12 ms·

In my opinion [0] a much more interesting track to pursue than super high-T scans that only work on mice (dead mice at that) is low field MRI scanning. MRI is a

by inasio 4y ago

In my opinion [0] a much more interesting track to pursue than super high-T scans that only work on mice (dead mice at that) is low field MRI scanning. MRI is amazing, but incredibly bulky and slow. In Canada you have to live for 6 months with a knee injury before surgery just because of the wait to access an MRI. Companies like Hyperfine (not affiliated) and Deepspin (just learned of them) make low power portable machines (I believe NFL teams were early costumers). A single MRI image is not super helpful, still more art than science, the real benefit comes from having periodic scans against a baseline. Boutique health clinics offer yearly scans to high net-worth individuals, rolling this out to a larger population could have a huge impact. [0] educated opinion, I also collaborated on a PNAS MRI paper

xtracto 4y ago
In Mexico you can buy a (private) head MRI scan with contrast for around $300 USD. It's really cheap. So theoretically you could do one every couple of months.
- riceart 4y ago
  Does that include the radiologist read?
  - xtracto 4y ago
    Yes
- harikb 4y ago
  Related - https://www.nytimes.com/2023/03/08/well/medical-tourism-mexico-kidnapping.html https://www.nytimes.com/2023/03/08/well/medical-tourism-mexi...
- inasio 4y ago
  Not that cheap for Mexican people, median salary is $600 USD/month
realitysballs 4y ago
Yes that does sound quite interesting and valuable v line of research but don’t you think one-off high-res MRI scans might advance humanities understanding of the brain in a meaningful way more so than low-field MRIs for all? I think this is more about the long game (scientific development) than how an average person right now could benefit from the new advance perhaps.
sidm83 4y ago
In India, you can book an appointment for MRI scans at private clinics the very same day or at worst within 1-2 days. Costs about USD 100 or lesser. There is also this startup - https://qure.ai https://qure.ai (Not my employer, I know someone who works there) which has already automated the report generation part for several classes of X Ray / CT / Ultrasound scans. This takes away the requirement of having a trained Radiologist to go through the scan and then create a report, which certainly helps in scaling the availability of such scans - you just need the machine and trained staff to operate it, and are not dependent upon having a doctor with a postgrad in radiology to write the reports.
- ramraj07 4y ago
  MRI scans in our budget MRI lab (yes that’s correct) a km away is 2500 Rs or like 60 USD and less than an hour wait time. How MRIs got commoditized in india through competition should be studied hard.
- esperent 4y ago
  The average monthly wage in India is about $300. I just checked and MRI scans in Ireland are about 300eur, while the average monthly wage is about 3300eur. I know average monthly wage isn't the most robust of measures, but still, looks to me like MRIs are pretty expensive in India relative to people's ability to pay for them.
  - spaceman_2020 4y ago
    OP likely shared the price at a major metro. The per capita income in metros is a lot higher. Bangalore, iirc, is $8k.
    - qwytw 4y ago
      Still only about $600-700 per year making an MRI scan relatively more expensive than in Ireland.
- spaceman_2020 4y ago
  Healthcare in India is rather amazing. When my wife was pregnant, we could get a sonography scan at a top private hospital for $30-40 without any insurance. The scan was done by an experienced doctor, not a technician.
folkrav 4y ago
> In Canada you have to live for 6 months with a knee injury before surgery just because of the wait to access an MRI. Really? I had a lower back MRI appointment at the hospital inside a month or so about 2 years ago, in the middle of the pandemic. Is it the surgery wait itself that takes that long, or did waiting times generally become that worse in that 2 years?
- Epa095 4y ago
  Maybe back problems are prioritzed higher than knee problems?
  - Aqwis 4y ago
    Another possible factor is specialist availability. As I assume is the case in all public healthcare systems (and in some way or another, e.g. through price differences, in private healthcare), some specialties have a glut of physicians while others have a real scarcity. I've personally experienced having to wait many times longer for a neurologist than a gastroenterologist, even though the issues my GP referred me to those specialists for were about equally serious, simply because there are so many more gastroenterologists available (relative to the demand) compared to neurologists (be it because too few neurologists were trained 5-40 years ago, because neurological issues have gotten more common, because GPs refer patients to neurologists more often than they used to, because neurologists may be more likely to go into private practice than gastroenterologists...). With medical imagery, you don't just need to get to get the MRI, CT or whatever done, there often needs to be a specialist available who can decide how (or if) to treat you based on the results (the exceptions being very routine stuff that a GP can often handle the treatment of, e.g. common bone fractures; or screenings where a negative result is expected in 95%+ of cases, such as if you present with a headache and your GP wants to make sure you don't have brain cancer). In the public healthcare system we have where I live, if my GP thinks I have a problem that's serious/non-obvious enough that an MRI would be useful (and it's not a highly routine issue as previously mentioned), the waiting time for that MRI will depend almost completely on when a specialist in the relevant field (or subfield) of medicine is available – otherwise, the MRI won't be up-to-date, etc. The MRI scans themselves tend to be done by private labs that are subcontracted by the public healthcare service anyway, and (as you'll learn if you ever book a private appointment with one such lab) these labs have lots of capacity. MRIs in themselves are cheap enough (it would surprise me if the public healthcare service paid these labs more than $500 per MRI on average, a pittance compared to the cost of a physician*) that there is no point for the public health service to queue up MRI appointments for months if they manage to book you an appointment with one of their own specialists. The details vary between countries, of course, but if a public healthcare system in a rich country has so few MRI machines (and doesn't subcontract out outpatient MRIs to private labs) and/or are so penny-pinching that they find a speedy $500-$1000 MRI to be too expensive, then I would say those problems seem to be relatively easy to fix without changing anything fundamental about how the country's healthcare works. *) Although this may not be the case if the physicians in your country earn less than, say, $30,000 USD on average – the cost of technical equipment matters less the richer a country is.
throwaway2990 4y ago
> Canada you have to live for 6 months with a knee injury before surgery just because of the wait to access an MRI The healthcare system in the west is just plain stupid. In asia you can walk into a clinic and see a doctor in 30m. Want to get a X-ray or mri etc at hospital? An hour? Yet in NZ a friends sister has been waiting 4 months now to have her shoulder checked by a specialist. It’s easier to fly to asia and see a doctor than it is to try see a doctor is a western country.
- jakeogh 3y ago
  I walked into an ER in Tucson, Arizona last winter, and was out within an hour with a CT scan and clear diagnosis. Took me another 2 days to get the raw data. It was awesome.
- xyzzyz 4y ago
  This is also how it works in US, you just go to imaging place and they do it immediately. You just have to pay for it. In countries with state controlled healthcare, service is rationed.
  - ad404b8a372f2b9 4y ago
    I wish we could have it both ways somehow: a baseline level of widely available cheap care and an expensive tier for people who'd pay anything to get quick care. I'm not a policy expert so I won't pretend to understand all the problems involved or the potential solutions. But as a patient I have a disability that makes it so the state covers 100% of my health expanses. I've been needing to see a physiotherapist for 3 years but can't find a single one that does home visits. Because of the dwindling number of physiotherapists even those that receive patients in their office sometimes have to see 5 patients at a time. So I have great coverage for terrible or no care at all. I was so desperate I called every physio in my region and told them I'd pay them any amount to come see me, but they can't take my money because the price of their service is regulated and they'd lose their license. Same thing for public hospitals, I came in Friday with three broken bones they wanted me out by Saturday, they didn't have a single available bed in their orthopedic unit and they needed the E.R bed back as soon as possible. All that because we decided to regulate the maximum number of doctors so now everyone has to go get care at the hospital instead of at home care by their local doctor. We do have some pretty stellar private hospitals though but it doesn't help because you don't choose where you get sent to when you call an ambulance. It's a mess.
bed99 4y ago
In Uruguay I got (multiple times) a 3T MRI for $300 in under 24h (https://cudim.org/ https://cudim.org/). Or 1.5T for free, no more than a week after the doctor asks. Anyone in the world can go there and pay for that and get it. It's insane to belive I have a 3T MRI 2 blocks away from my home. Now while staying in the US I just pray I don't need have health issue.
- justinator 4y ago
  Medical tourism to Uruguay sounds fantastic to me!
- raverbashing 4y ago
  Talking about "close to home" I wonder how close do you have to get for compasses to go haywire
  - deleted 4y ago
    [deleted]
vincnetas 4y ago
Off topic: "high net-worth" is word "rich" not politically correct anymore or what is the thinking behind using three words instead of one? This reminded me of "George Carlin on soft language" https://www.youtube.com/watch?v=o25I2fzFGoY https://www.youtube.com/watch?v=o25I2fzFGoY
- phone8675309 4y ago
  There are plenty of "old money" rich that are no longer "high net-worth" individually but their family name and other resources available to them more than make up for it.
  - regularfry 4y ago
    There's also "fat bank account and loads of debt" which nets out to not very much, but would count as "rich" if the bank account was all you cared about. And, in terms of liquid resources, it may well be.
spaceman_2020 4y ago
Why is the wait so long? Here in Delhi, I can walk into a private MRI scan center and get a scan anytime for under $100, even at the top centers. The wait time for government subsidized scans is longer but still not 6 months, and Delhi has far more people than any Canadian city.
- inasio 4y ago
  Public healthcare. It's free for everybody (with a Canadian healthcare card), but resources are limited.
virtualritz 4y ago
> In Canada you have to live for 6 months with a knee injury before surgery just because of the wait to access an MRI. That is insane. I dunno about the rest of Germany but in Berlin I can get a knee MRI appointment within two days. I know this from personal experience, twice, in the last five years.
- danielh 4y ago
  Do you have private health insurance? Because from my personal experience (in Cologne), the interaction goes like this: “I need an appointment for an MRI.” “Next one I can offer is in 4-8 weeks.” “I have private health insurance.” “Can you come in today?” Anecdotally, when I dislocated my shoulder in Sweden in 2006, the obly way to even get an MRI was to pay out of pocket.
  - rekado 4y ago
    FWIW I can also get radiology appointments within a few days in Berlin. I don't have private health insurance.
  - lostlogin 4y ago
    I’ve come across a place that does this to force people to use their higher paying insurance rather than lower paying systems. Quality providers. /s
  - virtualritz 4y ago
    > Do you have private health insurance? I do. But when I was waiting for the MRI I asked the three other people waiting there with me, out of curiosity about this exactly. Two told me they had public health insurance, one had been given the appointment one day prior, the other three. So at least for Berlin there seems to be no difference. But I can confirm that for seeing specialists, it does make a difference. My partner has public health insurance. I would say if I have to wait one week to get an appointment, she has to wait two. But it's never months, like you read from people that live in certain other countries. On a sidenote, my appointment for the MRI was at 8:15pm. It seems the radiology places here all run the machines long into the night to max out workload. I had a CT a few day later at a different clinic at 9pm!
DanBC 4y ago
> the real benefit comes from having periodic scans against a baseline. This is over-testing, and it leads to over-diagnosis and over-treatment and it is a well recognised form of harm in healthcare.
vegardx 4y ago
> Boutique health clinics offer yearly scans to high net-worth individuals, rolling this out to a larger population could have a huge impact. And are the outcomes of these high net-worth individuals any better than the overall population, in ways that cannot as easily be explained by other factors? I'm not really sold on the idea, and a lot of scientists and doctors aren't either.
reso 4y ago
Canada triages MRI access to high-urgency cases. My partner got an immediate MRI and 3 follow-ups within a month when she presented at an ER with stroke symptoms.
lostlogin 4y ago
> A single MRI image is not super helpful, still more art than science, the real benefit comes from having periodic scans against a baseline. An MR when someone has a problem is pretty helpful. Screening MR is not really a good thing except in a very narrow range of conditions - you just generate unnecessary procedures, more imaging and stress. In regard to low field MR, the likes of Siemens Deep Resolve and their low field magnet (0.55T) have taken this a long way, and really improves image quality. It looks useful for imaging around implants and metal. https://pubmed.ncbi.nlm.nih.gov/30932247/ https://pubmed.ncbi.nlm.nih.gov/30932247/ https://bmjopen.bmj.com/content/12/1/e056572 https://bmjopen.bmj.com/content/12/1/e056572 https://www.siemens-healthineers.com/magnetic-resonance-imaging/technologies-and-innovations/deep-resolve https://www.siemens-healthineers.com/magnetic-resonance-imag... https://www.siemens-healthineers.com/magnetic-resonance-imaging/high-v-mri/magnetom-free-max https://www.siemens-healthineers.com/magnetic-resonance-imag...
- inasio 4y ago
  If you have a major issue, say a tumor, MRI is great, but for smaller things I agree with you that a single image is not great for a quantitative assessment. What does have a lot of value is when you have a baseline image and you perform yearly scans that are compared against each other (similar to how carotid ultrasounds are used for cholesterol assessment)
  - lostlogin 4y ago
    The articles I link to say the opposite. MRI as a screening tool has limited application - it causes more problems than it solved.
geraldwhen 4y ago
My family has had same-day MRIs in the USA. I’ve never heard of anyone waiting, ever, outside maybe a few days or longer if they’re trying to line up their own schedule with availability. 6 months is crazy.
giarc 4y ago
6 months is hyperbole. My coworker fell in Costa Rica, hurt her knee and came back and had an MRI the same week. I saw my doctor in mid-March and she ordered an MRI on my neck, it's scheduled for next week. Do some people wait 6 months... yes, those that can wait 6 months are asked to wait 6 months. Those that need it quickly, get it quickly. It's the triage method. I also had the option to book a private MRI and get it next day. It would have been $650CAD or $483USD. I happen to be in LA when my issue came up and I looked at private MRI. It was way more expensive than the Canadian alternative (however, it could have been LA/Hollywood pricing).
- imjared 4y ago
  That private MRI cost is what I paid after insurance for my recent knee MRI here in the USA.
  - giarc 4y ago
    Next time just come on up to Canada for your scan!
- parthdesai 4y ago
  > 6 months is hyperbole. No it's not. I tweaked my knee pretty badly to the point where i would wake up at night from deep sleep due to pain (and I generally have a higher pain tolerance) and the best the doctor could do was prescribe ultra sound cause getting an MRI scan would take 6-7 months. Even then the earliest appointment I could get for a knee specialist to look at my knee is 6 months. It really depends on where you're. If you're in the city of Toronto, good luck getting an MRI appointment. > those that can wait 6 months are asked to wait 6 months You do know that you're body doesn't decide to wait 6 months for an MRI and stop developing scar tissue right?
  - giarc 4y ago
    http://waittimes.alberta.ca/CategorySummary.jsp?rcatID=18&levelOfCare=All http://waittimes.alberta.ca/CategorySummary.jsp?rcatID=18&le... In Alberta, where I live, median wait time for an MRI is 9 weeks. 22% are completed in less than 3 weeks. 14% are done in 4-6 months. As for Ontario, you can look up those times as well. https://www.ontariohealth.ca/public-reporting/wait-times-results-di https://www.ontariohealth.ca/public-reporting/wait-times-res... Priority 4 patients (the lowest priority) waited on average 73 days. Highest priority scanned on average of 3 days. Are the numbers great? No, only 42% of people are scanned within the recommended timelines (priority 4 - 28 days, priority 3 - 10 days and priority 2 - 2 days). But it hyperbole to say it's a 6 month wait when the data doesn't show that. Do some people wait 6 months... yes, but those are likely priority 4 people where a qualified medical provider has determined the scan is not a priority.
BaculumMeumEst 4y ago
damn that’s fucked up. at my medical facility when my doc ordered an MRI i literally just walked over to radiology and got it done on the spot for like a $40 copay.
robwwilliams 4y ago
Not an either-or situation at all. There is no one “more interesting track”. Always tradeoffs as I am sure you know. The key advances in this paper are four-fold: 1: Much higher spatial resolution and contrast that is essential to define boundaries of brain regions 2. Much faster scan time using multiple angle acquisitions 3. Accurate segmentation of brain regions of interest even for highly diverse genomes of mice. 4. Accurate alignment and multimodal merging of MRI with 3D lightsheet microscopy from the same animal with fluorescent labelling of multiple CNS cell types. fMRI in mice is limited in its resolution. To generate time series data we use large sets of isogenic (identical twin) mice. See figure 5 in the paper for a comparison of young and old mice that are identical twins—one a young adult and one quite old adult.

by inasio 4y ago

xtracto 4y ago

In Mexico you can buy a (private) head MRI scan with contrast for around $300 USD. It's really cheap. So theoretically you could do one every couple of months.

riceart 4y ago
Does that include the radiologist read?
- xtracto 4y ago
  Yes
harikb 4y ago
Related - https://www.nytimes.com/2023/03/08/well/medical-tourism-mexico-kidnapping.html https://www.nytimes.com/2023/03/08/well/medical-tourism-mexi...
inasio 4y ago
Not that cheap for Mexican people, median salary is $600 USD/month

realitysballs 4y ago

Yes that does sound quite interesting and valuable v line of research but don’t you think one-off high-res MRI scans might advance humanities understanding of the brain in a meaningful way more so than low-field MRIs for all? I think this is more about the long game (scientific development) than how an average person right now could benefit from the new advance perhaps.

sidm83 4y ago

In India, you can book an appointment for MRI scans at private clinics the very same day or at worst within 1-2 days. Costs about USD 100 or lesser. There is also this startup - https://qure.ai https://qure.ai (Not my employer, I know someone who works there) which has already automated the report generation part for several classes of X Ray / CT / Ultrasound scans. This takes away the requirement of having a trained Radiologist to go through the scan and then create a report, which certainly helps in scaling the availability of such scans - you just need the machine and trained staff to operate it, and are not dependent upon having a doctor with a postgrad in radiology to write the reports.

ramraj07 4y ago
MRI scans in our budget MRI lab (yes that’s correct) a km away is 2500 Rs or like 60 USD and less than an hour wait time. How MRIs got commoditized in india through competition should be studied hard.
esperent 4y ago
The average monthly wage in India is about $300. I just checked and MRI scans in Ireland are about 300eur, while the average monthly wage is about 3300eur. I know average monthly wage isn't the most robust of measures, but still, looks to me like MRIs are pretty expensive in India relative to people's ability to pay for them.
- spaceman_2020 4y ago
  OP likely shared the price at a major metro. The per capita income in metros is a lot higher. Bangalore, iirc, is $8k.
  - qwytw 4y ago
    Still only about $600-700 per year making an MRI scan relatively more expensive than in Ireland.
spaceman_2020 4y ago
Healthcare in India is rather amazing. When my wife was pregnant, we could get a sonography scan at a top private hospital for $30-40 without any insurance. The scan was done by an experienced doctor, not a technician.

folkrav 4y ago

> In Canada you have to live for 6 months with a knee injury before surgery just because of the wait to access an MRI. Really? I had a lower back MRI appointment at the hospital inside a month or so about 2 years ago, in the middle of the pandemic. Is it the surgery wait itself that takes that long, or did waiting times generally become that worse in that 2 years?

Epa095 4y ago
Maybe back problems are prioritzed higher than knee problems?
- Aqwis 4y ago
  Another possible factor is specialist availability. As I assume is the case in all public healthcare systems (and in some way or another, e.g. through price differences, in private healthcare), some specialties have a glut of physicians while others have a real scarcity. I've personally experienced having to wait many times longer for a neurologist than a gastroenterologist, even though the issues my GP referred me to those specialists for were about equally serious, simply because there are so many more gastroenterologists available (relative to the demand) compared to neurologists (be it because too few neurologists were trained 5-40 years ago, because neurological issues have gotten more common, because GPs refer patients to neurologists more often than they used to, because neurologists may be more likely to go into private practice than gastroenterologists...). With medical imagery, you don't just need to get to get the MRI, CT or whatever done, there often needs to be a specialist available who can decide how (or if) to treat you based on the results (the exceptions being very routine stuff that a GP can often handle the treatment of, e.g. common bone fractures; or screenings where a negative result is expected in 95%+ of cases, such as if you present with a headache and your GP wants to make sure you don't have brain cancer). In the public healthcare system we have where I live, if my GP thinks I have a problem that's serious/non-obvious enough that an MRI would be useful (and it's not a highly routine issue as previously mentioned), the waiting time for that MRI will depend almost completely on when a specialist in the relevant field (or subfield) of medicine is available – otherwise, the MRI won't be up-to-date, etc. The MRI scans themselves tend to be done by private labs that are subcontracted by the public healthcare service anyway, and (as you'll learn if you ever book a private appointment with one such lab) these labs have lots of capacity. MRIs in themselves are cheap enough (it would surprise me if the public healthcare service paid these labs more than $500 per MRI on average, a pittance compared to the cost of a physician*) that there is no point for the public health service to queue up MRI appointments for months if they manage to book you an appointment with one of their own specialists. The details vary between countries, of course, but if a public healthcare system in a rich country has so few MRI machines (and doesn't subcontract out outpatient MRIs to private labs) and/or are so penny-pinching that they find a speedy $500-$1000 MRI to be too expensive, then I would say those problems seem to be relatively easy to fix without changing anything fundamental about how the country's healthcare works. *) Although this may not be the case if the physicians in your country earn less than, say, $30,000 USD on average – the cost of technical equipment matters less the richer a country is.

throwaway2990 4y ago

> Canada you have to live for 6 months with a knee injury before surgery just because of the wait to access an MRI The healthcare system in the west is just plain stupid. In asia you can walk into a clinic and see a doctor in 30m. Want to get a X-ray or mri etc at hospital? An hour? Yet in NZ a friends sister has been waiting 4 months now to have her shoulder checked by a specialist. It’s easier to fly to asia and see a doctor than it is to try see a doctor is a western country.

jakeogh 3y ago
I walked into an ER in Tucson, Arizona last winter, and was out within an hour with a CT scan and clear diagnosis. Took me another 2 days to get the raw data. It was awesome.
xyzzyz 4y ago
This is also how it works in US, you just go to imaging place and they do it immediately. You just have to pay for it. In countries with state controlled healthcare, service is rationed.
- ad404b8a372f2b9 4y ago
  I wish we could have it both ways somehow: a baseline level of widely available cheap care and an expensive tier for people who'd pay anything to get quick care. I'm not a policy expert so I won't pretend to understand all the problems involved or the potential solutions. But as a patient I have a disability that makes it so the state covers 100% of my health expanses. I've been needing to see a physiotherapist for 3 years but can't find a single one that does home visits. Because of the dwindling number of physiotherapists even those that receive patients in their office sometimes have to see 5 patients at a time. So I have great coverage for terrible or no care at all. I was so desperate I called every physio in my region and told them I'd pay them any amount to come see me, but they can't take my money because the price of their service is regulated and they'd lose their license. Same thing for public hospitals, I came in Friday with three broken bones they wanted me out by Saturday, they didn't have a single available bed in their orthopedic unit and they needed the E.R bed back as soon as possible. All that because we decided to regulate the maximum number of doctors so now everyone has to go get care at the hospital instead of at home care by their local doctor. We do have some pretty stellar private hospitals though but it doesn't help because you don't choose where you get sent to when you call an ambulance. It's a mess.

bed99 4y ago

In Uruguay I got (multiple times) a 3T MRI for $300 in under 24h (https://cudim.org/ https://cudim.org/). Or 1.5T for free, no more than a week after the doctor asks. Anyone in the world can go there and pay for that and get it. It's insane to belive I have a 3T MRI 2 blocks away from my home. Now while staying in the US I just pray I don't need have health issue.

justinator 4y ago
Medical tourism to Uruguay sounds fantastic to me!
raverbashing 4y ago
Talking about "close to home" I wonder how close do you have to get for compasses to go haywire
- deleted 4y ago
  [deleted]

vincnetas 4y ago

Off topic: "high net-worth" is word "rich" not politically correct anymore or what is the thinking behind using three words instead of one? This reminded me of "George Carlin on soft language" https://www.youtube.com/watch?v=o25I2fzFGoY https://www.youtube.com/watch?v=o25I2fzFGoY

phone8675309 4y ago
There are plenty of "old money" rich that are no longer "high net-worth" individually but their family name and other resources available to them more than make up for it.
- regularfry 4y ago
  There's also "fat bank account and loads of debt" which nets out to not very much, but would count as "rich" if the bank account was all you cared about. And, in terms of liquid resources, it may well be.

spaceman_2020 4y ago

Why is the wait so long? Here in Delhi, I can walk into a private MRI scan center and get a scan anytime for under $100, even at the top centers. The wait time for government subsidized scans is longer but still not 6 months, and Delhi has far more people than any Canadian city.

inasio 4y ago
Public healthcare. It's free for everybody (with a Canadian healthcare card), but resources are limited.

virtualritz 4y ago

> In Canada you have to live for 6 months with a knee injury before surgery just because of the wait to access an MRI. That is insane. I dunno about the rest of Germany but in Berlin I can get a knee MRI appointment within two days. I know this from personal experience, twice, in the last five years.

danielh 4y ago
Do you have private health insurance? Because from my personal experience (in Cologne), the interaction goes like this: “I need an appointment for an MRI.” “Next one I can offer is in 4-8 weeks.” “I have private health insurance.” “Can you come in today?” Anecdotally, when I dislocated my shoulder in Sweden in 2006, the obly way to even get an MRI was to pay out of pocket.
- rekado 4y ago
  FWIW I can also get radiology appointments within a few days in Berlin. I don't have private health insurance.
- lostlogin 4y ago
  I’ve come across a place that does this to force people to use their higher paying insurance rather than lower paying systems. Quality providers. /s
- virtualritz 4y ago
  > Do you have private health insurance? I do. But when I was waiting for the MRI I asked the three other people waiting there with me, out of curiosity about this exactly. Two told me they had public health insurance, one had been given the appointment one day prior, the other three. So at least for Berlin there seems to be no difference. But I can confirm that for seeing specialists, it does make a difference. My partner has public health insurance. I would say if I have to wait one week to get an appointment, she has to wait two. But it's never months, like you read from people that live in certain other countries. On a sidenote, my appointment for the MRI was at 8:15pm. It seems the radiology places here all run the machines long into the night to max out workload. I had a CT a few day later at a different clinic at 9pm!

DanBC 4y ago

> the real benefit comes from having periodic scans against a baseline. This is over-testing, and it leads to over-diagnosis and over-treatment and it is a well recognised form of harm in healthcare.

vegardx 4y ago

> Boutique health clinics offer yearly scans to high net-worth individuals, rolling this out to a larger population could have a huge impact. And are the outcomes of these high net-worth individuals any better than the overall population, in ways that cannot as easily be explained by other factors? I'm not really sold on the idea, and a lot of scientists and doctors aren't either.

reso 4y ago

Canada triages MRI access to high-urgency cases. My partner got an immediate MRI and 3 follow-ups within a month when she presented at an ER with stroke symptoms.

lostlogin 4y ago

> A single MRI image is not super helpful, still more art than science, the real benefit comes from having periodic scans against a baseline. An MR when someone has a problem is pretty helpful. Screening MR is not really a good thing except in a very narrow range of conditions - you just generate unnecessary procedures, more imaging and stress. In regard to low field MR, the likes of Siemens Deep Resolve and their low field magnet (0.55T) have taken this a long way, and really improves image quality. It looks useful for imaging around implants and metal. https://pubmed.ncbi.nlm.nih.gov/30932247/ https://pubmed.ncbi.nlm.nih.gov/30932247/ https://bmjopen.bmj.com/content/12/1/e056572 https://bmjopen.bmj.com/content/12/1/e056572 https://www.siemens-healthineers.com/magnetic-resonance-imaging/technologies-and-innovations/deep-resolve https://www.siemens-healthineers.com/magnetic-resonance-imag... https://www.siemens-healthineers.com/magnetic-resonance-imaging/high-v-mri/magnetom-free-max https://www.siemens-healthineers.com/magnetic-resonance-imag...

inasio 4y ago
If you have a major issue, say a tumor, MRI is great, but for smaller things I agree with you that a single image is not great for a quantitative assessment. What does have a lot of value is when you have a baseline image and you perform yearly scans that are compared against each other (similar to how carotid ultrasounds are used for cholesterol assessment)
- lostlogin 4y ago
  The articles I link to say the opposite. MRI as a screening tool has limited application - it causes more problems than it solved.

geraldwhen 4y ago

My family has had same-day MRIs in the USA. I’ve never heard of anyone waiting, ever, outside maybe a few days or longer if they’re trying to line up their own schedule with availability. 6 months is crazy.

giarc 4y ago

6 months is hyperbole. My coworker fell in Costa Rica, hurt her knee and came back and had an MRI the same week. I saw my doctor in mid-March and she ordered an MRI on my neck, it's scheduled for next week. Do some people wait 6 months... yes, those that can wait 6 months are asked to wait 6 months. Those that need it quickly, get it quickly. It's the triage method. I also had the option to book a private MRI and get it next day. It would have been $650CAD or $483USD. I happen to be in LA when my issue came up and I looked at private MRI. It was way more expensive than the Canadian alternative (however, it could have been LA/Hollywood pricing).

imjared 4y ago
That private MRI cost is what I paid after insurance for my recent knee MRI here in the USA.
- giarc 4y ago
  Next time just come on up to Canada for your scan!
parthdesai 4y ago
> 6 months is hyperbole. No it's not. I tweaked my knee pretty badly to the point where i would wake up at night from deep sleep due to pain (and I generally have a higher pain tolerance) and the best the doctor could do was prescribe ultra sound cause getting an MRI scan would take 6-7 months. Even then the earliest appointment I could get for a knee specialist to look at my knee is 6 months. It really depends on where you're. If you're in the city of Toronto, good luck getting an MRI appointment. > those that can wait 6 months are asked to wait 6 months You do know that you're body doesn't decide to wait 6 months for an MRI and stop developing scar tissue right?
- giarc 4y ago
  http://waittimes.alberta.ca/CategorySummary.jsp?rcatID=18&levelOfCare=All http://waittimes.alberta.ca/CategorySummary.jsp?rcatID=18&le... In Alberta, where I live, median wait time for an MRI is 9 weeks. 22% are completed in less than 3 weeks. 14% are done in 4-6 months. As for Ontario, you can look up those times as well. https://www.ontariohealth.ca/public-reporting/wait-times-results-di https://www.ontariohealth.ca/public-reporting/wait-times-res... Priority 4 patients (the lowest priority) waited on average 73 days. Highest priority scanned on average of 3 days. Are the numbers great? No, only 42% of people are scanned within the recommended timelines (priority 4 - 28 days, priority 3 - 10 days and priority 2 - 2 days). But it hyperbole to say it's a 6 month wait when the data doesn't show that. Do some people wait 6 months... yes, but those are likely priority 4 people where a qualified medical provider has determined the scan is not a priority.

BaculumMeumEst 4y ago

damn that’s fucked up. at my medical facility when my doc ordered an MRI i literally just walked over to radiology and got it done on the spot for like a $40 copay.

robwwilliams 4y ago

Not an either-or situation at all. There is no one “more interesting track”. Always tradeoffs as I am sure you know. The key advances in this paper are four-fold: 1: Much higher spatial resolution and contrast that is essential to define boundaries of brain regions 2. Much faster scan time using multiple angle acquisitions 3. Accurate segmentation of brain regions of interest even for highly diverse genomes of mice. 4. Accurate alignment and multimodal merging of MRI with 3D lightsheet microscopy from the same animal with fluorescent labelling of multiple CNS cell types. fMRI in mice is limited in its resolution. To generate time series data we use large sets of isogenic (identical twin) mice. See figure 5 in the paper for a comparison of young and old mice that are identical twins—one a young adult and one quite old adult.