1. 1 year practical experience
with O-scan
Dedicated MRI
Interview with Dr. Marco Davico, MSK Radiologist
Dr. Marco Dr. Davico, why did you consider a dedi- Are you using the dedicated MRI for all
Davico is a MSK cated MRI unit in your hospital? the MSK pathologies?
radiologist Let’s be clear, everybody likes to have the We have done over 4000 patients so far and
biggest and greatest. On the other hand you I have send no more than 10 patient for an
working in a
have to look at the price/performance as few additional MRI exam on a whole body mostly
major clinic in of us can afford the luxury of a Ferrari. because we suspected a tumor. On the hand
Turin and has In extremity imaging there has not been other we got patients from the large MRI be-
experience on any real significant development over the cause the study of the peripheral joint of the
many type of last years. OK, things go faster, images look upper limb with O scan is easier because the
MRI systems. nicer but this has had only a marginal effect system is more comfortable for the patient,
on diagnostics. So if the hospital has a case- in particular elder patient.
load of extremities and you need to enlarge
Since 1 year, One of the issues that always come to
capacity, dedicated MRI is a logic step to be
Dr. Davico is taken. Image quality today is good; through- discussion on this type of systems is Fat-
using an O-scan put is fast so using common business sense sat.
dedicated MRI the choice for a dedicated unit almost comes You are right, initially I also had some doubts
unit next to the automatic. on how best to approach this issue. With
other 4 MRI the O-scan you can use STIR, gradient echo
Have your initial expectations been STIR and the X-Bone sequence. After some
units in the
met? initial testing we have fully adapted the X-
clinic. From a clinical point of view my expecta- Bone sequences that generates in one 4 to
tions have been met. The system has a very 5 minute examination very good T1, PD and
complete set of sequences, from traditional Fatsat images all in one go. Using X-Bone
Spin Echo to the Driven Equilibrium Steady- in the correct way in the imaging protocol
State sequences. All of them can be adapted reduces examination time substantially with-
to your needs and you can create and store out any compromises to diagnostic quality
your own scanning protocols very easy. whatsoever.
How about throughput? I know that How about contrast media?
you have a very busy clinic with a tight First of all, contrast media is not used very
schedule so does the O-scan live up to often in extremities. When we inject contrast
expectations in throughput? we either use a high resolution 3D sequence
Our normal schedule calls for 3 exams / hour or we perform Artro-MRI for which we use
from 7.00 in the morning to 19.00 in the the Xbone sequences which assures good
evening including a reduced shift on Satur- resolution and high sensibility in searching
day and we reached this level of throughput for bone marrow edema or the X-Bone with
about 1 month after installation. To do this, a small flip angle that gives a very good T1
also the logistics are important so we have enhancement.
2 changing rooms next to the magnet and
also our techs are well trained.

2. 1 year practical experience
with O-scan
Dedicated MRI
Many people consider the Real-Time Dis- Any suggestions to your colleagues that
play on the gantry a gadget. would like to start with dedicated-MRI?
This questions is actually more a question for Today, dedicated MRI is definitely quality
the operators but I know they like the Real- MRI, forget what you have seen in the past!
time-preview very much as they use it for Let’s consider for a moment X-ray, if I would
the positioning of every single patient. The perform an X-ray of broken leg on a 1 mln
magnet display makes positioning faster and euro angio-system I am sure that the images
more accurate, they never have to go back would be nice but people would say that I
to make changes which of course helps to was crazy doing this type of exam un such an
improve productivity. expensive system instead of using a simple
C-arm. Now, why don’t we apply the same
What has been the reaction of the clini- logic to MRI? You simply do not need a 3T
cians? for routine knee imaging; this is a waste of
We scan as well in house patients as also pa- healthcare money. Of course we are consid-
tients for other clinics and I have never had ering a 3T for our clinic for all the nice so-
any complaint about image quality. If you al- phisticated imaging, but for meniscal tears
low me, good MRI diagnosis is not a simple or ACL rupture? Today Dedicated MRI is sim-
job and you cannot expect from a radiologist ply a cost effective way to deliver a specific
that he knows everything. For me doing car- healthcare performance with good quality.
dio MR would not be easy independent from It’s time to break with tradition and accept
the system quality. What I want to say is that also this kind of solution that has a clear ben-
a minimum of specialization helps to give the efit both for the clinic and the patient with-
orthopedic surgeons what they want, good out compromising quality.
images with a good referral. With today’s
possibilities and quality the system that is I would like to thank Dr Davico for the
used only makes a marginal difference. courtesy of the interview and his clear
and frank responses to the questions.
How about the patients, do they like the
system?
This system is very patient friendly and is very
suitable also for examining elderly persons
and of course for a hand/wrist exam this is
the most patient friendly solution available.
At first look the gantry may look small but
also obese patients and professional sport
players are no problem. Proof; of 4000 ex-
ams we performed; we never had to send
anybody away.
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