MRI scanner upgrade instead of reinstallation with MR SmartPath to Ingenia 1.5T Evolution

It is a challenge many clinics and radiology practices face: in order to benefit from the latest innovations — especially in the field of MRI — a new system purchase must be considered. Future-proof software and the newest imaging methods are needed to expand diagnostic capabilities and increase speed. Workflow and comfort for patients and staff need to be improved. But the question is how to install a new system without having to shut down your practice for weeks? How do you get by not being able to scan any patients, having to postpone exams to a later date

These questions weighed heavily on radiologist Martin Kollerer. Together with Dr. Margit Purucker, he runs a radiological practice in Marktredwitz in Germany. Since 2002, he has been working with Philips solutions, including the Ingenia 1.5T MRI scanner, “A reliable, stable system,” he says.

And yet, it was time to expand functionality. Dr. Kollerer wanted to take advantage of recent advancements and make them accessible to his patients and staff. “Technology is constantly evolving towards enabling both faster examinations and higher quality images, as well as an increasing focus on the patient,” he says. However, an MRI scanner cannot typically be replaced just like that. A magnet weighing more than three tons can only be changed with great effort. Walls or ceilings may have to be lifted and a heavy-duty crane brought in to take the magnet in or out of the building. In addition, the magnet that has been in use in the Marktredwitz practice for several years, is still far from outdated. “Replacing it would have been neither economical nor sustainable,” says Dr. Kollerer.

Dr. Kollerer reached out to Philips to discuss options for strategically shaping his business model for the next years. “Working with Philips is like working with friends,” he says. For years, the relationship with Philips has been based on trust and characterized by open communication. “I knew that if I wanted to discuss my concerns and my ideas, it would be with this company.”

The solution they eventually agreed upon is called MR SmartPath, a Philips program to extend the useful life of MR systems. SmartPath gives a radiology practice the opportunity to easily and cost-effectively upgrade their Philips systems to the latest technology and thus expand the practice’s MRI capabilities. "For us, this was the optimal way," says Martin Kollerer.

Based on the SmartPath business case, it was decided to preserve the existing high-end system, but to equip it with new, comprehensive functionalities. This approach provides substantial benefits for ongoing operation. While a completely new scanner and thus magnet replacement would have paralyzed practical operation for quite a long time, the changeover time in the MR SmartPath program was just ten days [1]. “In ten days to a system for the next years—that’s what I call securing the future in a turbo process,” says Dr. Kollerer.

With the renewed Ingenia 1.5T Evolution system, the practice can now continue to provide a high level of diagnostic confidence and patient-friendly examinations. “For example, it allows us to use faster scan methods,” explains Martin Kollerer. “The integrated Compressed SENSE acceleration technology allow us to make scan times shorter [2], while maintaining consistently high image quality.”

This not only affects the work of staff in the practice, but also benefits the patients, as MRI technologist Ina Rank observes: “Thanks to Compressed SENSE, the examination time is remarkably shorter compared to the previous version of the scanner.” For patients, this means greater comfort. The technologists see great advantages for patients after upgrading the existing Ingenia 1.5T scanner to Ingenia Evolution. “For example, the upgraded scanner is now equipped with a special thick ComfortPlus mattress that is so comfortable that patients can lie completely relaxed.” This also has an effect on the image quality—the calmer the patients are, the better images can be achieved.

The upgraded system features VitalEye and VitalScreen, both of which contribute to a fast and smooth examination process. The sensor technology of VitalEye allows contactless monitoring of the patient’s breathing pattern, so that it relieves technologists from having to place a respiratory belt on the patient.

The VitalScreen provides technologists with the most important patient and examination information during patient positioning, its touchscreen allowing to adjust if necessary. “Along with improved usability, another important VitalScreen advantage is that the technologists can stay with the patient during the exam preparation. This has a very calming effect on most patients,” says Rank.

During the scan, AutoVoice gives spoken instructions to the patient and visible breathing instructions are automatically displayed along with information to let the patient know how long the examination will still take. Based on Ina Rank’s experience, these are pleasant distractions that ease the exam: when patients are more relaxed it is easier for them to remain still and this can benefit image quality.

According to Dr. Kollerer, the image quality gain is an essential advantage of the upgrade. "This is one of the most important requirements for our work. With high-resolution and excellent image quality we can make diagnoses as reliable as possible." This applies in particular to prostate cancer diagnoses. The Marktredwitz practice is certified as a center for prostate MRI, and as such specializes in diagnosing prostate cancer as early as possible with multiparametric MRI (mpMRI) to help them characterize the tumor and its spread.

Dr. Kollerer has found he really appreciates being able to use Compressed SENSE for dedicated, detailed prostate imaging. In addition, an acceleration of up to 35 percent was achieved with Compressed SENSE, according to a SpeedTrack analysis performed by Philips in the radiology practice [1,3]. Kollerer, one thing is certain, “With the MR SmartPath upgrade, Philips and I have set the course for the future security of this practice and our prostate center.”

“Philips and I”, that's what Dr. Kollerer repeatedly says. When asked about this, he laughs, “Indeed, it feels like we managed this upgrade project together, as equal partners.” This did not surprise him. His many years of experience with the Philips service team have been good. However, setting up a business case together requires an increased degree of trust, mutual respect and know-how on both sides.

It is foreseeable that at some point in future, perhaps again in ten years, a new functional expansion for the scanner will be necessary. Neither medicine nor medical technology stands still. Technical developments continue to progress. And Dr. Kollerer will keep an eye out for new emerging solutions and features he can use to keep his practice fit for the future and to provide his patients with the best possible care. One thing is already certain — it will be good to have a proven friend at his side. Dr. Kollerer explains, “Working with Philips is like working with friends.”