Jeffrey M. Bundy

MR shifts from incremental to step-change innovation

December 06, 2021
By Jeffrey M. Bundy

In every industry, periods of step-change (disruptive innovation) and incremental change occur. When incremental changes happen over time, industries can become complex and stagnant. When that’s happened in healthcare, the barriers to accessing critical technology have grown taller and impacted patient access.

In magnetic resonance (MR) imaging, decades of important incremental changes that advanced clinical capabilities also created layers of complexity. For technology, that’s evident in foundational hardware control systems, subsystems, and software that are increasingly hard to abandon. For clinical practice, it’s slowed business planning, clinical workflow, and even the marketing of capabilities.

Like the U.S. auto industry that relies on a backbone of gasoline/fuel stations but must migrate to charging stations, it’s expensive and challenging for MR to embrace step-change. The industry has inherent baggage — existing platforms, working practices and routines — that supports incremental change, but slows bigger change from bubbling up.

However, signs point to a new MR trend: an era of step-change that will fundamentally lower barriers to accessing technology and exams. Three activities are at the crest of this disruptive wave:

1. Form factor of machines. A small set of clinical and research field strengths and standard bore sizes dominated for over a decade. Newly explored field strengths and bigger bore sizes are now emerging to expand research and clinical utility. Bore size will increase beyond the current 15-year-old standard to accommodate new patients and revolutionize patient comfort. Scan speeds will experience an unprecedented, five-fold improvement to accommodate many more patients and help in-hospital MR expand beyond the imaging department.

2. AI-fueled throughput changes (inherent speed limited by physics and existing technology). Over the past 20 years, acceleration techniques began to increase image quality in a given time period. Now, applying deep learning applications to image reconstruction in MR and other modalities is rapidly showing signs of pronounced improvements in image acquisition time, and the potential to reduce physician workload through AI-based image segmentation and analysis. We see further workflow improvement and procedure enablement through new devices being used in combination with MR and other imaging systems.

3. New business models changing how equipment is sold and supported. Large IDNs are growing with consolidation and seeking streamlined cross-training and multisite operation. Users in all clinical settings want flexibility to adapt system capabilities to changing patient communities. Business models are now emerging that support standardization and rapid deployment of new technology — scanners and software — and allow providers to scale and replace aging technology. Required for “scale-up” success are improved investment protection, maintenance, and upgradeability, reduction of operational costs, and models to deploy new technologies on existing infrastructure -- things that have been largely missing. Academic groups increasingly need standardized platforms too, for efficient movement from life science systems to clinical systems. Translational medicine — bench to bedside delivery of new techniques — will be better supported by imaging platforms that facilitate seamless transitions from science to clinical practice.

Societal and organizational factors are forcing this wave of step-change in MR. Exams are still uncomfortable and difficult to endure. Obesity continues to rise. Access is limited by cost, and a scan capacity of two to three per hour. Organizations providing clinical MR are growing and standardizing. All this creates motivation (and pressure) and the necessary conditions for true step-change.

This trend of disruptive innovation will significantly accelerate MR access by expanding healthcare providers’ ability to provide exams to more people. It will help the industry break from two decades of incremental innovation — shedding aspects of the current delivery model that limit access, lowering costs, and increasing our ability to serve communities around the world.

About the author: Jeffrey M. Bundy, Ph.D. is the CEO of UIH Solutions at United Imaging.