Dr Mona Bhatia, Head of Radiology and Imaging, Fortis Escorts Heart Institute

Today radiology has evolved into an exponentially growing, high demand, result oriented field, delivering large volumes of qualitative and quantitative data of high quality, tailored to ensure highest value and outcome-based patient care. The changing approach involves a multidisciplinary, multimodality data analysis with growing machine learning and artificial intelligence.

MRI today trumps all other modalities in diagnostic capability and tissue characterization. It enjoys the undisputed position in a range of conditions from being the first screening modality to the pinnacle of super specialty imaging. However, complexity of scans, long exam duration, and high cost continue to be challenges.

Time in radiology being critical for both man and machine, innovations in MRI technology have focused not only on superior hardware but also improved sequences and softwares, enabling simplified imaging workflow, faster acquisitions, improved patient experience all of which have further encouraged expansions in the field of MRI.

Some of the important advances include multicontrast MR techniques, which deliver more data in a single acquisition, and in a fraction of the time used for conventional imaging. Shorter scans, fewer rescans, save time, cost and improve efficiency with better patient tolerability and lower sedation times. Enhanced patient experience innovations such as silent MRI sequences and ambient imagery, sound, and light, have been exceptional.

Given the rising number of patients using devices requiring MRI scanning and most implants such as knee and hip replacements, spine implants, pacemakers, and implantable cardioverter defibrillators (ICDs) now being MR-conditional, automated sequences for MR-conditional implant scans have increased the number of patients who benefit from MR scanning. Newer advances such as dedicated pulmonary software and weight-bearing MRIs are also contributing to enhanced growth.

One of the potentially game changing fields is cardiac MRI. Complexity of the examination with long scan times and high cost had made it rather prohibitive despite the diagnostic capability and indications. Simplification of advanced cardiac MR with automated image acquisition, visualization, free breathing exams, artificial intelligence, and machine learning speed cardiac MRI exam reviews and automatically identifies the anatomy and creates standard views including cardiac function, 4-D flow, 2-D phase contrast with identification of  regurgitation jets, vortices, and sheer wall stresses.

Last but not the least, while at the high end of the spectrum, FDA has cleared the first 7T MRI system in October 2017, demand is not restricted to A and B towns. Increased awareness and improved affordability with increasing numbers of older populations, are inherent drivers propelling the fast growth in the MR sector. However, researchers need to focus on low-cost, inexpensive, readily available, simplified and automated technology/equipment platforms.

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