3T breast MRI is twice as good!

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

3T-MRI (3 Tesla magnetic resonance imaging) is MRI done with the strongest possible magnet in clinical imaging.  We have done this since 2007.  We are the facility with the most 3T experience in Delaware.   3T MRI gives us higher resolution images and faster scan times.  The dynamic part of the study is completed in 8 -10 minutes.  We also use the safest contrast concept on both of our scanners.  (www.safecontrast.com) Ask your other facility.  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.   In the future 7T and 10T magnets may be used but currently 3T is the best we can offer!  Get the best MRI possible, use 3T. 

 

Dr. Philip Chao has 27.6 years experience interpreting MRI scans.  He has experience greater than most physicians in Delaware and notes that the best MRIs are done if you have newer equipment, better hardware and software and the best office staff as well.  But the most important difference is he wants to answer your questions.  He was also voted one of the 5 top doctors in Radiology in 2012 in Delaware Today magazine by his peers.

 

Dr. Chao worked at 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.  He worked with the physicians who later went out to change the world.  He is personally known by Dr. Felix Wehrli, Dr. Robert I. Grossman, Dr. Robert A. Zimmerman, Dr. Scott Atlas, Dr. Herbert Y. Kressel, Dr. Robert Lenkinski and others.   Basically he has seen the development of MRI and fMRI and cares about the quality of MRI in Delaware.  He even participated in the development of the prostate coil - working with Dr. Mitchell Schnall.

Sadly most doctors do not understand the differences in MRI hardware or software.  The newest software is almost always better.   The newest technology is not always better.  Ask Dr. Chao.   MRI machines change as rapidly as computers.  Dr. Chao goes to the annular Society of Magnetic Resonance in Medicine meetings.  He follows MRI developments for years before they become clincial products.  Eventually intelligent consumers and doctors will learn about the differences in MRI machines.    Younger machines means better pictures in most cases.  What some people would be astounded to know is that some machines were installed as early as 1988 in Delaware.  A scanner that is 22 years old no matter how many times they supposedly upgraded the machine is not the same as a mcahine which is 2 years old.  New technology can also be unreliable.  Also the new wireless technology is supposed to be better.  But Dr. Chao notes that means there is more to break and it also makes the coils heavier.  And so far Philips surface coils are not yet 32 channel for this NEW technology.  Having less channels is a deficiency.

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.  It offers clearer spine, brain, musculoskeletal and especially shoulder imaging.

 

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, and clearer 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?  OPEN low field MRI basically misses things.  I have many examples of missed findings using low field OPEN MRI.

 

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.  We now have 3T MRI in Lewes.  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. Eovist is third safest.  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)

Breast MRI at 3T is better!  We can see with 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.   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.