Activity has resumed in 2022 and automation is becoming the standard, according to Thierry Munier, European Director of MRI at Canon Medical Systems Europe, who told VISIONS what customers can expect in terms of novelty at the dawn of a new year.

‘We’re back to an almost traditional operation level inside the organization and with users or future customers, whom we’ve been able to meet again in product presentations or conferences such as the ECR, JFR or SIRM,’ he said. ‘We were able to restart site visits and take potential customers on tour.’

The COVID-19 pandemic put MRI sales on hold in 2020 and early 2021, but activity has resumed, with a stark increase in new installations and replacements.

‘There’s a strong demand because patients who had abandoned their care journey have now returned,’ he explained. ‘There’s a long waiting list and we have to respond as soon as possible. We can’t lose time in intermediate operations that don’t contribute to diagnosis.’

Current market trends
The pandemic has put a strain on already tight resources, and there is a very strong interest in improving workflow with automation.

‘Healthcare systems are bled dry, both financially and in terms of human resources. There are difficulties in recruiting skilled personnel, and there are fewer and fewer radiographers and technicians. Physicians have more and more tasks to manage and there’s a lot of burnout. Systems must be made easier to use. Workflow must be increasingly simple and fast.’

Automation is becoming the standard, but there are a few obstacles that remain to be tackled, according to Thierry. ‘While many companies provide software that enable ease of workflow, these solutions are usually focused on specific applications. And unlike CT, which is increasingly specialized, an MRI scanner traditionally serves all purposes inside a hospital. We need either a more generalized post-treatment solution or a lot of small bricks that correspond to all the needs,’ he suggested.

Imaging equipment vendors do not have the means to develop solutions for every application, so the market is likely to move towards a market place style and forge partnerships with AI companies, he predicted. ‘There are so many diverse and varied requests that one type of software can’t answer all the clinical specificities, especially in MRI, where image types vary a lot depending on the anatomy.’

The challenge will be to meet the different customers’ needs and accompany them in performing automated post-processing tasks.

2022 has been a milestone for Canon Medical with the launch of the new Vantage Fortian 1.5T MRI system, now installed in Japan, Spain and France, and further installations in the pipeline. ‘It’s been a marketing and sales success. We’ve sold 14 scanners since the system was launched in July and feedback is very positive from the installed equipment.’

The Vantage Fortian was launched together with new features that bring many improvements, which have also been added to other equipment in the portfolio, such as the Orian 1.5T and the Galan 3T systems.

‘The reliability and reproducibility of MR images continue to be improved, and we’re very proud to show that we develop solutions that meet the needs of our users and improve their diagnostic efficiency,’ Thierry said. ‘Part of my team’s role is to understand the users’ needs and communicate them to Japan, where engineers can develop products that will make a difference.’

Horizon 2023 and beyond

A lot of exciting things are going to happen this year, with the introduction of features such as Auto Consult Brain, a fully automated procedure that covers all steps of an examination from patient positioning to image analysis and reporting, with live automation during the acquisition.

‘The choice of sequences automatically takes into account the patient’s history,’ he explained. ‘The software automatically recovers the previous protocol through the PACS or RIS, and reprograms the same type of examination with the same positioning of the slices, which is great for reproducibility.’

At the end of the basic protocol, the data are sent to the automatic analysis software, while the patient is still on the examination table, and the system compares two types of images (FLAIR and diffusion) to see if there is any inconsistency between the two.

Depending on the results, the system either informs that no additional information is needed or sends an instruction to complete the examination using sequences with or without contrast. The protocol is guided by the results of the automation platform in real time.

‘Automation systems and real-time analysis will become widespread in the next 20 years,’ Thierry said. ‘The competence is not necessarily there. Teleradiology is developing more and more, so there may be a medical supervisor on site, who might not have skills in medical imaging. Real-time automation will have an impact on the way imaging services are organized.’

Auto Consult Brain will first target stroke, to enable earlier diagnosis and treatment onset. Other applications will follow, such as oncology, multiple sclerosis, prostate or MSK imaging.

Another exciting release in 2023 will be the introduction of PIQE, an AI-fed tool already used in CT scans to improve image resolution. In MRI, the software will enable to obtain a high resolution on standard acquisitions with small size matrices, by applying the algorithm to raw data. The solution will be applicable everywhere.

'In MRI we want to go for resolution of fine anatomies like the knee, the polygon of Willis, or small ones like the pituitary gland and the inner ear,’ he said. ‘We also continue to develop a technique of motion correction using AI.’

The challenges for MRI remain to expedite examination times and improve image quality to boost diagnostic efficiency, either with finer images or new acquisition techniques, all the while trying to reduce motion artifacts.

There is no doubt that future equipment will help overcome these limitations, Thierry believes. ‘I’m blessed to be working in a modality that is still evolving. I started 35 years ago and I learn every day. It’s always surprising to see that things we thought were impossible become so, thanks to advances made in science and technology. We manage to solve problems that we thought were unsolvable before.’

You can also download this article as PDF or the full edition of the respective VISIONS