiana
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - R Todd Constable
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
4
|
Winter L, Periquito J, Kolbitsch C, Pellicer-Guridi R, Nunes RG, Häuer M, Broche L, O'Reilly T. Open-source magnetic resonance imaging: Improving access, science, and education through global collaboration. NMR IN BIOMEDICINE 2024; 37:e5052. [PMID: 37986655 DOI: 10.1002/nbm.5052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 08/01/2023] [Accepted: 09/09/2023] [Indexed: 11/22/2023]
Abstract
Open-source practices and resources in magnetic resonance imaging (MRI) have increased substantially in recent years. This trend started with software and data being published open-source and, more recently, open-source hardware designs have become increasingly available. These developments towards a culture of sharing and establishing nonexclusive global collaborations have already improved the reproducibility and reusability of code and designs, while providing a more inclusive approach, especially for low-income settings. Community-driven standardization and documentation efforts are further strengthening and expanding these milestones. The future of open-source MRI is bright and we have just started to discover its full collaborative potential. In this review we will give an overview of open-source software and open-source hardware projects in human MRI research.
Collapse
Affiliation(s)
- Lukas Winter
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - João Periquito
- Department of Infection, Immunity & Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - Christoph Kolbitsch
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | | | - Rita G Nunes
- Institute for Systems and Robotics and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Martin Häuer
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
- Open Source Ecology Germany e.V. (nonprofit), Berlin, Germany
| | - Lionel Broche
- Biomedical Physics, University of Aberdeen, Aberdeen, UK
| | - Tom O'Reilly
- Leiden University Medical Center (LUMC), Leiden, The Netherlands
| |
Collapse
|
5
|
Anazodo UC, Plessis SD. Imaging without barriers. Science 2024; 384:623-624. [PMID: 38723100 DOI: 10.1126/science.adp0670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Low-field magnetic resonance imaging can be engineered for widespread point-of-care diagnostics.
Collapse
Affiliation(s)
- Udunna C Anazodo
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Insitute, McGill University, Montreal, QC, Canada
- Medical Artificial Intelligence Laboratory, Crestview Radiology Ltd., Lagos, Nigeria
| | - Stefan du Plessis
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
6
|
Duncan NW, Rae CL. Geographical and economic influences on neuroimaging modality choice. ROYAL SOCIETY OPEN SCIENCE 2024; 11:231496. [PMID: 38699551 PMCID: PMC11061638 DOI: 10.1098/rsos.231496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/01/2024] [Accepted: 02/23/2024] [Indexed: 05/05/2024]
Abstract
The current neuroimaging literature is unrepresentative of the world's population due to bias towards particular types of people living in a subset of geographical locations. This is true of both the people running the research and those participating in it. These biases mean we may be missing insights into how the brain works. As neuroimaging research expands out to more of the world, the reality of global economic disparities becomes salient. With economic conditions having an effect on many background conditions for research, we can ask whether they also influence the neuroimaging research being done. To investigate this, the number of neuroimaging publications originating from a country was used as a proxy for the type of research being done there in terms of imaging modalities employed. This was then related to local economic conditions, as represented by national gross domestic product and research and development spending. National financial metrics were positively associated with neuroimaging output. The imaging modalities used were also found to be associated with local economic conditions, with magnetic resonance imaging (MRI) research positively and electroencephalography (EEG) negatively associated with national research spending. These results suggest that economic conditions may be relevant when planning how neuroimaging research can be expanded globally.
Collapse
Affiliation(s)
- Niall W. Duncan
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
| | | |
Collapse
|
7
|
Looking towards the future of MRI in Africa. Nat Commun 2024; 15:2260. [PMID: 38480725 PMCID: PMC10937907 DOI: 10.1038/s41467-024-46567-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
|
8
|
de Vos B, Remis RF, Webb AG. Characterization of concomitant gradient fields and their effects on image distortions using a low-field point-of-care Halbach-based MRI system. Magn Reson Med 2024; 91:828-841. [PMID: 37749850 DOI: 10.1002/mrm.29879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Concomitant gradient fields have been extensively studied at clinical field strengths. However, their effects have not yet been modeled for low-field point-of-care (POC) systems. The purpose of this work is to characterize the effects associated with concomitant fields for POC Halbach-array-based systems. METHODS The concomitant fields associated with a cylindrical gradient coils designed for a transverseB 0 $$ {B}_0 $$ and a signal model including the tilting effect of the effective magnetic field are derived. The formalism is used to simulate and predict concomitant field related distortions. A 46-mT Halbach-array-based system with a maximum gradient strength of 15 mT/m is used to verify the model using two-dimensional spin-echo sequences. RESULTS The simulations and experimental results are in good agreement with the derived equations. The fundamental characteristics of the concomitant field equations are different to conventional MRI systems: Image distortions occur primarily in the transverse directions and a cross-term only exists when applying transverse gradient pulses simultaneously. CONCLUSION The level of image warping in the frequency encoding direction is insignificant for the POC systems discussed here. However, when trying to achieve short echo-times by using strong phase encoding and readout-dephasing gradients, the combination can result in image warping and blurring which should be accounted for in image interpretation.
Collapse
Affiliation(s)
- Bart de Vos
- Radiology, C.J. Gorter MRI Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob F Remis
- Micro-electronics, Signal Processing Systems, Delft University of Technology, Delft, The Netherlands
| | - Andrew G Webb
- Radiology, C.J. Gorter MRI Center, Leiden University Medical Center, Leiden, The Netherlands
- Micro-electronics, Terahertz Sensing, Delft University of Technology, Delft, The Netherlands
| |
Collapse
|
9
|
Zalis ME, Slutzman JE. Technical and Administrative Advances to Promote Sustainable Radiology. J Am Coll Radiol 2024; 21:274-279. [PMID: 38048966 DOI: 10.1016/j.jacr.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023]
Abstract
Climate change mandates that we take steps to understand and mitigate the negative environmental consequences of the practice of health care, so that health care advances sustainably. In this article, the authors review and discuss a sample of technical and administrative advances required to align the practice of radiology with principles of environmental sustainability.
Collapse
Affiliation(s)
- Michael E Zalis
- Director, Mass General Brigham Radiology Center for Sustainability, Boston, Massachusetts; Divisions of Cardiovascular and Interventional Radiology, Department of Radiology, Mass General Hospital, Boston, Massachusetts.
| | - Jonathan E Slutzman
- Director, Mass General Center for the Environment and Health, Massachusetts General Hospital, Boston, Massachusetts; Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
10
|
Campbell-Washburn AE, Keenan KE, Hu P, Mugler JP, Nayak KS, Webb AG, Obungoloch J, Sheth KN, Hennig J, Rosen MS, Salameh N, Sodickson DK, Stein JM, Marques JP, Simonetti OP. Low-field MRI: A report on the 2022 ISMRM workshop. Magn Reson Med 2023; 90:1682-1694. [PMID: 37345725 PMCID: PMC10683532 DOI: 10.1002/mrm.29743] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/21/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023]
Abstract
In March 2022, the first ISMRM Workshop on Low-Field MRI was held virtually. The goals of this workshop were to discuss recent low field MRI technology including hardware and software developments, novel methodology, new contrast mechanisms, as well as the clinical translation and dissemination of these systems. The virtual Workshop was attended by 368 registrants from 24 countries, and included 34 invited talks, 100 abstract presentations, 2 panel discussions, and 2 live scanner demonstrations. Here, we report on the scientific content of the Workshop and identify the key themes that emerged. The subject matter of the Workshop reflected the ongoing developments of low-field MRI as an accessible imaging modality that may expand the usage of MRI through cost reduction, portability, and ease of installation. Many talks in this Workshop addressed the use of computational power, efficient acquisitions, and contemporary hardware to overcome the SNR limitations associated with low field strength. Participants discussed the selection of appropriate clinical applications that leverage the unique capabilities of low-field MRI within traditional radiology practices, other point-of-care settings, and the broader community. The notion of "image quality" versus "information content" was also discussed, as images from low-field portable systems that are purpose-built for clinical decision-making may not replicate the current standard of clinical imaging. Speakers also described technical challenges and infrastructure challenges related to portability and widespread dissemination, and speculated about future directions for the field to improve the technology and establish clinical value.
Collapse
Affiliation(s)
- Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kathryn E Keenan
- Physical Measurement Laboratory, National Institute of Standards and Technology, Boulder, Colorado, USA
| | - Peng Hu
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, China
| | - John P Mugler
- Department of Radiology & Medical Imaging, Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
| | - Andrew G Webb
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Kevin N Sheth
- Division of Neurocritical Care and Emergency Neurology, Departments of Neurology and Neurosurgery, and the Yale Center for Brain and Mind Health, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jürgen Hennig
- Dept.of Radiology, Medical Physics, University Medical Center Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthew S Rosen
- Massachusetts General Hospital, A. A. Martinos Center for Biomedical Imaging, Boston, Massachusetts, USA
- Department of Physics, Harvard University, Cambridge, Massachusetts, USA
| | - Najat Salameh
- Center for Adaptable MRI Technology (AMT Center), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Daniel K Sodickson
- Department of Radiology, NYU Langone Health, New York, New York, USA
- Center for Advanced Imaging Innovation and Research, NYU Langone Health, New York, New York, USA
| | - Joel M Stein
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - José P Marques
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Orlando P Simonetti
- Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Department of Radiology, The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
11
|
Hennig J. An evolution of low-field strength MRI. MAGMA (NEW YORK, N.Y.) 2023; 36:335-346. [PMID: 37289275 PMCID: PMC10386941 DOI: 10.1007/s10334-023-01104-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/05/2023] [Accepted: 05/17/2023] [Indexed: 06/09/2023]
Abstract
The paper describes the evolution of low-field MRI from the very early pioneering days in the late 70 s until today. It is not meant to give a comprehensive historical account of the development of MRI, but rather to highlight the different research environments then and now. In the early 90 s, when low-field systems below 1.5 T essentially vanished, there were just no reasonable means available to make up for the factor of roughly three in signal-to-noise-ratio (SNR) between 0.5 and 1.5 T. This has drastically changed. Improvements in hardware-closed Helium-free magnets, RF receiver systems and especially much faster gradients, much more flexible sampling schemes including parallel imaging and compressed sensing and especially the use of AI at all stages of the imaging process have made low-field MRI a clinically viable supplement to conventional MRI. Ultralow-field MRI with magnets around 0.05 T are also back and constitute a bold and courageous endeavor to bring MRI to communities, which have neither the means nor the infrastructure to sustain a current standard of care MRI.
Collapse
Affiliation(s)
- Juergen Hennig
- Department of Radiology, Medical Physics, Faculty of Medicine, University of Freiburg, Killianstr.5a, 79106, Freiburg, Germany.
| |
Collapse
|