Director’s Circle: MRI

Each month, ICE Magazine reaches out to healthcare systems, imaging centers and vendors to garner the latest insights, tips and advice regarding an imaging modality. MRI is the modality in the spotlight in this issue of ICE Magazine.

Participants in this roundtable-style Director’s Circle article on MRI are:

• University Hospitals MRI Supervisor Martin Ayres, RT(R) (MR), MRSO(MRSC);
• Banner Imaging Associate Director Michelle Brady; 
• Crothall Healthcare Imaging Director Gulf Coast Region Brian Howell; and
• Scripps Clinic Imaging Manager Toni Anne Serna, ARDMS 

Q: What emerging trends in MRI are you most excited about?

Ayres: The emergence of AI in MRI is very exciting. This technology not only allows for faster acquisition times, but it can also be used to improve both image sharpness and resolution.

Brady: There are so many exciting trends in MRI right now. AI, remote scanning, increase in number of implants that can be scanned, new air coils are just a few examples. I am most excited about the use of AI in the newer versions of software that are being released by vendors. This allows the ability to maximize throughput without sacrificing image quality. This equates to less time in the scanner for patients, which is a big win for claustrophobic patients.

Howell: I’m particularly excited about MRI systems with reduced helium requirements. These systems are not only more economical, but also require a smaller footprint and have lower installation costs. Additionally, larger bore sizes enhance the patient experience and make it easier for facilities to transition away from traditional Open MRI systems.

Serna: Specifically in cardiac MRI, we are excited about faster imaging sequences, AI-assisted motion correction, and improved tissue characterization techniques. These advances are making cardiac scans more accurate, efficient and accessible for a broader range of patients. 

Q: How do you prioritize upgrades or investments in MRI systems within your department?

Ayres: Our system prioritizes system upgrades largely based on the age of the overall unit. Older units often lack the ability to match the quality and speed of the newer magnets and must be retrofitted with new hardware and software or be fully replaced to do so. 

Brady: We have 22 scanners in our fleet. We prioritize our upgrades by the age of the scanner, tracked downtime, cost of repairs and maintenance, appointment availability, as well as community needs of both patients and providers. 

Howell: We prioritize upgrades by collaborating with our partners to evaluate system performance, operating costs, and emerging technologies that enhance diagnostic capabilities and patient satisfaction. We also rely on replacement priority scores that factor in equipment age, utilization, and clinical impact – helping us make objective, data-driven decisions. By reviewing this data alongside peer insights from across the country, we ensure our recommendations align with both clinical goals and long-term value.

Serna: We prioritize upgrades based on feedback from our technologists and radiologists – they’re the ones using the systems every day and know where improvements are needed. We also consider patient experience and clinical demand when making investment decisions. 

Q: What role does service and maintenance support play in your long-term planning?

Ayres: MRI machines, just like all pieces of machinery, require preventive maintenance at routine intervals to ensure peak performance. It is important to have a pre-existing service contract in place so unexpected repairs can be resolved in a timely manner. Our sites rely heavily on our field service engineers to keep our machines running smoothly. This relationship and support is crucial to our current and future success. Afterall, what good is a non-working MRI machine?

Brady: Given how expensive MRI systems are to operate and maintain, service and maintenance support play a vital role in the long-term planning. Service and maintenance determine how quickly you get back up and running so it is very important to choose vendors and contracts wisely. Support equipment should also be considered, such as chillers and injectors.

Howell: Service and maintenance support are essential to both operational performance and long-term planning. By tracking system uptime, repair history, and total cost of ownership, we can identify performance issues early and plan replacements before they impact care. This data-driven approach helps align equipment decisions with broader capital planning and clinical goals.

Serna: Service and maintenance are essential to our long-term planning. They minimize downtime, keep our schedule running smoothly, and ensure consistent, high-quality imaging. A responsive service team helps us avoid costly delays, maintain patient trust, and extend the life span of our equipment – making it a smart investment as well as a clinical necessity. 

Q: Are you using or evaluating any AI or machine learning tools with your MRI systems? How are they impacting workflow or diagnosis?

Ayres: AI is currently being used on a few select MRI machines/exams within our system. The technology is being closely analyzed and compared against conventional acquisitions to confirm both quality and accuracy. We do utilize machine learning tools within the University Hospitals system for offline processing of stroke, tumor, dementia, as well as other exams. These machine learning tools allow for faster and more thorough evaluations for our patients.

Brady: We are fortunate to have systems that are utilizing the AI software to scan. This has had a positive impact on our workflows. We are able to utilize shorter scan times without sacrificing image quality. Having the shorter scan times has been a huge patient satisfier for our claustrophobic patients, as well as allowing us to get through any backlog of volume all while maintaining exceptional image quality. Everyone can appreciate less time in an MRI scanner.

Howell: AI and machine learning are becoming key tools in how we service MRI systems. These technologies help us detect irregular performance patterns earlier, prioritize service response, and even predict failures before they occur. It’s allowing our teams to shift from reactive repairs to more proactive, targeted support that keeps systems running more reliably.

Serna: Yes, our GE 3T MRI system uses Deep Learning software. It enhances image reconstruction, reduces scan times and improves workflow efficiency without compromising diagnostic quality. 

Q: How do you manage scan time efficiency while maintaining image quality?

Ayres: Our site has prebuilt protocols that take full advantage of conventional, non-AI acceleration techniques. The sequences within the protocols have been fine-tuned and allow for just the right balance of signal and resolution with parameters that meet or exceed ACR standards and are acquired within an acceptable time frame. That being said, it is really the skill and understanding of the technologist behind the scanner that makes this possible. They must be in tune with the patient and the task at hand and know when to prioritize speed, resolution or sometimes both. 

Brady: Safety and quality are our top priority. Although it is wonderful to be able to scan faster, we have ensured that image quality has not been sacrificed. We have continued to work the vendors, radiologists, and technologist to optimize the software for the protocols that we utilize. We have also implemented a variety of workflows to help ensure our quality is maintained, such as a QC program, technologist assistants so the techs can focus on the patient, as well as MRSO personnel to help the technologists clear their patients with implants. All of these tools allow for the technologists to focus on the images and patient in front of them, and limiting the distractions around them.

Howell: With our newer systems, AI has really assisted in these areas. Both in scan time and post-processing image analysis.

Serna: We focus on clear communication and setting expectations before the scan begins. Taking a little extra time to make patients comfortable upfront helps us maintain both efficiency and image quality. 

Q: What advice would you give to other imaging centers looking to invest in new MRI systems?

Ayres: I would suggest investing in a machine with a fully capable package of software licenses and MRI coils. The features I would look for are as follows: powerful gradients, high channels, acceleration and reconstruction techniques including AI, large scan range without coil repositioning and a dockable table. All of these elements combined will help result in the fastest, most comfortable exam experience for the patient. 

Brady: I would advise anyone looking to invest in a new MRI system to know what you want/ need out of the system. Maybe you specialize in ortho cases, or the need is for breast imaging? Know what you need from the system and then explore all vendors. Get radiologist feedback regarding image quality and scan optimization opportunities. There are great advancements with software, coils, etc. I would also recommend that you work closely with an MRI lead technologist, so you have a clear understanding of how to optimize the department workflow as well as protocols. This will allow you to be as efficient as possible while maintaining quality and safety. 

Howell: Build a strong partnership with your imaging service team. Their expertise provides valuable insights into system performance and life cycle planning, helping you make more informed, cost-effective investment decisions tailored to your department’s needs.

Serna: Understand your patient demographics and which types of imaging drive your business. Invest in MRI systems that align with both your current needs and future goals – wide bore systems are a must for patient comfort and versatility.