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Murali S, Ding H, Adedeji F, Qin C, Obungoloch J, Asllani I, Anazodo U, Ntusi NAB, Mammen R, Niendorf T, Adeleke S. Bringing MRI to low- and middle-income countries: Directions, challenges and potential solutions. NMR IN BIOMEDICINE 2024; 37:e4992. [PMID: 37401341 DOI: 10.1002/nbm.4992] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 07/05/2023]
Abstract
The global disparity of magnetic resonance imaging (MRI) is a major challenge, with many low- and middle-income countries (LMICs) experiencing limited access to MRI. The reasons for limited access are technological, economic and social. With the advancement of MRI technology, we explore why these challenges still prevail, highlighting the importance of MRI as the epidemiology of disease changes in LMICs. In this paper, we establish a framework to develop MRI with these challenges in mind and discuss the different aspects of MRI development, including maximising image quality using cost-effective components, integrating local technology and infrastructure and implementing sustainable practices. We also highlight the current solutions-including teleradiology, artificial intelligence and doctor and patient education strategies-and how these might be further improved to achieve greater access to MRI.
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Affiliation(s)
- Sanjana Murali
- School of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Hao Ding
- School of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Fope Adedeji
- School of Medicine, Faculty of Medicine, University College London, London, UK
| | - Cathy Qin
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Johnes Obungoloch
- Department of Biomedical Engineering, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Iris Asllani
- Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, New York, USA
| | - Udunna Anazodo
- Department of Medical Biophysics, Western University, London, Ontario, Canada
- The Research Institute of London Health Sciences Centre and St. Joseph's Health Care, London, Ontario, Canada
| | - Ntobeko A B Ntusi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
- South African Medical Research Council Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, Cape Town, South Africa
| | - Regina Mammen
- Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, UK
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrück Centre for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sola Adeleke
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
- High Dimensional Neuro-oncology, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
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Glans A, Wilén J, Hansson B, Audulv Å, Lindgren L. Managing acoustic noise within MRI: A qualitative interview study among Swedish radiographers. Radiography (Lond) 2024; 30:889-895. [PMID: 38603992 DOI: 10.1016/j.radi.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/22/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Acoustic noise from magnetic resonance imaging (MRI) can cause hearing loss and needs to be mitigated to ensure the safety of patients and personnel. Capturing MR personnel's insights is crucial for guiding the development and future applications of noise-reduction technology. This study aimed to explore how MR radiographers manage acoustic noise in clinical MR settings. METHODS Using a qualitative design, we conducted semi-structured individual interviews with fifteen MR radiographers from fifteen hospitals around Sweden. We focused on the clinical implications of participants' noise management, using an interpretive description approach. We also identified sociotechnical interactions between People, Environment, Tools, and Tasks (PETT) by adopting a Human Factors/Ergonomics framework. Interview data were analyzed inductively with thematic analysis (Braun and Clarke). RESULTS The analysis generated three main themes regarding MR radiographers' noise management: (I) Navigating Occupational Noise: Risk Management and Adaptation; (II) Protecting the Patient and Serving the Exam, and (III) Establishing a Safe Healthcare Environment with Organizational Support. CONCLUSION This study offers insights into radiographers' experiences of managing acoustic noise within MRI, and the associated challenges. Radiographers have adopted multiple strategies to protect patients and themselves from adverse noise-related effects. However, they require tools and support to manage this effectively, suggesting a need for organizations to adopt more proactive, holistic approaches to safety initiatives. IMPLICATIONS FOR PRACTICE The radiographers stressed the importance of a soundproofed work environment to minimize occupational adverse health effects and preserve work performance. They acknowledge noise as a common contributor to patient distress and discomfort. Providing options like earplugs, headphones, mold putty, software-optimized "quiet" sequences, and patient information were important tools. Fostering a safety culture requires proactive safety efforts and support from colleagues and management.
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Affiliation(s)
- A Glans
- Department of Nursing, Umeå University, Umeå, Sweden; Department of Diagnostics and Intervention, Radiation Physics, Umeå University, Umeå, Sweden.
| | - J Wilén
- Department of Diagnostics and Intervention, Radiation Physics, Umeå University, Umeå, Sweden
| | - B Hansson
- Department of Clinical Sciences Lund, Diagnostic Radiology, Lund University, Lund, Sweden
| | - Å Audulv
- Department of Nursing, Umeå University, Umeå, Sweden
| | - L Lindgren
- Department of Nursing, Umeå University, Umeå, Sweden
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Yamashiro T, Takatsu Y, Morita K, Nakamura M, Yukimura Y, Nakajima K. Effect of acoustic noise reduction technology on image quality: a multivendor study. Radiol Phys Technol 2023; 16:235-243. [PMID: 36964891 DOI: 10.1007/s12194-023-00712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/26/2023]
Abstract
The purpose of this study was to clarify the appropriate use of a combination of pulse sequences and acoustic noise reduction technology in general-purpose brain magnetic resonance imaging. Five pulse sequences commonly used in brain magnetic resonance imaging examinations-turbo spin-echo T2-weighted imaging, T1-weighted fluid-attenuated inversion recovery, T2-weighted fluid-attenuated inversion recovery, diffusion-weighted imaging, and magnetic resonance angiography-were performed on healthy participants at three vendors where acoustic noise reduction technology was available. The results showed that acoustic noise reduction technology reduced sound pressure levels and altered image quality in all pulse sequences across all vendors' magnetic resonance imaging scanners. Although T2-weighted imaging and T1-weighted fluid-attenuated inversion recovery resulted in little image quality degradation, T2-weighted fluid-attenuated inversion recovery, diffusion-weighted imaging, and magnetic resonance angiography had significant image degradation. Therefore, acoustic noise reduction technology should be used with caution.
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Affiliation(s)
- Takanobu Yamashiro
- Department of Radiology, Minoh City Hospital, 5-7-1 Kayano, Mino-shi, Osaka, 562-8562, Japan.
- Department of Systems and Control Engineering, Faculty of Engineering, Tokushima Bunri University, 1314-1 Shido, Sanuki-shi, Kagawa, 769-2193, Japan.
| | - Yasuo Takatsu
- School of Medical Sciences, Fujita Health University, Molecular Imaging, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan
| | - Kosuke Morita
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1 Honjo, , Kumamoto-shi, Kumamoto, 860-0811, Japan
| | - Masafumi Nakamura
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan
- Department of Radiology, Otsu City Hospital, 2-9-9 Motomiya, Otsu-shi, Shiga, 520-0804, Japan
| | - Yoshihiro Yukimura
- Department of Radiology, Ikeda City Hospital, 3-1-18 Jyonan, Ikeda-shi, Osaka, 563-8510, Japan
| | - Kazuhiro Nakajima
- Department of Radiology, Minoh City Hospital, 5-7-1 Kayano, Mino-shi, Osaka, 562-8562, Japan
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Ayasrah M. MRI Safety Practice Observations in MRI Facilities Within the Kingdom of Jordan, Compared to the 2020 Manual on MR Safety of the American College of Radiology. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2022; 15:131-142. [PMID: 35592097 PMCID: PMC9113556 DOI: 10.2147/mder.s360335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose The absence of ionizing radiation in MRI applications does not guarantee absolute safety. Implementing of safety guidelines can ensure high-quality practice in the clinical MRI with the minimum risk. For this purpose, this cross-section quantitative study conducted in Jordan Kingdom aimed to assess current MRI safety guidelines in comparison with those of 2020 Manual on MR Safety of the American College of Radiology (ACR). Patients and Methods A site observation study of 38 MRI units was undertaken in June 2021. A well-structured MRI safety questionnaire was the primary data collection method. Data were subjected to a descriptive statistics content analysis by the SPSS version 20. The results were analyzed to yield comprehensive discussions. Results A total of 38 MRI facilities in participated in this study with the responding rate of 44.7%. Patient screening areas and changing rooms were available in about 29% (11/38) of the MRI facilities. Most facilities (55%, 21/38) conducted verbal screening only whereas 21% implemented both written and verbal screening for their patients and companions in zone II, which was present in a percentage of 29% in the approached facilities. Meanwhile, only 13 (43.2%) of 38 facilities used handheld magnets for physical screening, 25 (65.8%) of MRI units did not use any kind of ferromagnetic metal detection systems. Three (7.9%) participating centers had MR-safe wheelchairs, ventilators, anesthesia machines, and stretchers. Most MRI facilities participating in this study (71%) had emergency preparedness plans for alternative power outages. Despite a relatively low number of participating centers having an emergency exit or code (26.3% and 10.5%, respectively), none of them performed practice drills for such scenarios. Conclusion Investing in new MR-safe equipment requires introducing ferromagnetic detecting systems. More research is needed to establish the degree of MRI professional’s safety-related education.
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Affiliation(s)
- Mohammad Ayasrah
- Department of Allied Medical Sciences-Radiologic Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Amman, Jordan
- Correspondence: Mohammad Ayasrah, Department of Allied Medical Sciences-Radiologic Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, PO Box 3030, Irbid, 22110, Jordan, Tel +962 27201000-26939, Fax +962 27201087, Email
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Korom M, Camacho MC, Filippi CA, Licandro R, Moore LA, Dufford A, Zöllei L, Graham AM, Spann M, Howell B, Shultz S, Scheinost D. Dear reviewers: Responses to common reviewer critiques about infant neuroimaging studies. Dev Cogn Neurosci 2021; 53:101055. [PMID: 34974250 PMCID: PMC8733260 DOI: 10.1016/j.dcn.2021.101055] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/28/2021] [Accepted: 12/26/2021] [Indexed: 01/07/2023] Open
Abstract
The field of adult neuroimaging relies on well-established principles in research design, imaging sequences, processing pipelines, as well as safety and data collection protocols. The field of infant magnetic resonance imaging, by comparison, is a young field with tremendous scientific potential but continuously evolving standards. The present article aims to initiate a constructive dialog between researchers who grapple with the challenges and inherent limitations of a nascent field and reviewers who evaluate their work. We address 20 questions that researchers commonly receive from research ethics boards, grant, and manuscript reviewers related to infant neuroimaging data collection, safety protocols, study planning, imaging sequences, decisions related to software and hardware, and data processing and sharing, while acknowledging both the accomplishments of the field and areas of much needed future advancements. This article reflects the cumulative knowledge of experts in the FIT’NG community and can act as a resource for both researchers and reviewers alike seeking a deeper understanding of the standards and tradeoffs involved in infant neuroimaging. The field of infant MRI is young with evolving standards. We address 20 questions that researchers commonly receive reviewers. These come from research ethics boards, grant, and manuscript reviewers. This article reflects the cumulative knowledge of experts in the FIT’NG community.
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Affiliation(s)
- Marta Korom
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA.
| | - M Catalina Camacho
- Division of Biology and Biomedical Sciences (Neurosciences), Washington University School of Medicine, St. Louis, MO, USA.
| | - Courtney A Filippi
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Roxane Licandro
- Institute of Visual Computing and Human-Centered Technology, Computer Vision Lab, TU Wien, Vienna, Austria; Department of Biomedical Imaging and Image-guided Therapy, Computational Imaging Research, Medical University of Vienna, Vienna, Austria
| | - Lucille A Moore
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Alexander Dufford
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Lilla Zöllei
- A.A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Alice M Graham
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Marisa Spann
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Brittany Howell
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Department of Human Development and Family Science, Virginia Polytechnic Institute and State University, Roanoke, VA, USA
| | | | - Sarah Shultz
- Division of Autism & Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | - Dustin Scheinost
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
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