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Luigi Manfrè, General Secretary of the European Society of Neuroradiology (ESNR), explained his vision for neuroradiology and what MRI holds for the future at ECR2024 last month.

‘We started to have the stand-up position only 10 million years ago, that means our spine didn’t adapt to modern life. That’s why we have so many people with so many spinal diseases,’ said Manfrè, who works as a spinal interventional radiologist at UPMC Salvator Mundi International Hospital in Rome, Italy.

‘Spine is in the top five of the most frequent diseases in the world,’ he told DI Europe contributor Ben Giese. ‘We have to focus on this topic because this is the main health cost in our life. Health is with no cost, but healthcare, it’s got a cost.’

Weight-bearing examinations have completely changed clinical practice and have opened opportunities for the future, first with regards to diagnosis. ‘You cannot do proper diagnosis, and we are talking about mechanical instability, if you don’t examine the spine in a normal situation,’ he said. ‘A normal situation is not lying on a bed. If you want to look at the spine, you need to look at it in the upright position.’

Weight-bearing examinations also have an impact on treatment and results, he added. ‘We have to check our patients, follow them up. And if we want to prove that our treatment was correct and want to demonstrate what happened to the spine after surgery, we need to check the spine back again in the upright.’

MRI has got a lot of advantages when performing advanced procedures, as it is radiation-free and offers the possibility to do real-time imaging. Future procedures will include a combination of CT, fluoroscopy and MRI, Manfrè believes.

‘We will have the possibility to have an MRI-guided procedure, so we will use MRI like a sophisticated ultrasound, and perform, as we are doing in my department, interventional procedures staying together with the patient (…) We will see exactly in real time what we are doing, using proper devices. As Abraham Lincoln once said: ”If you want to predict the future, help to create the future.” We have to create the future using MRI for our procedures.’