Sustainable low-field cardiovascular magnetic resonance in changing healthcare systems

Qin, Cathy; Murali, Sanjana; Lee, Elsa; Supramaniam, V; Hausenloy, Derek J.; Obungoloch, Johnes; Brecher, Joanna; Lin, R.; Ding, Hao; Akudjedu, Theophilus N.; Anazodo, Udunna; Jagannathan, Naranamangalam R.; Ntusi, Ntobeko; Simonetti, Orlando P.; Campbell-Washburn, Adrienne E; Niendorf, Thoralf; Mammen, Regina; Adeleke, Sola

doi:10.1093/ehjci/jeab286

Cited by 24 publications

(24 citation statements)

References 149 publications

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“…Low-field MRI systems are significantly cheaper than high-field systems and not only does it have the potential to address most clinical needs in SSA, but also has manifold advantages over high-field MRI 14,16,33 . Furthermore, low-field equipment requires less technical expertise to run and maintain.…”

Section: Resultsmentioning

confidence: 99%

“…While cardiovascular disease has decreased globally over the past decades 10 , the incidence is steadily increasing in SSA 11,12 . By enabling accurate assessment of cardiac morphology, function, flow, perfusion, acute tissue injury, and fibrosis, MRI can help determine disease etiology and risk, thus facilitating effective management of heart failure and other cardiomyopathies 13 -even at low magnetic field strengths 14 . MRI is the recommended standard of care in the diagnosis and treatment of neurological diseases, including but not limited to seizures 15 , strokes 16,17 and dementia 18 .…”

Section: Introductionmentioning

confidence: 99%

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A Framework for Advancing Sustainable MRI Access in Africa

Anazodo

Ehiogu

et al. 2022

Preprint

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MRI technology has profoundly transformed current healthcare and research systems globally. The rapidly growing burden of non-communicable diseases in Africa has underscored the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education & Research in Africa (CAMERA) is a network of African experts, global partners, and ISMRM/ESMRMB members implementing novel strategies to advance MRI access and research in Africa. To identify challenges to MRI usage and provide a framework for addressing MRI needs in the region, CAMERA conducted a Needs Assessment Survey (NAS) and a series of symposia at international MRI society meetings over a 2-year period. The 68-question NAS was distributed to MRI users in Africa and completed by 157 clinicians and scientists from across Sub-Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at <1, of which, 39% were obsolete low-field systems yet still in use to meet clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher-field (1.5T) MRI scanners in the region. However, these systems are underutilized with only 8% of facilities reporting clinical scans of 15 or more patients daily per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. Our NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up-to-date data on MRI density in Africa and offers unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA. Findings from the NAS and focused discussions at ISMRM and ESMRMB provided the basis for the framework presented here for advancing MRI capacity in SSA.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Framework for Advancing Sustainable MRI Access in Africa

Anazodo

Ehiogu

et al. 2022

Preprint

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“…30 3.9.2 | Invest in low-field MRI as a cost-effective and adaptable alternative to high-field MRI Low-field MRI systems are significantly cheaper than high-field systems, and not only do they have the potential to address most clinical needs in SSA, they also has manifold advantages over high-field MRI. 14,16,36 Furthermore, low-field equipment requires less technical expertise to run and maintain. It is important to note that low-field equipment is significantly less heavy and easier to transport than high-field systems, thus reducing transportation costs and the challenges associated with setting up the equipment.…”

Section: Create Vendor-financing Programsmentioning

confidence: 99%

“…11,12 By enabling accurate assessment of cardiac morphology, function, flow, perfusion, acute tissue injury, and fibrosis, MRI can help determine disease etiology and risk, thus facilitating effective management of heart failure and other cardiomyopathies, 13 even at low magnetic field strengths. 14 MRI is the recommended standard of care in the diagnosis and treatment of neurological diseases, including, but not limited to, seizures, 15 strokes, 16,17 and dementia. 18 MRI can help determine seizureetiology in epilepsy management, 15 visualize, and quantify tissue perfusion, vascular flow, and treatment response in acute and subsequent phases of stroke.…”

Section: Introductionmentioning

confidence: 99%

“…While cardiovascular disease has decreased globally over recent decades, 10 its incidence is steadily increasing in SSA 11,12 . By enabling accurate assessment of cardiac morphology, function, flow, perfusion, acute tissue injury, and fibrosis, MRI can help determine disease etiology and risk, thus facilitating effective management of heart failure and other cardiomyopathies, 13 even at low magnetic field strengths 14 …”

Section: Introductionmentioning

confidence: 99%

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A framework for advancing sustainable magnetic resonance imaging access in Africa

Anazodo

Ehiogu

et al. 2022

NMR in Biomedicine

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Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low‐resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2‐year period. The 68‐question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub‐Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low‐field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher‐field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up‐to‐date data on MRI density in Africa and offers a unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high‐value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low‐resource settings.

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Cardiac MRI at Low Field Strengths

Campbell‐Washburn,

Varghese,

Nayak

et al. 2023

Magnetic Resonance Imaging

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Cardiac MR imaging is well established for assessment of cardiovascular structure and function, myocardial scar, quantitative flow, parametric mapping, and myocardial perfusion. Despite the clear evidence supporting the use of cardiac MRI for a wide range of indications, it is underutilized clinically. Recent developments in low‐field MRI technology, including modern data acquisition and image reconstruction methods, are enabling high‐quality low‐field imaging that may improve the cost–benefit ratio for cardiac MRI. Studies to‐date confirm that low‐field MRI offers high measurement concordance and consistent interpretation with clinical imaging for several routine sequences. Moreover, low‐field MRI may enable specific new clinical opportunities for cardiac imaging such as imaging near metal implants, MRI‐guided interventions, combined cardiopulmonary assessment, and imaging of patients with severe obesity. In this review, we discuss the recent progress in low‐field cardiac MRI with a focus on technical developments and early clinical validation studies.Evidence Level5Technical EfficacyStage 1

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Sustainable low-field cardiovascular magnetic resonance in changing healthcare systems

Cited by 24 publications

References 149 publications

A Framework for Advancing Sustainable MRI Access in Africa

A Framework for Advancing Sustainable MRI Access in Africa

A framework for advancing sustainable magnetic resonance imaging access in Africa

Cardiac MRI at Low Field Strengths

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