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‘Smart value’ Achieva 1.5T SE is impressive performer

Best Practice
Ahrens, Mark, BS RT (R) (MR) Glendale, Orthopaedic Hospital of Wisconsin USA
Dorn, Eric, M.D. Glendale, Orthopaedic Hospital of Wisconsin USA

'Smart value' Achieva 1.5T SE is impressive performer

The Orthopaedic Hospital of Wisconsin has always had an excellent reputation for image quality and sees this as a high priority in the purchase of any new imaging system. So when it recently opened a new hospital, it looked carefully at the range of entry-level MRI systems available, and chose the Achieva 1.5T SE principally because it provides a lot more value for money than any of the other systems according to Mark Ahrens, B.S. R.T.(R)(MR), Director of Diagnostic Services.
 Eric Dorn, MD Mark Ahrens The Orthopaedic Hospital of Wisconsin
Eric Dorn, MD
Mark Ahrens
The Orthopaedic Hospital of Wisconsin

Achieva 1.5T SE combines outstanding image quality with economic attractiveness

The Achieva 1.5T SE is a highly-affordable 1.5T MR system without the typical compromises that usually come with this. Based on the proven Achieva platform, it shares its technological design with the top-of-the-range Achieva systems, and offers access to the extensive range of advanced clinical applications available on these systems. But it is in a price bracket normally associated with entry-level systems.

The hospital's previous system was a Philips Intera 1.5T running software release 12.1. Although this was still giving good service, it was decided to move with the times and install an up-to-date system in the new hospital.

"Naturally we didn't want to spend more than needed on our new MRI system so the Achieva 1.5T SE was attractive," says Mark Ahrens. "For orthopedic imaging, 8 channels is usually sufficient, and we saw that Philips already had a complete set of 8-channel coils for orthopedic imaging on the Achieva 1.5T SE, including a foot/ankle coil, a knee coil and a wrist coil that all seemed to fit perfectly with our applications. The system's specs are also a lot higher than for other systems in this price range; the Achieva SE has better gradients, a large 53 cm FOV and excellent homogeneity. It therefore made a lot of sense to go with the SE."

Achieva 1.5T SE takes MSK imaging to the next level

The Orthopaedic Hospital deals with a large variety of orthopedic cases, and the imaging center's work is focused on musculoskeletal imaging - mainly joints and spine. In rare cases the hospital also performs brain MRI for stroke evaluation as well as oncological imaging to look for bone lesions.

The Achieva 1.5T SE has been in operation at the hospital since last November and, according to Mark Ahrens, it's more than living up to expectations. "The image quality is outstanding. Previously, we already prided ourselves that our quality was acknowledged as being better than that of any other center in the Milwaukee area, but what we're getting now with the SE takes the imaging standard to a completely different level."

Radiologist Eric Dorn, MD, Director of MSK Imaging, agrees. "Image quality is clearly superior to the old system which was already exceptionally good," he says. He also sees that the large FOV offers big advantages for total spine imaging, especially with Philips' MobiView software, which automatically fuses linked image stacks into a single image of the total spine.

"Another feature we particularly like is the ability to work at very small FOVs. We frequently use the Philips microscopy coil set to get excellent wrist and finger images at FOVs as low as 50-80 mm. The system is able to still maintain good SNR while working at these very small FOVs and that's a huge advantage."

"Our basic imaging protocol concentrates on imaging in all three planes with proton density (PD) weighted and PD fat-saturated or T2-weighted fat-saturated sequences, sometimes combined with DRIVE to increase the sensitivity for fluids," says Dr. Dorn.

He is also happy with the range of new tools on the Achieva 1.5T SE, such as asymmetric TSE. "That's something we didn't have before. Now when we run Turbo Spin Echo with asymmetric profile ordering, we can speed up the scan and still get great image quality. And that really improves our proton density imaging."

Although best image quality rather than speed is normally their first priority, Dr. Dorn points out that the center also makes use of the scanner's 8-channel SENSE imaging capability to reduce scan time for patients who can't tolerate staying too long in the scanner.

Superb off-center performance is important for orthopedic imaging

The Achieva 1.5T SE offers a tenfold improvement in homogeneity compared with standard entry-level systems, and this reflects dramatically on the system's off-center imaging. "Thanks to its excellent off-center imaging, we get very good fat-suppressed images of the elbow with the arms by the sides," explains Mark Ahrens. "Without such homogeneity, image quality suffers when scanning with the patient's elbow close the side of the bore, so that patients have to be scanned in the so-called Superman position with arms over the head, which is a problem for some patients. However, with the Achieva 1.5T SE and the 8-channel SENSE Wrist coil, we're seeing beautiful image quality."

 PD-weighted FFE
Images show a complete ulnar collateral ligament tear at metacarpophalangeal joint. The coronal PD-weighted image shows the ulnar collateral ligament rupture of the left thumb metacarpophalangeal joint. The central image shows a proximal rupture of the ulnar collateral ligament. The right image shows a small distal avulsion fragment and cystic degenerative change of the ulnar proximal thumb base. FOV 5 cm, 2 mm slices.

View more clinical cases:

ExamCards provided smooth switchover from old to new

"All these wonderful ExamCards supplied by Philips meant that after the installation we were ready to go with minimum tweaking," recalls Dr. Dorn. "If protocols we ported over from the prior magnet didn't, for whatever reason, totally come up to the image quality we had before, we were able to use one of the scanner's pre-existing ExamCards and make some changes to quickly get back to where we needed to be. What's more, when you have a new coil and initially no protocol for it, it's great to be able to pull up an ExamCard from the scanner or download one from NetForum and start with that rather than having to build everything from scratch. And if you want to try a different technique, it helps first to see what Philips has already provided."

A good business choice

From the business aspect too, Mark Ahrens considers the Achieva 1.5T SE to have been an excellent choice. "The system's PowerSave power management function, which reputedly saves up to 50% on energy bills, is obviously attractive," he says. "And very important for us was the system's small footprint. It needs only 27 square meters for the entire system, which has had a huge impact by allowing us to save costs on building the MRI suite, as well as on heating and cooling."

Although for the hospital's current range of orthopedic applications, the Achieva 1.5T SE is more than sufficient, Mark Ahrens and Dr. Dorn also have an eye on the future. "The fact that the system is built on the Achieva platform is a tremendous bonus since it provides us with a pathway for extending the system's capabilities," concludes Dr. Dorn. "Right now, we are very comfortable with the system, but if in the future market forces or our own imaginations dictate that we should upgrade to more channels or better gradients, that option is there."

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Jan 20, 2011

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Best Practice
Achieva 1.5T
Release 2.5, Release 2.6
Nova, Nova Dual, Pulsar
Ankle, Elbow, Foot, Musculoskeletal, Oncology, Wrist

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