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Low-field MRI in combination with AI could be a solution to address the helium crisis and adopt a more sustainable approach in radiology, Kai Vilanova, Head of MRI at the Cliníc Girona in Spain, told Mélisande Rouger at SERAM 2024, the 37th meeting of the Spanish Society of Radiology (SERAM), last May in Barcelona.

MRI scanners require 2,000 liters of ultra-cold liquid helium to keep their magnets cool enough to work. However helium is a nonrenewable element found within the Earth’s crust and resources are running low. Hospitals are thus faced with a long-term problem of scarce supply. 

One strategy could be to use low-field MRI scanners, according to Vilanova, who will chair the congress of the European Society for Magnetic Resonance in Medicine and Biology (ESMRMB) in October in Barcelona.

’70 to 80% of the MRI scanners in the hospital are high-field. High-field MRI requires large quantities of helium, so this is expensive – both in terms of maintenance and energy costs,’ he said. ‘Today, we have to go for a sustainable approach and low-field MRI consumes four to five times less energy than high-field MRI.’

 Kai Vilanova is Head of MRI at the Clinic Girona and Associate professor Coordinator of Radiology at Girona University in Spain. He will preside the local congress committee of ESMRMB2024 in Barcelona on 2-5 October 2024.

Low-field MRI also enables to shorten examination time as compared with a decade ago, and scanners are open space, providing much more comfort for the patient. Using both high-field and low-field MRI depending on the application would make MRI cost effective, he explained.

‘In my department I use both low-field and high-field MRI. Certain types of examinations, for example of the heart, prostate or breast, require high-field imaging. But 80% of the requests we receive for MRI are musculoskeletal. The knee and lumbar spine represent 40% of MRI demands globally. So most examinations can be low-field, and I do 80% of my examinations with our low-field scanner, which offers high quality for these two examinations.’

Radiologists have to bear in mind that they have to carry out sustainable examinations, said Vilanova, who gave a lecture on the topic at ECR 2023 in Vienna. ‘This is a big issue for us and we have solutions such as low field MRI. I am for this type of examination, but it’s hard for hospitals to provide this.’

Most hospitals today work with high-field MRI, partly because radiologists demand this type of equipment. ‘Radiologists want the biggest and fastest tools because they don’t have to pay for this,’ he said. ‘Radiologists also like nice images that high-field MRI provides. But something can come and disrupt this, and that tool is artificial intelligence.’

AI Must Prove Its Value

AI can improve image resolution in low-field MRI and enable to obtain images like high-field MRI.

Radiologists are increasingly using AI, according to Vilanova, who conducted a survey among the audience at SERAM 2024. ‘In a simple MSK radiology session, I asked the audience how many were using AI and I was kind of surprised because 45% of the attendants said they were using it,’ he said. 

Experience has showed that the technology offers good results for plain films of the thorax and bone fractures, as well as for automatic reporting.

In MRI, AI reduces examination time and increases resolution. ‘Patients have to spend less time in the scanner and we have better images, that’s good for the radiologist. It’s great for diagnosis,’ he said. 

Everyone wants to incorporate or try AI now, but the technology must still be fine tuned to deliver the expected results, according to Vilanova, who incorporated an algorithm in daily routine eight months ago.

‘I am using one of these solutions at my hospital, but we still have to work on it. Tools are still evolving and implementation has to be settled. The next step in the near future will be to see which of these AI tools really works.’

Vilanova also expects the commercialization of new contrast media that reduce the amount of gadolinium that is necessary to carry out an MRI examination. ‘With less gadolinium, we can obtain the same information,’ he explained. ‘Gadolinium is a drug, it’s not innocuous. We will reduce cost and toxicity, so this is a big, expected project that for sure we will have in a few months in Europe.’