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sampleinajar

> The average cost of a WB-MRI scan for NSCLC patients was £317

Wow! $3000+ here in the US. Ever get the feeling you've been cheated?

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If you prepay, costs around $400 to $500, but that is not involving private insurance.

https://www.mdsave.com/

Not affiliated, just interesting to see prices of various diagnostics around the US.

There are others that are less expensive if you do some searching, like https://radiologyassist.com/ (depending on where you live).

Also, if you call independent MRI centers they will usually give you a much lower cash price (but then insurance won't reimburse).

Another point to consider is that hospital MRIs can cost 10x (ten times) more than independent MRI centers.

And while we're talking about MRIs, it's important to mention that the safer contrast agents are the macrocyclics. Avoid the linear agents if you are concerned about possible gadolinium deposits in your brain and other organs, and potential kidney damage.

Regarding gadolinium, linear agents are almost never used anymore (and shouldn't be), at least in the US. Also, macrocyclics do also deposit in your brain in very small amounts, however there has never been any negative effect from this shown to date. And lastly, gadolinium is not known to cause any kidney damage. The problem in the past (in particular with linear agents) was nephrogenic systemic fibrosis, which was shown to occur in patients with pre-existing poor kidney function, probably as a result of being unable to quickly clear the gadolinium, which could then deposit in tissues. There is very little risk (if any) of NSF with newer macrocyclic agents.

I've seen Groupons for MRI scans and thought surely it must be a scam. From the reviews, sometimes they pressure you to get a package for periodic scans and use the first as a base line. But interesting indeed!

State of the art MRI machine costs $3 million up front. Would take 20 scans a week, every week, for 10 years to break even on that investment at $300 per scan. Not counting physician & staff time or cost of capital.

For reference, I recently went to an MRI ‘center’ and their business hours are 7:30am to 10pm 7 days a week.

So, even charging $500 and booking every 30 minutes, payback on investment is much less than a year.

That sounds so ridiculous compared to Germany, where grocery stores aren’t even open 7 days a week.

My insurer pays like $450. The hospitals seem to be doing ok, if anything there are way too many MRIs out there.

A few years back that was the "japanese problem": the price of MRI machines started falling but the act itself (whose price is set by policy / negotiations) hadn't been revised yet, so every clinic started getting one, which contributed to the price falling, and a price revision or two later the price was revised to ~$100, but the cheap MRIs and habit to use them remained.

We're talking circa 2010, around the time of the obamacare debate in the US.

Only 20 scans a week?

A scan takes 30-60 minutes. So even if they only work 8 hour days and assume an hour for lunch/flex that's 35 scans per 5 day week. If they use it on weekends at all or run it for more than eight hours, that's just gravy.

I'm not sure where you got the 20 scans a week number.

Because scans are not booked wall to wall every hour of every day. Needs more likely follow a poisson distribution with ample waits in between uses.

To try and pack it that densely, with the large variation in how people show up at the hospital, would cause bottlenecks and loss of service.

20 a week is a more common number for most places.

Here's actual data [1] measured on site. The usage is indeed around 50%, so the 20 is a much better answer.

[1] https://www.researchgate.net/figure/MRI-scanner-utilization-...

40% utilization means that it was in use for 67 hours per week. I don't think an MRI takes three hours.

(In the case of the study listed, the utilization figures might be out of ~35 hours, which would make things different - but they also exclude scans scheduled in advance)

The link states "As a result, in our study the maximum hours per week on each scanner was limited to 35 h for the Vision (no hours on Tuesdays), 39 h for the Harmony, 32 h for the Sonata (no hours on Wednesdays) and 38 h for the Avanto."

Why guess 67 when you can look at the answer?

Because from my reading that's not the number of hours they used the machines, but the number of hours in which the machines were available to be used. And since they also state that their utilization figures only include emergency cases (and exclude scheduled scans) I don't consider it a particularly relevant source in the first place.

>I don't consider it a particularly relevant source in the first place.

Care to provide a relevant source?

MRIs take as long as you can afford.

I have actually run ~3 hour MRIs for experiments, but we're being very fussy and trying to get the best possible image with the smallest possible voxel, which you do by acquiring tons of volumes and averaging them. Obviously, you can be in and out of there much quicker if you're just looking for a gaping hole.

This is data from a hospital. In the U.S. at least, a lot of MRI scans are done in outpatient centers, scheduled well in advance, and so utilization can be much higher. This would certainly be true of prophylactic scans.

The utilization could also be much lower. If not enough people need to sign up for each and every day, then it will not be full. It's extremely unlikely the needs in a region match the capacity anywhere near 100%. Such a tight capacity would result in many problems, so reasonable planning would have excess capacity to deal with busy seasons/holidays/weekends/etc.

Just like the hospital case, things like this likely follow a Poisson distribution, and it is therefore reasonable to assume similar usage patterns.

Have a link with data for your claim? I looked and found none.

A lot has changed since 2011 but even back then the MR scanner should always have been full and the next patient should have been waiting outside. If a scanner is very early or late you call the next patients and alter scheduling. Anything else is a waste of time and money.

There's a reason we design roads, electric grids, food supply, and so on, to not perfectly match needs. It's impossible and foolish to assume constant rates of needs.

For the same reason, no hospital would assume MRI scanners are 100% in use all the time. You cannot schedule people needs that perfectly without fail, on holidays, summer versus winter, day and night, weekends versus Mondays, and so on.

Utilization is less in a hospital, especially when you're measuring "active scanning time" and not all the time that you're really using a room. Hospitals also don't book scans so aggressively since someone might need a scan pronto- in an emergency, or near-emergency- and it can't be scheduled weeks in advance like you do in outpatient settings.

Complex cases where you need anesthesia, especially, may involve a lot of mucking about before and after the "active scanning" period, where the room is being used, but the scanner is not actively scanning anyone. Also, paediatrics cases.

Utilization is a lot higher in outpatient settings where you can line patients up and turn the room around in a few minutes.

>Because scans are not booked wall to wall every hour of every day. //

I had a scan in the UK, and this is exactly how it was done. Mine was actually in a mobile unit set up in a car park (for several months).

It took about 20mins and I was in the ante-room getting prepped as someone else was in the scanner, someone else was in the waiting room waiting to go next. At least a couple an hour and there were a couple of shifts of workers too (I asked).

As an aside the workers were all foreign, how fortunate we were/are and how sad for those countries to lose their talent to us.

Yep, places I've work with have usually two shifts and at least one scan an hour. So, easily, 20 scans a day.

Yes but you don't do 20 scans a week, you do that per day

Looks like you're pretty close: https://www.radiologybusiness.com/topics/business-intelligen...

>Ultimately, UVI increased appointment slots to 407 a week, efficiency was boosted to about 82%, and it is averaging 433 examinations per week.

That's for four machines.

Isn't 20 scans a day something like 15 hours of continuous, back-to-back scanning?

Are you saying that you wouldn't have your multi-million dollar imager running as much as possible?

I'm saying that it seems like a most optimistic, best-case scenario, and not the average case.

When my partner needed an outpatient MRI, we got it done the next day by accepting the 11pm time slot. This was at a private hospital in Australia in 2006. We were super impressed by everything that department did to maximise utilisation. It was like a production line!

Some scans are very fast. For a basic knee scan done well it’s 10-15 minutes of imaging time and lumbar spine scans are a couple of minutes longer. With 2 staff the changeover can be a minute of 3. With good scheduling the scans that are similar are booked back to back and equipment changes are minimal.

NHS isn't a for profit healthcare system; and they'll break even earlier on the early detection and diagnosis as since it covers you for life treating you early is less expensive then treating you later when the treatment costs would be higher.

Considerations would be different if the MRI scanner was running as for profit; or you could switch coverage so the later costs would be borne by someone else.

treating you early is less expensive then treating you later when the treatment costs would be higher.

This is true retrospectively, for anyone who it turns out really has the disease.

But studies show that prospectively (when you don't know if somebody actually has a given disease), the cost of preventative care - including follow-up tests and unnecessary treatments - exceeds the benefit that you outlined.

EDIT: add quote to clarify what I'm responding to.

Which makes sense intuitively. You're trading away risk.

This is a little circular, in that we do the preventive care that we actually do is the sort that we think is effective.

If it were obvious that these whole-body scans were cost effective, the NHS would have people lining up.

10-20 scans per day is a full days work in MRI for an 8-9 hour day. I’m an MR radiographer.

Well if you are not including external costs, you can get a MRI machine at around $100k to $500 depending on your needs[0].

[0]:https://www.alibaba.com/product-detail/IN-16CT-Hospital-Medi...

Not only that, but it's also an X-Ray and CT scanner. What a bargain!

In all seriousness the product linked is a CT scanner, which are way less expensive in general.

Not all MRI machines are equal, though, so it's hard to tell without specifics.

A low field 0.2T machine might be $150k. A full bells+whistles 3T machine might be $3M.

1.5T or 3T is where imaging gets useful and then you’re back at the high end of the pricing.

Don't forget the price increase when the MR software developers sprinkle in the machine learning pixie dust!

(Source: am a MR software developer)

I’d love there do be more interaction between radiographers and devs. There are some strange bugs on all the major platforms (my GE experience is now probably too old to be relevant) and removing them would be so excellent. What is your area/role?

Without outing my specific company and location: I do primarily operating system and associated plumbing level development for a platform supporting MR applications as well as some application work atop that.

The 'bells and whistles' model is starting to move to 7T, and the price scales accordingly.

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