The MRI market continues to grow at a steady pace, driven by technological innovations, increased adoption of high-field MRI systems, an aging population in the U.S., and the discovery of new helium deposits, according to analysts Markets and Markets. In a report released in July, the B2B analysts project the global MRI market will eclipse $7.09 billion by 2023, up from $5.85 billion in 2018. Closed MRI systems held the largest market share in 2017, say the researchers, who also predict that very-high-field MRI systems will see the strongest sales growth in the next five years.

All of which is good news for the panel of experts participating in this 24×7 Magazine imaging roundtable on the MRI market, including Martijn Hartjes, senior director, head of global MR product marketing, for Andover, Mass.-based Philips Healthcare; Mike Ghazal, president/CEO of MRI and CT service for Lake Zurich, Ill.-based Zetta Medical Technologies; and Heather Lewis, the MR marketing director for Malvern, Pa.-based Siemens Healthineers North America.

The MRI market is expected to grow steadily over the next several years. What are some of the factors or trends fueling the market?

Martjin Hartjes: The main driver for the steady growth is the increased demand for MR procedures. Procedure volume growth is seen in musculoskeletal (MSK), body oncology, and cardiovascular. The growth in MSK is driven by the increase of outpatient imaging centers. In body oncology, there is more demand for prostate and breast procedures because of the clinical value MR brings. Cardiovascular, although relatively low compared to other procedures, continues to show high-growth percentages, driven by accelerated exams and the availability of non-contrast enhanced techniques.

Heather Lewis: We have seen speed, automation, and motion correction at the forefront of trends fueling growth in the market. Each of these ultimately impacts patient satisfaction, which is paramount for administration and clinicians. One key element to the patient experience is exam length. Siemens Healthineers has continually invested in accelerated imaging techniques, like Compressed Sensing, Simultaneous Multi-Slice (SMS), and CAIPIRINHA, to reduce exam time. Another contributor to faster scanning is automation. Automation tools, such as our Dot technology, not only aid in speeding up throughput, but they also help with consistency and reproducibility. The third trend fueling the market is motion correction, which can improve image quality, reduce the number of rescans, and increase diversity in procedure mix.

Mike Ghazal: The MRI market is expected to grow worldwide because of the rising numbers of the aging population, and because of the increase in incidents of diseases like cancer increasing physician demand for MRI scans. There are parts of the world that are finally catching up to this advanced technology as well, and that is where the most growth will be realized. Also, the commercializing of newer combined technologies, like PET/MRI, will trigger an increase in the North American and European markets.

What are some of the biggest innovations in MRI right now?

Lewis: Precision medicine, i.e., delivering the right care for the right patient at the right time, is the ultimate goal for patient care. Siemens Healthineers has been developing MRI technologies targeted toward this goal. Artificial intelligence is being explored and utilized to develop numerous new innovations for MRI. Siemens Healthineers MRI recently introduced BioMatrix technology (consisting of sensors, tuners, and interfaces) with its MAGNETOM Vida 3T MRI scanner.  This technology addresses unique, individual patient characteristics to reduce unwanted variability in MRI.

Ghazal: PET/MRI scanners and the newly FDA-cleared 7.0T MRI for patient scans are the two products that come to mind first.

Hartjes: The biggest innovations are breakthroughs in speed, productivity, and efficiency with the introduction of new acceleration techniques, like Compressed SENSE, which can be used with our Philips Ingenia Elition MR. Compressed SENSE helps customers to scan more patients per day by reducing scan times by up to 50% with virtually equal image quality. With the introduction of adaptive intelligence being used in MR, we foresee the first breakthroughs in context-specific workflows, robust image acquisition, and image-interpretation support. Other key innovations include technologies such as Philips VitalEye, which is a unique approach to detecting patient physiology and breathing movement – allowing routine exam set-up time to occur in less than a minute, even for less experienced operators. With SmartExam, we’re enabling guided patient set-up with analytics for automatic planning, scanning, and processing, which frees up time and enables a single operator to manage the full scan from the patient’s side with the single touch of a button.

What are some of the biggest challenges currently affecting the MR sector? How is the industry working to overcome them?

Ghazal: The shortage of helium for high-field MRI. Helium supplies have been in a question over the past decade. Remote magnet monitoring has become a critical component to preventing unexpected helium loss. Zetta has developed and implemented a software system called Z-Pulse to address this issue. Key to this prevention is constant live monitoring of the magnets critical parameters, instant notification of any parameter that is outside the preset threshold, and proactive response to any alert received. These features are all incorporated into our Z-Pulse solution.

Lewis: Compared to other modalities, like CT or ultrasound, MRI is more difficult to site, with longer exam times and more expensive upfront system cost, as well as service costs. Siemens Healthineers has introduced many innovative technologies that contribute to overcoming these challenges. We have designed lighter magnets and systems with a smaller footprint, addressing siting difficulties. As mentioned previously, we have driven exam speed and workflow throughput. This has also helped address the increasing number of MRI exams without causing a backlog. Likewise, by decreasing exam slot times, more patients can be accommodated; this improves not only patient satisfaction but also return on investment (ROI).

Hartjes: With all the pressures on reimbursement, one of the biggest challenges for many customers is simply to get the most value out of their equipment. This is why the industry is working on acceleration techniques, such as Compressed SENSE. In addition, there’s always the focus on getting “first-time-right” images every time. To help overcome obstacles in image acquisition, MRI scanners will become more automated, easier-to-use and more efficient. With scanners becoming faster, the need for quantitative MR, or other forms of clinical decision support, will also contribute to faster overall turnaround times. We will see more and more emphasis on the patient experience, particularly around comfort, safety, and well-being during the exam itself, which will lead to increased patient satisfaction and improved clinical outcomes as well.

What special considerations or best practices should be adhered to by biomedical engineers in the servicing, maintenance, handling, and repair of MRI machines?

Hartjes: Today, everything is connected, so remote diagnostics and remote service already play a big role. This will only increase and improve the overall response times for customers and increase the equipment uptime overall. So, the ability to see both remotely and in real-time what is going on with the machine should be a key requirement for biomedical engineers when servicing MRI machines.

Lewis: Biomeds and other imaging staff need to do their part to keep the MRI scanners safe and secure, in part due to HIPAA and other patient privacy issues. Not only do Biomed staff need to be aware of the dangers an MRI poses, but they need continual training as technology advances at a rapid pace.

 Good quality, preventative maintenance processes need to be established. Utilization of remote diagnostic capabilities needs to be understood. Periodic follow-up visits from national support engineers are important. Quality management reporting of service history and service metrics is imperative. And the availability of locally stocked parts is key for faster repair times.

For potential customers shopping for a new MRI, what advice can you give to help them with their ultimate purchase decision?

Lewis: MRI customers are keeping their systems longer than ever before. With that in mind, it is key that significant consideration is given to a vendor’s history of proven reliability, service acumen, and product performance. Additionally, a vendor’s innovation leadership should be evaluated. For instance, if you plan on keeping your magnet 12-plus years, keep in mind that many innovations can occur during that time. If you purchase a system that is on the cutting edge of innovation today, you are future-proofing your purchase.

Hartjes: In a world where value-based healthcare will become the standard, MRI has become a much more strategic purchase decision. Toward that end, healthcare providers should look for vendors that will work with them as collaborative partners to deliver integrated solutions that help them achieve their goals. For MR technology, this often means a solution that delivers speed, a better patient and staff experience, increased productivity, and, at the same time, helps to enable a more confident diagnosis. It’s all about speed, comfort, and confidence. Next, the support and capabilities to get the most out of that technology is more important than ever today. Customers must consider service, application, and performance improvement support, as well as choose a vendor that is willing to offer a business model that fits their specific situation and deliver an integrated solution.

 Explore the used MRI market first. You will see an amazing difference in price compared to new MRI systems (which are $1 million to $3 million). You will experience savings with used MRI scanners, which will enable you to run and operate your business with lower initial capital. Quality used MRI scanners will do a great job for you and will produce quality images. Evaluate the expected usage of the machine to determine what technology is a requirement versus luxury. In most cases, a later model used MRI scanner will perform the majority of the sequences required at a fraction of the cost of a new system.

In your expert opinion, how do you see the MRI market taking shape in the future?

Lewis: I see artificial intelligence growing in importance for MRI as well as the healthcare industry in general. We will see automation and quantitative imaging techniques become even more prevalent in MRI. The industry will further drive MRI to be an even faster exam, which will help this modality show up in places not traditionally seen, such as the ER. It will also increase its presence in the interoperative space and in radiation oncology. This will further fuel an ever-growing, ever-changing procedural mix.

Ghazal: It depends on the tariffs and taxes applied to medical equipment coming from overseas. Most manufacturers now have many system models manufactured at overseas facilities, and if these taxes are not removed, the prices for new systems will go up. If these taxes are removed, then our U.S. market may experience new, incoming systems manufactured by Chinese companies. Prices and new technological advancement of such systems may attract customers in the U.S.

Hartjes: I believe there is still huge, untapped potential for MR. One aspect is that MR can become more accessible, so more patients can benefit from the clinical capabilities of the technology. Additionally, MR has the potential to become even more definitive, and support precision diagnostics and precision medicine with quantitative MR, adaptive intelligence, and other technology innovations. This will all help to expand the role of MR in the health continuum beyond diagnosis, to include preventative screening, as well as enabling it to be used as a guidance tool for minimally-invasive treatment.