Trends in Weight-Bearing MRI for Spine Practices: Q&A With Dr. Douglas Smith

Laura Dyrda -   Print  | Email

SpineDouglas K. Smith, MD, interventional spine radiologist and founder of Musculoskeletal Consultants, and Stephen H. Hochschuler, MD, co-founder and spine surgeon at Texas Back Institute, will discuss spine MRI in a webinar titled "Weight-Bearing MRI in the Modern Spine Practice: Meeting Challenges of Milliman Criteria." The webinar is sponsored by Esaote North America and Musculoskeletal Imaging Consultants.


Dr. Smith and Dr. Hochschuler will address these topics and more in the upcoming free webinar. To learn more and register for this complimentary webinar, click here.


Esaote is an Italian-based international company focused on developing weight-bearing MRI, the Esaote G-scan Brio. The G-scan Brio utilizes second generation MRI (2GMRI) technology with improvements in both receiver coil and XP technology that produces sharper images with even less field strength than similar products on the market at less than 50 percent of the cost.


Q: What are the perceived benefits of The Esaote MRI system over traditional MRIs?


Dr. Douglas Smith: The Esaote G-scan Brio is the first Tiltable MRI that allows an individual to be examined in both upright weight-bearing position and supine non-weight-bearing position. This demonstrates why anatomic structure while standing and also shows why conventional supine MRI images fail to demonstrate the etiology of the positional pain.


The benefits of over traditional "closed bore" MRI relate to the open architecture that serves the needs of claustrophobic patients and the tiling MRI that allows MRI to be obtained in both standing and supine position. Metallic artifact is much less with low field MRI and can be beneficial in examining metallic spinal implants.


Q: When would one use weight bearing MRI technology? Does this help address Milliman criteria?

DS: The best indication for weight-bearing MRI is for the evaluation of individuals with symptoms while standing that are diminished or relived while lying down. If a patient has positional symptoms or only experiences radiculopathy or myelopathy when weight-bearing, then one should examine the patient using weight-bearing MRI. Most of the imaging related Milliman criteria are related to demonstrating compression of neural elements or spinal instability and these more commonly seen in the standing or weight-bearing position.

Q: How would this technology influence decision-making in light of healthcare reform changes?


DS: I am not sure this is knowable but I suspect being able to identify the etiology of positional symptoms in order to direct patients to the most appropriate treatment is likely to be more cost effective than treating empirically when supine MRI fails to demonstrate the etiology of the positional symptoms.

Q: What is the time and space needed for G-scan Brio installation?


DS: Best practice would be to allow six months to order, plan, and install and implement. Project profroma is critical to assure profitability or to assess the project goals and direct and indirect capital return on investment. There are many practice specific variables that contribute to project profitability and success and proper vetting is important predictor of project success — nothing replaces experience and thorough project modeling.


Q: What options are available for "Radiology as a Service" (pay-for-what you use) model for radiology management software and services?


DS: One of the major determinants of profitability is the capital expenditure costs for the software, hardware and training for scheduling patients, meeting meaningful use requirements, business analytics and billing and accounting (i.e. Radiology Information system or RIS). MIPPA requirements, site management and quality assurance programs and supervising physician services can all be provided by a cloud computing based 'Radiology as a Service" model.


In this business model, all services are provided by a cloud based service where the group pays a small charge per study for the services needed rather than having the large upfront capital expenses that can reduce profitability. This "pay for only what you use" model provides economy at low scale of the G-scan Brio model of a few cases per day and can make the difference between profit and loss.


To be a complimentary reviewer at the 20th Annual Becker's ASC Meeting on Oct. 24 to 26 in Chicago, please also email or call 18004172035. There are approximately five spots left to be reviewers.


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