While most people probably think of party balloons and chipmunk voices when helium comes up, in the medical industry folks are well aware that this non-renewable resource is part of a powerful industrial gas market – and much more than fun and games.

Although helium is abundant in the universe, it’s a non-renewable resource that can be hard to come by on Earth.

The industry is dominated by just a few large companies, such as Air Liquide, Air Products and Linde. Praxair, another leader in the helium industry, announced plans to merge with Linde late last year.

The combined companies, based on 2015 financials, would have pro forma revenues of about $30 billion and a present market cap above $65 billion, according to the companies, allowing them to emerge at the top of the industry.

The U.S. is the largest producer and supplier of helium, followed by Qatar and Russia, each of which has plans to increase helium production in the near future. Through its East Siberian Gas Program, which is planning on tapping large gas reserves in Irkutsk and Yakutia, Russia is aiming to become the world's largest helium producer.

So what does all this have to do with health care?
Helium, in its ultra-cold liquid state, is what allows MR magnets to become superconductive and gives them their diagnostic value. So, as the behemoths of the gas industry shuffle the deck, it could have real-world implications for MR imaging providers.

HealthCare Business News reached out to several experts with a finger on the pulse of the helium market to get a better idea of shifts in the industry and how evolving technology is changing the way providers think about the natural gas.

Greater supply, smaller demand?
In the old days, helium boil-off was a constant reality in maintaining even the most sophisticated MR systems. But in recent years, improvements in technology have resulted in less boil-off, and therefore, less of an investment in helium. As helium prices have trended upward over the last several years, this is a good thing.

Historically, magnets were kept at 10 degrees Kelvin. But today, most new MR magnets are at 4 degrees Kelvin. That colder temperature means less helium is boiled off and systems don’t need to be topped off as often.

Helium shortages, like the one from 2011-2013 when several U.S. plants had production issues, have hastened the adoption of new zero boil-off technology, in which helium is recondensed and brought back to a liquid state.

Zero boil-off can mean huge savings in terms of helium spending, but some experts say preventive maintenance is key to reaping those benefits.

The systems are zero boil-off under optimal conditions, barring power outages, which can sometimes lead to problems with the supporting infrastructure. Trouble may occur, according to Wayne Scott, owner of Independent Magnet Technology, when you’re dealing with a broken coldhead, compressor or chiller.

Marshall Shannon, director of operations at Imaging Technology Consulting, says that zero-boil-off systems are at greater risk of losing helium due to chiller failure than older systems. For that reason, he says remote monitoring is “imperative.”

How do you monitor your MR?
When helium leaks go unnoticed, they can turn into financial catastrophes costing upwards of tens of thousands of dollars to repair, and lead to stops in patient throughput. Historically, these situations were avoided by implementing monitoring protocols among technicians and MR staffers, but today some facilities are moving toward a more automated approach.

With remote monitoring, the readings don’t require an in-person inspection. Depending on the particulars of a monitoring solution, a customer would be notified via text message or email or phone call when the MR chiller is out of spec, or the compressor turned off, or the magnet pressure exceeded the alarm threshold or helium levels are dropping, for example.

In some cases, according to Ron Schultz, field service manager with Cool Pair Plus, a facility might be on a service contract with a vendor that does not include helium fills. For those facilities, spending a little more on a diligent monitoring system is better than getting hit with a big helium bill or facing downtime due to an undetected leak.

His company offers a service called DaVinci Magnet Monitoring which takes into account helium levels, chill flows and temperatures, compressor power, magnet pressure, shield temperature and coldhead temperature.

“With data provided by the DaVinci, we are able to predict most problems before they become a major issue,” says Schultz.

For facilities that choose to monitor their own systems, Marc Fessler, owner of Independence Cryogenic Engineering, emphasizes diligence.

“Maintain a weekly list of compressor operating hours, magnet helium level, magnet vessel pressure and shield temperatures,” he advises.

The direction helium prices have gone in the last 12 months depends on who you ask. Some stakeholders told HCB News that prices have gone up a bit and attributed that to shifts in the industrial gas industry. Others say prices are marginally lower than they were in 2016, but everyone agrees that the prices are no longer as high as they were during the shortage.

“Supply has eased from the force majeure conditions of several years ago, but everyone knows helium is a finite commodity,” says Jim Spearman, CEO of Consensys Imaging Services. “Prices have settled a bit, but there must be a permanent alternative soon, otherwise supply won’t be able to keep up with demand and that will drive costs sky-high.”

In Spearman’s opinion, remote monitoring is not as crucial as others think.

“Historical data shows that helium leaks, whether detected immediately via remote monitoring or at routine checks (unless there’s a quench), result in roughly the same loss,” he says. “Thus, proper and thorough maintenance, along with strict adherence to environmental specifications, are significantly more critical in sustaining minimal helium boil-off.”

Scott, with Independent Magnet Technology, echoes that sentiment. Although remote monitoring may provide a higher level of convenience, he says having techs record levels once a week, or daily, might do the trick just as well.

“I feel it’s better to have human interaction,” he adds.

The decision on how to monitor helium levels, and other MR vitals, may depend on the resources available to an individual facility. Whatever the particulars of your MR suite, Charlie Lewis, vice president, MRI products and services, BC Technical, has top-level advice to ensure things stay superconductive.

“Keep relationships with multiple providers and pay your bills on time,” he says.

A future less dependent on helium
In recent years, the advances in reduced helium boil-off have been one-upped by a new breed of MR technology that virtually forgoes helium altogether.

At RSNA last year, GE Healthcare unveiled a technology called Freelium, which requires 20 liters of liquid helium to perform scans. When compared to the conventional 2,000 liters used in conventional systems, that’s a drastic reduction in gas dependence.

The company says magnets with Freelium would not require helium refills during transportation or throughout their lifetime. They also would not require the extensive venting infrastructure that normal systems do.

Aspect Imaging has developed a helium-free compact industrial and preclinical MR called the WristView MR System.

“It is the largest bore, permanent MR that we know of and it requires no helium for cooling, no special power supply, or a big shielded room,” Andrew Lonergan, vice president of sales and marketing with Aspect Imaging, told HCB News at RSNA last year.

Another company exploring the frontiers of helium-free MR imaging is Mitsubishi Electric, which has partnered with Kyoto University and Tohoku University on the development of a preclinical small model 3T MR system with a high-temperature superconducting coil that doesn’t need to be cooled.

“Funding and acceleration of [helium-free MR] research should be amplified,” says Consensys Imaging Services’ Spearman. “It not only has the potential to lower the cost imparted by helium to the medical imaging market [fill lines, dewars, transportation, refinement], but also lower the risks associated with liquid helium [quenches, helium burns/injuries, suffocation, etc].”

Tips for chiller maintenance
Like helium, chillers rarely get the credit they deserve for making MR imaging possible, but without them, the whole system is pretty much useless. Chillers are systems that constantly remove heat from heavy iron medical equipment like linear accelerators, cyclotrons and MR scanners.

These relatively simple systems use plain water, or a mixture of water and antifreeze (glycol), to do their jobs and the technology behind them has remained fundamentally unchanged for several decades.

But none of that takes away from the vitality of a smoothly operating chiller. HCB News reached out to some of the experts to find out what providers should be doing to make sure their systems don’t suddenly lose their cool.

The problems that are most likely to plague chillers are generally derived from poor maintenance and a lack of OEM training, says Kyla Whitehead, sales and marketing administrator at KKT Chillers. Other experts in the industry agree that having a dependable chiller starts with regular inspections and preventive maintenance.

Standard-style medical chillers weighing between 15 and 30 tons generally fall into the price range of $20,000 to $40,000, a relatively minor expense compared to the capital investment of the MR scanners that depend on them to operate.

The short answer to servicing frequency is that it depends on what the OEM specifications call for, but the rule of thumb seems to be that no fewer than two preventive maintenance inspections per year are typically in order – and more can’t hurt.

“When a customer signs a chiller service contract with us, they receive start-up and three preventative maintenance service visits per year,” says Turner Hansel, vice president of sales, medical chillers, at Filtrine Manufacturing Company. “During the PM, the service agent carefully looks at the chiller, cleans the condenser, checks the fluids and makes sure the pressures, flows and temperatures are correct.”

Citing the problems that can arise from a chiller going down, Legacy Chiller Systems recommends quarterly servicing. Most facilities make the mistake of not installing backup systems, says company CEO Martin King, and without that security blanket, neglecting maintenance can usher in a host of troubles.

His company, which manufactures chillers for all industrial and commercial fluid cooling applications, also offers an installation and operation manual on its website highlighting some best practices for chiller maintenance.

On a monthly basis, the recommendations call for checking the condenser coil inlets of an air-cooled chiller for foreign debris, visually inspecting the system for water leaks and proper tank level and listening for excessive vibrations or motor noise. Legacy Chiller Systems also recommends checking electrical connections and components, checking the fan and pump rotation to make sure they’re operating correctly and verifying compressor oil levels.

In an emergency, the use of city water, from the local system, can be used as a stopgap solution should a chiller go down. The water in a typical chiller is usually around 48 degrees Fahrenheit, but it can be 70 degrees or more. The water that comes out of a tap is typically around 55 degrees Fahrenheit, so for a short period of time, that is good enough.

12 tips for success
For annual inspections, Legacy Chiller Systems offers the following 12 tips:

1. Tighten all electrical connection screws.
2. Check the glycol solution for cleanliness. Drain and refill with clean solution if excessive sludge or dirt is present. Flush the system prior to refilling.
3. Check motor amp draws and voltage supplies. Make sure they are within nameplate rating.
4. Check operating pressures of the refrigeration system.
5. Check super heat and sub cooling.
6. Inspect for leaks with a sensitive electronic leak detector.
7. Check for excess wear or burned contacts on motor starters. Replace if in doubt.
8. Wash out the condenser coils of an air-cooled system.
9. Check the operation of the safety devices and thermostat.
10. Ensure that the pipe insulation is dry and not broken down.
11. Check mechanical mounts and vibration isolators for wear.
12. Remove and clean the magnetic flow switch.