3T MRI Consultants LLC (302)-295-3367

3T-MRI (3 Tesla magnetic resonance imaging) is MRI done with a stronger magnet.  Using a stronger magnet results in better images.  Tesla is a unit of “magnetic field.”  Using 3T-MRI, we can get better and sharper pictures in less time than is possible with a weaker magnet.  3T-MRI is the best way to do MRI.   And at 3T we can use 1/2 dose contrast (due to the T1 lengthening effect) and this makes our machine safer for all patients.  By using the combination of the safest MRI contrast (Prohance) and 1/2 dose, we feel that it would be almost impossible to get NSF.  NSF is a rare disease which affects patients with poor renal function.  It causes [painful thickening of their skin and their joints become immobile.  It is an awful way to suffer.  Our facility was the first to screen elderly patients for renal function.  And we are the only facility in Delaware using Prohance which is the safest contrast.  At 1.5T we use Multihance which is also used at 1/2 dose and is believed to be the safest contrast at 1.5T.   This is the recommendation of Dr. Richard Semelka from the University of North Carolina at Chapel Hill.  He is an old colleague of mine. 

When I was a medical student at the University of Rochester, MRI was just an idea in its creator’s mind.  It became a revolutionary way to image the human body when I was in medical school and because I felt it would be the future advancement in what we can see and do, I was determined to understand and follow this technology.  Radiology used to be simply the study of diagnostic x-rays, but we now have many more methods to image the body including MRI and ultrasound.  When I first started, the strongest super conducting magnets were 0.6T.  They were remarkable in their day, but very slow when compared to what we now have available to us.  At that time, closed 0.3T machines tried to challenge the stronger 0.6T machines.  The inferior lower-strength magnets (which created poorer images) lost.  Simply put, stronger field strength means better pictures.  Over time, the 0.1T, 0.3 and 0.4T systems all became dinosaurs. They lost out in the evolution of MRI. 

The next big kid was 1.5T.  I was fortunate to have had a fellowship at the University where 1.5 Tesla MRI was developed.  In 1985, the Hospital of the University of Pennsylvania teamed up with the GE Corporation to introduce the most advanced MRI system of its time — 1.5 Tesla MRI.  That was two and half times stronger than the then-standard 0.6T machines.  As MRI technology evolved, the 0.6T became outdated, and 1.5T became the standard field strength that is still used today.  We have a 1.5T super wide open bore MRI system for our claustrophobic patients.  We are the only facility to have a OPEN MRI 1.5T scanner right next to a 3T MRI scanner. The patient can choose between the best scanners in the world.

My latest prediction is software.  Eventually intelligent consumers will learn about the differences in MRI machines.  I wish this had come at the physician level - but the better software will win.  BLADE is one example of this software.  By freezing motion and producing clearer images.  Systems with BLADE installed have a clear advantage over systems that cannot use BLADE.  Currently this is only available on Siemens MRI scanners.   BLADE is truly revolutionary.  It saves lives.

In the early 1990’s Japanese corporations developed software and permanent magnets at 0.3T, and ingeniously marketed them as OPEN MRI units (so named because of the design of the unit).  The sides of these machines were open, but the space for the patient was, in fact, narrower than the more powerful, super conducting, MRI units.  Today OPEN MR enjoys some success in competing with 1.5T and 3T-MRI units due to this clever marketing.  The truth, however, is that OPEN MRI makes inferior pictures.  OPEN MRI units are narrower and take two or three times longer to scan fewer images of a quality which can result in missing very important things.  Let’s be honest: if I asked to scan you on an extremely slow, poor quality MRI machine with narrower walls and less chance to finding a potential problem, would you actually do it?

As an MRI fellow, I sought to enlighten and teach.  One thing I taught in the 1980’s is that computerized tomography study (CT) of the brain and spine is sub-optimal.  It shows so little detail and misses so many things that it is incredible that we use it at all.  A positive CT scan leads to an MRI study to find out more detail.  A negative CT also leads to an MRI study just to make sure.  So the CT study is essentially superfluous, a waste of time and money.  CT studies should be used sparingly, if at all.  This also applies to OPEN MRI.  Like CT, it is a very poor study, which can miss huge abnormalities.  In some countries, OPEN MRI machines are actually banned for this reason.  Most patients are completely unaware of this, however, believing “an MRI is an MRI.” But not all MRIs are created equal, and OPEN MRI machines are definitely inferior.  In terms of physics, the “signal to noise” (a measure of the elements used to creating an MRI image – a bit like talking about “pixels” in a digital camera) is actually one-tenth that of a 3T MRI study.  To obtain the same “signal to noise” as a 3T MRI study on an OPEN MRI, you might have to scan up to 100 times longer.  The physics involved also show that 3T-MRI is about 2-4 times better than a 1.5T unit.  There are definite instances where 3T-MRI picked up lesions that were missed by both an 0.3T OPEN MRI unit and a 1.5T MRI standard closed unit.  A large cerebral aneurysm was missed on OPEN MRI.  If this had burst, it might have been fatal.  Fortunately it did not.  OPEN MRI missed a case of avascular necrosis of the shoulder, which diagnostically looks like a bone tumor.  1.5T MRI missed a case of multiple brain lesions.  1.5T MRI missed subtle bleeding in the brain.  Generally speaking, using 3T-MRI lets us see more clearly and the contrast effect is doubled.  Our ability to detect hemorrhage is at least doubled.  Another advance called susceptibility weighted imaging (SWI) is also a true advance in this.  In patients with severe head trauma they get subtle lesions in the brain called white matter shearing injury.  While a 3T system with GRE imaging will probably detect this with the greatest senstivity - recent evidence suggests that 1.5T scanners with SWI can also do a very decent job at this.  Our 1.5T Espree does have this sequence - which does take 5 mintues to scan.  However - we will use this in all head trauma cases to eliminate the worry about subtle hemorrhage.  Our scanners simply see better.  Choose the best.

If you do not have your scan at 3T, you will never know what might have been missed.  Patients drive to our facility in Newark DE all the way from Lewes because we are the closest 3T-MRI machine.  Educated doctors insist on 3T-MRI quality.  I hope you will also consider that we use the safest Gadolinium contrast.  Many people do not know there are 5 different contrasts marketed for MRI - Prohance is the safest.  Second in safety is Multihance. Magnevist was considered to be a little safer but Dr. Semelka has placed it in the least safe group.  The least safe group are Optimark and Omniscan.  All of these are trademark names.  Please note Prohance is considered safest because it has never been shown to have a case of nephrogenic systemic sclerosis by itself.  There is one case which was Prohance and Magnevist together.  And since Magnevist has been show to have about 260 cases of NSF.  It is thought to be the drug responsible. www.safecontrast.com

My point?  If you need an MRI, have it done on the very best machine available.  The first time.  Use the safest contrast.  Have an MRI specialist monitor your exam.  Having an MRI done on a less powerful, inferior, machine—which can miss things—will result in your needing a second one on a better, more powerful, machine to confirm the results. If your test is positive on the poor test you will repeat it at 3T-MRI because you can see more.  If your test is negative, you will repeat it to make sure there is nothing there.  So, why waste your time and money?  Why not be sure from the beginning?  3T-MRI is better than CT and most OPEN MRI, both of which give inconclusive results.  If you need imaging, get the very best available.  Use 3T-MRI.  If you are a patient of size or very claustrophobic rest assured, our OPEN MRI is 1.5T magnet strength and quality and is better than all other closed MRI scanners in the state of Delaware at 1.5T (www.mriconsultants.net)

See our commercial on Discovery channel - that breast MRI at 3T is better!  We can see in higher resolution and contrast, the edges of a breast cancer.  This is very helpful in determining if the cancer is possibly malignant.  We also have better temporal and contrast resolution to generate the proper curves to look at lesion washout kinetics.  This is a technical term but better data means a little better total evaluation of the tumor.  New techniques including diffusion weighted imaging (REVEAL) may be improved at 3T and also spectroscopy.  We currently offer REVEAL at 1.5T.  We have BLADE, NATIVE,BEAT and SWI at 1.5T as well.