MRI machines: An open and shut case

ANDRÉ PICARD

From Tuesday's Globe and Mail

Last year, Jenny Halls was exercising at the Edmonton YMCA when she collapsed to the floor, suffering a stroke that left her paralyzed. For the neurologist to determine the extent of bleeding and the damage to her brain, a magnetic resonance imaging test was required.

Ms. Halls recovered fully but, as part of her follow-up treatment, she underwent three more MRIs. While the diagnostic imaging tests were necessary, they were never pleasant: Patients are placed on a small table and pulled into a noisy, confining tunnel.

For a self-described "big woman," the process was particularly difficult. "I'm a size 18 myself, and I'm pretty sure the machine was about a size 10," Ms. Halls said.

She found it difficult to breathe during the tests and had to wear earplugs because of the noise.

"Every time I went in there, I wondered if I would come out," the 45-year-old said. "They give you a panic button, and I held on to it for dear life every time."

But a few weeks ago, Ms. Halls had an MRI that she described as "excellent" and "easy." That's because the confining tunnel was gone, and so was the jackhammer-like pounding.

The so-called open MRI, which recently opened in a private Calgary clinic, is one of only a handful in Canada.

Yet, about one-third of the population is too big or overweight to fit into a traditional MRI, and another 10 per cent of patients refuse the test because of claustrophobia, so the machines are being closely considered by health administrators.

Many patients, especially children, have to be sedated or placed under general anesthetic before an MRI. That additional step requires the presence of an anesthesiologist, and greatly increases the cost of testing, as well as the length of waiting times, which stretch into months in some provinces.

"Getting an MRI is scary," said Deepak Kaura, a pediatric radiologist at Alberta Children's Hospital and one of the founders of the company Open MRI of Canada.

"The great thing about this technology is that it reduces anxiety."

MRIs use radio waves in the presence of magnetic fields to allow doctors to look inside the body without invasive surgery and without resorting to radiation. To get the sharpest image possible, patients are held still, close to the magnets, meaning a tight, confined space.

The knock against open MRIs, which have been available in the United States for several years, is that they produce a less precise image, and images take more time to produce.

But Normand Laberge, chief executive officer of the Canadian Association of Radiologists, said the new generation of open MRIs, like the brand-new machine installed in Calgary, produces images that are as good or better than most MRIs currently in use in Canada, and in a comparable time.

"Today's open MRI is the equivalent of the closed MRI purchased five years ago," he said.

Mr. Laberge said he hopes open MRIs become available around the country because they would help to reduce waiting lists, and provide the tests to patients who cannot benefit fully from closed machines.

While Calgary has the new machine, the catch is that Open MRI of Canada is a private company that charges $695 per scan. (Only a few hospitals in the country have open MRIs and some are not the latest models.)

Dr. Kaura said he hopes government will agree to pay for the scans, particularly for people who cannot tolerate the traditional MRI.

He said access to open MRIs is extremely limited in Canada right now, which is unfortunate because "it's a service that would benefit a lot of people."

Dr. Kaura said a traditional MRI table can hold patients weighing up to 135 kilograms (297 pounds), while the new technology can hold a person weighing up to 250 kilograms (550 pounds).

But children, who are often frightened by traditional MRIs, would benefit the most. The open MRI allows parents to go in with their children, and even lie down with them.

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