MRI and mammography exams can help save lives, but patients often avoid them due to anxiety and pain
Lying completely still in a small space for an hour underneath a heavy contraption while doctors look at your brain. Having a machine firmly compress your breasts between two hard, cold plates. These aren’t exactly anyone’s idea of a good time.
Yet for radiologists, neuro researchers, technologists and other clinicians, mammography and MRI scans are often the best tools to help save lives. This passion for defeating disease is in full display at the Radiological Society of North America (RSNA) in Chicago this week, where medical professionals who perform these exams from around the world convene to see the latest technology.
With the latest advancements in medical imaging on display designed specifically with the patient in mind, medical designers and engineers are showing it’s possible to improve patient comfort while simultaneously enabling technologists to obtain clear and detailed images quickly - even for some of the most difficult and sensitive exams, such as the brain or breasts.
The newest MRI scanner and mammography system have breakthroughs that are already beginning to show results.
Blanket-like coil for Magnetic Resonance Imaging (MRI)
During an MRI, patients must lie still under a contraption called an RF coil.
The coils, which act like an antenna picking up signals from the patient’s body and converting them into images, are traditionally bulky, heavy, stiff and can be uncomfortable for the patient and difficult for the technologist to position. This is a serious consideration as MRI scans can sometimes last up to 90 minutes.
“A radiologist we work with reacted to a traditional MR coil by saying ‘I don’t want Neil Armstrong’s space boots, I want Cinderella’s slipper!’,” said Fraser Robb, PhD, and manager of MR RF Coils at GE Healthcare. “It was ironic as GE actually did design Neil Armstrong’s space boots a long time ago. So, we set out for Cinderella’s slipper.”
The engineers held an innovation technology competition to redefine the MRI experience by focusing on patient comfort.
The result is a revolutionary suite of coils, unlike anyone in the industry – and patients - have ever seen before. Revealed just this month, and aptly named AIR Technology, this new coil is 60 percent lighter than conventional coils, benefiting both patients and technologists, offers greater flexibility in all axes to help conform to patients’ anatomies and fits 99.9 percent of patients.
“In my opinion, one of the greatest advancements in MR is AIR Coil technology,” said Tammy Heydle, Senior MR Technologist at the University of Wisconsin – Madison and a member of the team who evaluated the AIR Technology Suite in a clinical study. “There are almost endless possibilities for its use. The AIR Coils are light like a blanket, versatile and very comfortable for patient positioning.”
“We pretty much made our fairytale dreams of creating Cinderella’s slipper come true with the AIR Coil,” Robb said.
He believes the new coil will be especially beneficial in scanning pediatric and bariatric patients.
“The coil easily wraps around the anatomies of patients of all sizes and are so light-weight that they even lay comfortably on a baby,” Robb said
By eliminating copper waste and utilizing sustainable processes to reduce typical electronics and packaging waste, the AIR Technology Suite is also 90 percent greener and consumes 50 percent less power for lower operating costs compared to conventional coils, compared to conventional technology.
The AIR Technology Suite can be used in collaboration with the SIGNATM Premier - GE Healthcare’s newest wide bore 3.0T MRI system and the result of a collaboration between research institutions around the world working to design new imaging tools, particularly to aid researchers in the detection of biomarkers for the potential diagnosis of mild Traumatic Brain Injury. The SIGNA Premier also features a wide bore that accommodates larger patients and those who suffer from claustrophobia.
“SIGNA Premier is going to be our go-to neuroimaging system for many of our clinical and research applications,” said Dr. Scott Reeder, professor, Vice Chair of Research, and Chief of MRI at the University of Wisconsin-Madison. “It is hoped that it will improve our understanding of diseases like chronic traumatic encephalopathy and mild traumatic brain injury. This is the best tool we have for performing neuroimaging exams on these patients.”
A mammogram system designed for women by women, that puts the patient in control
Similar to the team that created AIR Technology, the mammography team wanted to design a new system centered around the patient.
A team of female engineers and designers at GE Healthcare came together to use their unique insights as patients to create a system that they would want to be scanned on.
“My challenge was how to totally change the perception of mammography, especially for the patient, and increase adherence,” said Aurelie Boudier, Industrial Designer at GE Healthcare.
The result is Senographe PristinaTM – the first mammography system to feature a patient-assisted compression remote control that enables the patient, with the help of a technologist, to set the compression that feels right for her. A handheld wireless remote control, called Pristina DuetaTM, allows the patient to adjust the compression force after breast positioning by the technologist. The technologist then guides the patient while she operates the remote control to adjust compression until she reaches an adequate compression level.
The best chance of early detection of breast cancer is a mammogram. Evidence shows that finding breast cancer early reduces a woman’s risk of dying from the disease by 25-30 percent or more. But for many women, the top reason they don't schedule a mammogram is because of the fear and anxiety from the potential result and exam discomfort.
“The design strives to minimize women’s perceived pain and discomfort by giving them an active role in the application of compression,” Boudier says.
“This is a new age in breast imaging,” said Dr. Kathy Schilling, Medical Director of the Boca Raton Regional Hospital’s Christine E. Lynn Women’s Health & Wellness Center and the radiologist who conducted a clinical review of the new tool. “Patients who used the remote control said the exam was more comfortable and they were visibly more relaxed. Any breast radiologist knows that when patients are relaxed, we are able to get better images and better images lead to a more confident diagnosis.”
Surveys of patients in Europe show four out of five patients using Pristina Dueta said it made the exam more comfortable and more than half said the device led to less anxiety during the exam.
Senographe Pristina offers other design enhancements to make the exam more comfortable, including a thinner image detector and rounded edges so there is less sharp metal coming in contact with a patient’s bare skin.
The design also changes the way a patient is positioned. Instead of women projecting their stress onto the handles on the system by grabbing them too firmly, which tenses pectoral muscles and has an impact on image quality, they can lean comfortably on the armrests, relaxing the muscles to simplify positioning, compression, and image acquisition. Poor positioning is a leading cause of retakes, and the lack of proper positioning may decrease mammography sensitivity.
“Finally, somebody listened to all the comments that we’ve been hearing and created a machine that is accommodating to our patients and the staff,” says Adela Parro, Lead Mammographer at The Christine E. Lynn Women’s Health & Wellness Institute at Boca Raton Regional Hospital.
 IPSOS Patient Satisfaction Study sponsored by GE Healthcare, conducted with 160 patients who used patient assisted compression across 2 sites in Europe, February 2017. Data on file.
 Taplin SH, Rutter CM, Finder C, et al. Screening Mammography: Clinical Image Quality and the Risk of Interval Breast Cancer. AJR 2002; 178: 79