A twisting passageway leads to the basement of the Boardman Building at 330 Cedar St., home to the Department of Diagnostic Radiology at the Yale School of Medicine. Though it may be off the beaten trail, with the addition of two state-of-the-art magentic resonance scanners, the department will become a center of imaging in New England.
The future acquisition of new scanners is part of a multimillion dollar effort by the University to revamp its medical facilities over the next decade. Diagnostic radiology, which currently houses four magnetic resonance scanners for patient care and clinical research, is purchasing a 1.5-Tesla and a 3.0-Tesla scanner from General Electric Healthcare. These scanners will replace the oldest scanner in the facility, which dates back to 1985. Currently under renovation, the facility is expected to be completed in April, said Dr. Jeffrey Weinreb, a professor of diagnostic radiology.
Every year magnetic resonance scanning technology becomes significantly faster, Weinreb said, and the new scanners will be equipped with the latest computers, electronics and magnets.
“This is a technology that has been in use since the 1980s,” Weinreb said. “It has been evolving rapidly, and so the technology quickly becomes outdated.”
But the scanners cost millions of dollars, and replacing them is a sizeable investment. Weinreb said the unit’s scanners have been upgraded several times. Since MRI machines are expensive, every effort is made to upgrade rather than replace them. But at some point, Weinreb said, new scanners are needed to provide the best care possible.
The University is currently engaged in a $5-6 million project to update the MRI department. Yale’s contract with GE for the new machines includes a built-in evergreen, or non-obsolescence, policy so the scanners can be upgraded.
“For the next five to seven years, GE will update the machines,” Weinreb said. “Otherwise, they’d become obsolete very fast.”
Weinreb said the new facility will include an intensive care unit and recovery room, as well as anesthesiology capabilities to make scanning patients with special needs easier.
“The facility needs significant renovations,” Weinreb said. “It’s 20 years old, and when the MR scanners were initially installed, we really didn’t know how to do MRI on very sick patients or kids.”
Not all scanners are created equal. Among the approximately 6,000 scanners in use across the country, machines range from those that can produce information of limited detail to more expensive devices which provide doctors with high-resolution data. Although the 1.5-Tesla scanner is a technology that has been around many years, the machine Yale is purchasing has more channels than older scanners. More channels allow for faster, higher resolution scanning and larger fields of view, said Dr. Arnold C. Friedman, the associate chair of the Department of Radiology at the University of Florida Health Science Center in Jacksonville.
“A university hospital such as Yale would find this type of machine not only useful in providing state-of-the-art patient care, but also in acquiring research grants both from government and the private sector,” Friedman said.
The 1.5-Tesla scanner will be especially useful for cardiovascular and whole-body exams, Diagnostic Radiology staff technologist Kate Hutchins said.
A technological advance from the 1.5-Tesla scanner, the new 3.0-Tesla scanner offers improved speed and imaging quality. Although its clinical importance has not yet been fully established, Friedman said Yale’s recent acquisition will allow researchers to explore the unique benefits this machine can offer to clinical care.
As clinical expectations have grown, many large academic centers are racing to install new scanners, but there is more to good scanning than money.
“Doctors here are very knowledgeable about how to exploit these machines,” Weinreb said.
In order to operate the new scanners, technicians and radiologists will need to be retrained. Hutchins said GE is reviewing MRI techniques with staff members and teaching the technicians how to use the new scanners’ software. GE is also sending a specialist to train Yale staff with an MRI simulator.
“The 3.0-Tesla scanner is very new,” Hutchins said. “Most people here haven’t worked with it, and there are safety issues involved in using it.”
While 1.5-Tesla scanners have been around for the last 15 years, there is much less clinical experience with 3.0-Tesla scanners, and the magnet’s great strength presents more pronounced safety issues.
“People walk around with a lot of metal on them, including prosthetic devices,” Weinreb said. “We know what is safe at 1.5 Tesla from experience, but we will have to be on our guard with the 3.0-Tesla scanner.”
He said 3.0-Tesla scanners are now being tested across the country, and researchers are sharing their experiences.
In another four to five years, Weinreb said Yale will construct a new building, which will house four additional scanners. Although staffers now have to cope with constant construction and shuffle department activities from room to room, they said the renovated center will be worth the wait.