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Fifty years of MRI: how the LUMC can make this indispensable technology affordable for the rest of the world

It is exactly 50 years ago that Paul Lauterbur published the basic principle of MRI in Nature. A revolution in medicine. Since then, MRI has produced increasingly detailed images but has also become more expensive. This makes it inaccessible to a large subset of the world’s population. Professor Andrew Webb from Leiden University Medical Center (LUMC) describes in Nature this week what is needed to make MRI available to the entire world population.

The LUMC team travelled to Uganda with their small MRI to show local engineers and students how to assemble and maintain the device.

To make MRI small and affordable can’t you just replace expensive materials with cheap alternatives? ‘Unfortunately, it’s not that simple,’ says Professor of Radiology Andrew Webb. ‘MRI is a complex technique. To make a smaller version that can also be used in regions such as rural Africa, we had to design the system from scratch.’

They replaced the usual superconducting magnet with thousands of small magnets and redesigned the electrical components to run on far lower power or even batteries. They also modified the algorithms that process MR images so they filter out noise from the outside. The result? A scanner that weighs 75 kg, is 50 by 50 centimetres in dimensions and can easily be assembled without specialised tools. And the material costs are around 1% of the price of a normal MRI.

MRI for everyone

While in Europe there are as many as 35 MRI machines available per million inhabitants, in Africa there are less than one. ‘A machine like ours should enable doctors in Africa to diagnose and treat life-threatening diseases on the spot,’ says Webb. Although the quality of a normal MRI cannot be matched, this small MRI also has added value for high-income countries. ‘It makes the scan more accessible. In theory, it could be placed in an ambulance to better help stroke patients, for example,’ says Webb.

Last year, the LUMC team shipped a system in kit form to Uganda and trained local engineers and researchers to build and maintain the system themselves. ‘On a technical level, we have shown that we can make an affordable MRI. Now we have to demonstrate that it can also be used in clinical practice.’ In the coming months, the device will be used to train students from many other African countries.

Webb and his colleagues have consciously chosen not to apply for a patent on their technique. ‘Our goal is to make MRI accessible to the whole world, and that will go faster if everyone has free access to our design.’ The techniques developed by Webb and his colleagues will be or are already being used in Paraguay, Spain and Uganda, where researchers are also investigating whether they could be used to diagnose viral brain and musculoskeletal disorders.

A historical perspective

‘MRI has turned medicine and biomedical research upside down over the past 50 years,’ says Mark van Buchem, head of the Radiology department. Until the 1970s, only X-rays were used in radiology. ‘That technique provided only limited information about the human interior. With the introduction of MRI, tissues could be assessed on the basis of many more characteristics. This resulted in a wealth of information that enabled much more accurate diagnoses,’ says Van Buchem. ‘The device has become indispensable for patient care.’

Simple is not always easy

One of the first MRI scanners in the Netherlands was installed in the LUMC about 40 years ago. To this day, the LUMC is still working to improve MRI techniques. Andrew Webb’s group and others at the Gorter Center are also working on this. ‘On the one hand, we work on state-of-the-art technologies, while on the other hand, we work on making things as simple and inexpensive as possible,’ says Webb. But that too is innovation. ‘Making things simple is extremely difficult,’ he concludes.

In Nature, Webb, along with Johnes Obungoloch of Mbarara University of Science and Technology, describes five steps to make MRI scanners more affordable for the whole world.

Image: Philips

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