An Unmatched Radio Frequency Chain for Low-Field Magnetic Resonance Imaging

Magnetic Resonance Imaging (MRI) is a safe and versatile diagnostic tool for intracranial imaging, however it is also one of the most expensive and specialized making it scarce in low- to middle-income countries (LMIC). The affordability and portability of low-field MRI offers the potential for increased access to brain imaging for diseases like Hydrocephalus in LMIC. In this tutorial style work, we show the design of a low powered and low cost radio frequency chain of electronics to be paired with a previously reported prepolarized low-field MRI for childhood hydrocephalus imaging in sub-Saharan Africa where the incidence of this condition is high. Since the Larmor frequency for this system is as low as 180 kHz, we are able to minimize the impedance of the transmit coil to 5 ohms rather than match to 50 ohms as is traditionally the case. This reduces transmit power consumption by a factor of 10. We also show the use of inexpensive and commonly available animal enclosure fencing (“chicken wire”) as a shield material at this frequency and compare to more traditional shield designs. These preliminary results show that highly portable and affordable low-field MRI systems could provide image resolution and signal-to-noise sufficient for planning hydrocephalus treatment in areas of the world with substantial resource limitations. Employment of these technologies in sub-Saharan Africa offers a cost-effective, sustainable approach to neurological diagnosis and treatment planning in this disease burdened region.Fil: Harper, Joshua R.. Pennsylvania State University; Estados UnidosFil: Zárate Evers, Cristhian Manuel. Universidad Nacional de Asunción; Paraguay. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Krauch, Federico. Universidad Nacional de Asunción; ParaguayFil: Muhumuza, Ivan. Mbarara University Of Science And Technology; UgandaFil: Molina, Jorge. Universidad Nacional de Asunción; ParaguayFil: Obungoloch, Johnes. Mbarara University Of Science And Technology; UgandaFil: Schiff, Steven J.. Pennsylvania State University; Estados Unido

Bringing MRI to low- and middle-income countries: Directions, challenges and potential solutions

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

Low-field MRI: a report on the 2022 ISMRM workshop

In March 2022, the first ISMRM Workshop on Low-Field MRI was held virtually. The goals of this workshop were to discuss recent low field MRI technology including hardware and software developments, novel methodology, new contrast mechanisms, as well as the clinical translation and dissemination of these systems. The virtual Workshop was attended by 368 registrants from 24 countries, and included 34 invited talks, 100 abstract presentations, 2 panel discussions, and 2 live scanner demonstrations. Here, we report on the scientific content of the Workshop and identify the key themes that emerged. The subject matter of the Workshop reflected the ongoing developments of low-field MRI as an accessible imaging modality that may expand the usage of MRI through cost reduction, portability, and ease of installation. Many talks in this Workshop addressed the use of computational power, efficient acquisitions, and contemporary hardware to overcome the SNR limitations associated with low field strength. Participants discussed the selection of appropriate clinical applications that leverage the unique capabilities of low-field MRI within traditional radiology practices, other point-of-care settings, and the broader community. The notion of "image quality" versus "information content" was also discussed, as images from low-field portable systems that are purpose-built for clinical decision-making may not replicate the current standard of clinical imaging. Speakers also described technical challenges and infrastructure challenges related to portability and widespread dissemination, and speculated about future directions for the field to improve the technology and establish clinical value.Radiolog

Sustainable low-field cardiovascular magnetic resonance in changing healthcare systems.

Cardiovascular disease continues to be a major burden facing healthcare systems worldwide. In the developed world, cardiovascular magnetic resonance (CMR) is a well-established non-invasive imaging modality in the diagnosis of cardiovascular disease. However, there is significant global inequality in availability and access to CMR due to its high cost, technical demands as well as existing disparities in healthcare and technical infrastructures across high-income and low-income countries. Recent renewed interest in low-field CMR has been spurred by the clinical need to provide sustainable imaging technology capable of yielding diagnosticquality images whilst also being tailored to the local populations and healthcare ecosystems. This review aims to evaluate the technical, practical and cost considerations of low field CMR whilst also exploring the key barriers to implementing sustainable MRI in both the developing and developed world

Centering inclusivity in the design of online conferences: An OHBM-Open Science perspective

As the global health crisis unfolded, many academic conferences moved online in 2020. This move has been hailed as a positive step towards inclusivity in its attenuation of economic, physical, and legal barriers and effectively enabled many individuals from groups that have traditionally been underrepresented to join and participate. A number of studies have outlined how moving online made it possible to gather a more global community and has increased opportunities for individuals with various constraints, e.g., caregiving responsibilities. Yet, the mere existence of online conferences is no guarantee that everyone can attend and participate meaningfully. In fact, many elements of an online conference are still significant barriers to truly diverse participation: the tools used can be inaccessible for some individuals; the scheduling choices can favour some geographical locations; the set-up of the conference can provide more visibility to well-established researchers and reduce opportunities for early-career researchers. While acknowledging the benefits of an online setting, especially for individuals who have traditionally been underrepresented or excluded, we recognize that fostering social justice requires inclusivity to actively be centered in every aspect of online conference design. Here, we draw from the literature and from our own experiences to identify practices that purposefully encourage a diverse community to attend, participate in, and lead online conferences. Reflecting on how to design more inclusive online events is especially important as multiple scientific organizations have announced that they will continue offering an online version of their event when in-person conferences can resume

A framework for advancing sustainable magnetic resonance imaging access in Africa

Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low-resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2-year period. The 68-question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub-Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low-field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher-field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up-to-date data on MRI density in Africa and offers a unique insight into Africa\u27s MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low-resource settings

A framework for advancing sustainable magnetic resonance imaging access in Africa

Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low-resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2-year period. The 68-question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub-Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low-field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher-field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up-to-date data on MRI density in Africa and offers a unique insight into Africa’s MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low-resource settings.Africa has a massive population with few infrastructural resources and an untapped potential to effect transformative change in healthcare. To advance magnetic resonance imaging (MRI) access across all African countries and improve health and well-being in low-resource settings over the next decade, the MRI community is called to partner with the Consortium for Advancement of MRI Education and Research in Africa (CAMERA) to create enabling clinical and research MRI environments that will utilize the rich intellectual resources in Africa to realize lasting and equitable MRI for all Africans and the world at large.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/175918/1/nbm4846_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/175918/2/nbm4846.pd

A framework for advancing sustainable magnetic resonance imaging access in Africa

Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low-resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2-year period. The 68-question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub-Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low-field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher-field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up-to-date data on MRI density in Africa and offers a unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low-resource settings