Comment by smitec | Hacker News Reader

Comment by smitec | Hacker News Reader

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There are a number of machines that don't use superconducting magnets and hence don't have such stringent cooling needs. These machines typically need these sort of cooling setups to support higher fields but imaging is still possible at low field. Some years ago, and I'm by no means up to date with this, there was a group working on imaging using the earth's magnetic field as the main field [1]. While this is the extreme MRI has been functional longer than superconducting magnets have been feasible.

On the flip side of this things like compressed sensing and MRI fingerprinting [2] reduce further the need for a traditional 'full' scan. We are still some way off seeing these sorts of things in clinical MRI but that may be more attributable to the pace at which companies like GE and Phillips move in this space. That and the sheer cost of R&D.

Overall it is a pretty exciting time to be in MRI, despite the outside view being that it has changed very little in recent decades.

disclosure: PhD candidate in electrical engineering, focused on MRI

[1] http://www.ncbi.nlm.nih.gov/pubmed/16828566 [2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376817/

How is the patent situation? Does a well funded startup have a chance to disrupt this field ?

Because if the potential were seeing in research on fmri neurofeedback for example does work, we might be talking about something that will make virtual reality look insignificant.

One example is accelerating mental learning processes that take experienced meditators decades(they call it enlightenment which leads to development of deeply happy and caring human beings ) into a period of weeks/months of a much less intense effort, so the experience may be available to everyone, not just a rare few.

MRI like a lot of other med tech is very heavily patented. The core tech has long since expired but any of the cutting edge work will probably have patents around it. I do believe that an MRI startup has a chance to disrupt but it may be more of an innovation in application, or accessibility than in pure technology.

>> innovation in accessibility

Do you mean business model innovation ?

Yeah essentially, I meant that in the sense of innovating how people access MRI scans and the data associated with them.

>How is the patent situation?

In the original Xconomy article[0], there's this quote:

“I could no longer wait. I’m still writing up the patents. But I am incredibly excited to strike off on this direction,” she says.

Doesn't answer your question of course, but the fact she's already writing patents is interesting.

[0] http://www.xconomy.com/san-francisco/2016/05/06/mary-lou-jep...

Cool! Will this mean MRIs take less time in the future? If so, any sense for how much less? I imagine it'd be more routine and give more people accurate diagnostics if it took 5-10 minutes instead of 45 to get a scan.

That's the hope. A little outside my field but current compressed sensing in MRI research is looking at reduction factors of about 2-8 (typically 2, 4, or 8 from tradition) in compressed sensing. This is still pretty rare in commercial machines though.

Some sequences such as EPI [1] can get images very fast (200ms) with a trade off in spatial resolution. This is for things like cardiac imaging where low resolution images of the heard every 200ms are more useful than a single high resolution image. Also for moving parts of the body there is often blurring artefacts due to movement within the image window using longer sequence types.

Unfortunately I think the biggest inhibitor of MRI being more common is still the price of a scan. Here in Australia it can be a few hundred dollars for a scan (and I understand it can be far more elsewhere). Again though if we had access to a cheaper option the idea of regular scans may not be too far off.

I like to imagine a point in the future where the sci-fi full body diagnostic scanning is a reality. Still a lot of work to get there but it is certainly getting closer.

[1] http://radiopaedia.org/articles/echo-planar-imaging-1

When I had an MRI on my knee in 2009, my out of pocket expense was $1500. A few hundred dollars seems cheap to me. Just the doctor visit to get the MRI ordered cost me $200.

That price really doesn't make a lot of sense. I find it hard to believe that it bears any meaningful relationship to the cost of the MRI machine or the cost of running it or analysing the results.

After all such an MRI takes only a few minutes of machine time. Let's be generous and say it takes an hour and that it is in use for only 10 hours a day 20 days a month. That means it turns over 300kUSD per month, 3.6MUSD per year.

You can probably buy one that would do the job for less than 500kUSD; see http://info.blockimaging.com/bid/92623/MRI-Machine-Cost-and-....

I think insurers have caught on nowadays, but MRI scanning used to be a major profit center for US hospitals because the cost of the machines had gone down but their prices kept going up. Probably still is if you have to pay list price.

Thank you for all this interesting information!

With your knowledge, would you consider MRI R&D to be as open for disruption like space technology was until a few years ago?

Do you think the same reductions in cost can be achieved by a group of similarly insanely smart people like those at SpaceX?

You're welcome, not often that MRI related posts come up so it is nice to share this side of what I do.

I think certainly there is room for it and I know there have been some recent entrants into the field which consider themselves MRI R&D. Up to this point though they are mostly bring quite secretive about what they are working on. I think though with the right funding and some smart cash behind a team that knows the space there is room to make big changes and drive price down competitively.

One example of a team in this space is Magnetica [1] who are working on smaller (physically) MRI systems for extremity imaging. (I know them through the university and my supervisor is CTO but I have no personal stake in the company otherwise)

There is 'the' MRI conference on this week in Singapore (ISMRM for those interested) which may result in some MRI related press in the coming days. Not sure where to look for it though as unfortunately the conference content is member only at this point.

[1]: http://magnetica.com/

Great answer, thank you. I find MRI related posts one of the most exciting - there is so much potential in the technology, especially as medicine moves from treatment of symptoms to prevention more and more. If there would only be more people working on this instead of social media apps...

I find it interesting to see that the trend in this space seems to move towards small MRI units. Do you know of similarly innovative companies that work on full-body MRI machines?

For me, the perfect business case (esp. in a country with a public health system) is having regular, accurate full-body scans that are checked by software for tissue changes. Early detection of some of the most deadly diseases would save insurances a tremendous amount of money and human beings from unquantifiable suffering. Are there any publications / blogs that you would recommend to stay up to date with MRI technology?

Hopefully speeding up image acquisition will also bring down cost. If you can reduce the acquisition time by a factor of 4, you should be able to make the scans at least 2 times less expensive, with correct management of the queue.

Acquisition is one cost but paying an expert radiologist to actually read the scan is another cost entirely. Decreased cost may increase use in cases where it's not necessary, which could reduce the mean throughput of the system.

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