6 ms·

"Clinicians operating in areas outside of major metropolitan areas need rapid diagnostic imaging results especially in cases of stroke, which requires immediate

"Clinicians operating in areas outside of major metropolitan areas need rapid diagnostic imaging results especially in cases of stroke, which requires immediate treatment to prevent death or poor outcomes for patients. For instance, the portable device could be used by doctors in poor countries, rural areas, or even in ambulances to differentiate between stroke symptoms caused by a brain bleed or blood clot. " Sounds pretty neat. I wonder why this is only a brain thing, something about size constraints maybe? I have no idea how these things might work. Can they make a mini-mri for the rest of the body?

roywiggins 6y ago
The size of the machine tends to scale more-than-linearly with the cross-section of the thing you're scanning. Small animal MRI machines are really tiny: https://rs2d.com/en/mri/irm-1-5t/ https://rs2d.com/en/mri/irm-1-5t/
hexxiiiz 6y ago
I think (I might be wrong) the brain might be a good target because there is not much motion. To get fast readings from an MRI you probably need the stronger magnets. MRI works not by capturing spatial variation directly like a camera, but collects a time series of aggregate magnetic field readings while a gradient field is used to create changing spatial variation. In essence, the time series gives the k-space of the image, which is then Fourier transformed into the original image. Consequently, the body must remain fairly still while this k-space time series is constructed. The heart, for instance, is notoriously hard to image.
- lostlogin 6y ago
  The heart is hard to image but it’s impressive to see the results. Looking at cardiac cine series is impressive.
l33tman 6y ago
You don't typically need an MRI in an ER setting except for the problem stated, differentiating between various reasons for a stroke. A CT can do the rest and is way cheaper and simpler to setup and operate. There are other reasons an MR could be better though, for example no ionizing radiation, so you could argue you could send more patients through it than you would with an ER CT (you would only send patients you have a higher confidence of them requiring it to avoid spamming radiation).
- thomasfedb 6y ago
  Even for a stroke, the standard ED protocol is a CT in the majority of cases.
  - ska 6y ago
    That has a lot to do with the difficultly and cost of siting an MRI close enough and keeping it open for for emergency protocols.
    - lostlogin 6y ago
      It also relates to the patient though. Stroke patients are often not very compliant and a morality that is slow and requires a still patient is ill suited to a lot of the work an ED sees.
      - ska 6y ago
        True enough, but MRI is not inherently too slow for this use. If the economics otherwise made sense, an acceptably fast throughput stroke protocol MR is quite doable.
        lostlogin 6y ago
        It is. The requirements of the MR environment make it a lot more difficult than CT though. For example a tubed patient is harder to manage in MR than CT, and while this is done regularly it isn't as easily done as CT.
        ska 6y ago
        True, but the improved contrast would probably make it a no-brainer if the other issues were taken care of .
        lostlogin 6y ago
doctoring 6y ago
MRI has a pretty unique value proposition for the brain, as it can detect and discern things that other modalities (CT, US) simply cannot. Even a poor quality MRI (essentially what this is) provides more information within the brain than a high resolution CT. Many of the brain pathologies are also very time-sensitive. So a good place to start. Elsewhere in the body, MRI is less useful, and isn't really a workhorse as it is with neuroimaging. (Except maybe joint imaging.) Most emergent problems are detectable via those other cheaper, faster, & less onerous technologies. Your guess about size is also likely correct; the positioning of the antenna/coils and relation to the magnet are very important (especially with a weak magnet) and much more challenging/variable if you're thinking about the range of abdomen sizes (for example) versus head sizes.
- toomuchtodo 6y ago
  Do MRIs have any value in replacing physical examinations (prostate, colonoscopy) with diagnostic imaging? My understanding is that assay testing is getting better, but still no replacement for the physical procedures I mentioned.
  - jrowley 6y ago
    For measuring spread of disease like prostate cancer imaging can be really helpful, see: PSMA PET-CT. I could imagine a world where imaging is really cheap and agents were safer, in which case we might opt to use imaging instead of physical exams, as they would offer way earlier detection. But for now the additional radiation (not present in MR), cost, risk, time, etc makes it a no go for standard of care screening.
  - dwelch 6y ago
    Imaging in general has an important role in screening for certain diseases, and in some cases is already more important than physical examination. This mainly depends on how "well" physical examinations can detect an illness, the characteristics of a particular imaging study (cost, radiation exposure, etc), and the characteristics of a disease (prevalence in a population, potential benefit of early detection/treatment). So in short, for MRI to replace physical exam and/or lab testing in screening for a particular disease, the cost needs to come down or the benefit should outweigh the cost. Prostate cancer screening in general is no longer officially recommended by the AAFP as a rule [1], but if a patient decides to opt-in to screening, the "assay" (PSA) is preferred over a digital rectal examination, which has been shown to be increasingly useless in the detection of prostate cancer. MRI doesn't currently have a role in prostate cancer screening, but Prostate MRI has an increasingly critical role in diagnosis. CT colonography is currently a viable option for colon cancer screening instead of colonoscopy, though colonoscopy is still considered the gold standard. Chest CT is currently recommended to screen for lung cancer in patient's that meet certain criteria (age, smoking history). Mammography is obviously the workhorse of screening for breast cancer, rather than physical examination. But MRI is recommended as a screening mechanism for certain patient populations with very high risk of breast cancer (e.g. certain BRCA mutations). The small population, high prevalence, and benefit of early detection combine to make this a viable option. [1] https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/cw-prostate-cancer.html https://www.aafp.org/family-physician/patient-care/clinical-...
richardkmichael 6y ago
They have video of knee, neck and foot. Evidently "works-in-progress" and not part of their FDA filing. https://www.hyperfine.io/clinical https://www.hyperfine.io/clinical
jmhmd 6y ago
I saw a demo of this device at RSNA last year. It is quite small, which is their goal to make it as portable as it is. But, the opening where the body parts go is also small, and at this point too small I think to fit the whole body. It would work for head and extremities I should think.
- swader999 6y ago
  I'm inquiring about using this in a veterinary hospital. Might be a ideal for this.
  - lostlogin 6y ago
    You need a lot of Tesla’s for animal work. Everything is so small that fine slices and high in-plane resolution is needed. The spinal cord on a small dog is not always easily imaged at 3T, 0.1T is going to be a problem.
    - swader999 6y ago
      Thanks. Makes sense why there's no info on their site regarding vet use.

roywiggins 6y ago

The size of the machine tends to scale more-than-linearly with the cross-section of the thing you're scanning. Small animal MRI machines are really tiny: https://rs2d.com/en/mri/irm-1-5t/ https://rs2d.com/en/mri/irm-1-5t/

hexxiiiz 6y ago

I think (I might be wrong) the brain might be a good target because there is not much motion. To get fast readings from an MRI you probably need the stronger magnets. MRI works not by capturing spatial variation directly like a camera, but collects a time series of aggregate magnetic field readings while a gradient field is used to create changing spatial variation. In essence, the time series gives the k-space of the image, which is then Fourier transformed into the original image. Consequently, the body must remain fairly still while this k-space time series is constructed. The heart, for instance, is notoriously hard to image.

lostlogin 6y ago
The heart is hard to image but it’s impressive to see the results. Looking at cardiac cine series is impressive.

l33tman 6y ago

You don't typically need an MRI in an ER setting except for the problem stated, differentiating between various reasons for a stroke. A CT can do the rest and is way cheaper and simpler to setup and operate. There are other reasons an MR could be better though, for example no ionizing radiation, so you could argue you could send more patients through it than you would with an ER CT (you would only send patients you have a higher confidence of them requiring it to avoid spamming radiation).

thomasfedb 6y ago
Even for a stroke, the standard ED protocol is a CT in the majority of cases.
- ska 6y ago
  That has a lot to do with the difficultly and cost of siting an MRI close enough and keeping it open for for emergency protocols.
  - lostlogin 6y ago
    It also relates to the patient though. Stroke patients are often not very compliant and a morality that is slow and requires a still patient is ill suited to a lot of the work an ED sees.
    - ska 6y ago
      True enough, but MRI is not inherently too slow for this use. If the economics otherwise made sense, an acceptably fast throughput stroke protocol MR is quite doable.
      - lostlogin 6y ago
        It is. The requirements of the MR environment make it a lot more difficult than CT though. For example a tubed patient is harder to manage in MR than CT, and while this is done regularly it isn't as easily done as CT.
        ska 6y ago
        True, but the improved contrast would probably make it a no-brainer if the other issues were taken care of .
        lostlogin 6y ago

doctoring 6y ago

MRI has a pretty unique value proposition for the brain, as it can detect and discern things that other modalities (CT, US) simply cannot. Even a poor quality MRI (essentially what this is) provides more information within the brain than a high resolution CT. Many of the brain pathologies are also very time-sensitive. So a good place to start. Elsewhere in the body, MRI is less useful, and isn't really a workhorse as it is with neuroimaging. (Except maybe joint imaging.) Most emergent problems are detectable via those other cheaper, faster, & less onerous technologies. Your guess about size is also likely correct; the positioning of the antenna/coils and relation to the magnet are very important (especially with a weak magnet) and much more challenging/variable if you're thinking about the range of abdomen sizes (for example) versus head sizes.

toomuchtodo 6y ago
Do MRIs have any value in replacing physical examinations (prostate, colonoscopy) with diagnostic imaging? My understanding is that assay testing is getting better, but still no replacement for the physical procedures I mentioned.
- jrowley 6y ago
  For measuring spread of disease like prostate cancer imaging can be really helpful, see: PSMA PET-CT. I could imagine a world where imaging is really cheap and agents were safer, in which case we might opt to use imaging instead of physical exams, as they would offer way earlier detection. But for now the additional radiation (not present in MR), cost, risk, time, etc makes it a no go for standard of care screening.
- dwelch 6y ago
  Imaging in general has an important role in screening for certain diseases, and in some cases is already more important than physical examination. This mainly depends on how "well" physical examinations can detect an illness, the characteristics of a particular imaging study (cost, radiation exposure, etc), and the characteristics of a disease (prevalence in a population, potential benefit of early detection/treatment). So in short, for MRI to replace physical exam and/or lab testing in screening for a particular disease, the cost needs to come down or the benefit should outweigh the cost. Prostate cancer screening in general is no longer officially recommended by the AAFP as a rule [1], but if a patient decides to opt-in to screening, the "assay" (PSA) is preferred over a digital rectal examination, which has been shown to be increasingly useless in the detection of prostate cancer. MRI doesn't currently have a role in prostate cancer screening, but Prostate MRI has an increasingly critical role in diagnosis. CT colonography is currently a viable option for colon cancer screening instead of colonoscopy, though colonoscopy is still considered the gold standard. Chest CT is currently recommended to screen for lung cancer in patient's that meet certain criteria (age, smoking history). Mammography is obviously the workhorse of screening for breast cancer, rather than physical examination. But MRI is recommended as a screening mechanism for certain patient populations with very high risk of breast cancer (e.g. certain BRCA mutations). The small population, high prevalence, and benefit of early detection combine to make this a viable option. [1] https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/cw-prostate-cancer.html https://www.aafp.org/family-physician/patient-care/clinical-...

richardkmichael 6y ago

They have video of knee, neck and foot. Evidently "works-in-progress" and not part of their FDA filing. https://www.hyperfine.io/clinical https://www.hyperfine.io/clinical

jmhmd 6y ago

I saw a demo of this device at RSNA last year. It is quite small, which is their goal to make it as portable as it is. But, the opening where the body parts go is also small, and at this point too small I think to fit the whole body. It would work for head and extremities I should think.

swader999 6y ago
I'm inquiring about using this in a veterinary hospital. Might be a ideal for this.
- lostlogin 6y ago
  You need a lot of Tesla’s for animal work. Everything is so small that fine slices and high in-plane resolution is needed. The spinal cord on a small dog is not always easily imaged at 3T, 0.1T is going to be a problem.
  - swader999 6y ago
    Thanks. Makes sense why there's no info on their site regarding vet use.