Similarly, kids that have autism, have psychiatric illnesses like schizophrenia, depression, dementias, early dementias, Alzheimer’s, etc. Usually we can’t pick these up with conventional imaging of the brain. So functional holds a lot of real promise and we’ve just had a very active interest in this and we’ve been piloting programs to use functional as a quantitative tool to compare a particular patient with normative control populations and segment the brain into very discreet areas to compare side-by-side as to whether a person has normal or abnormal function.



HCB News: How does it compare with traditional MRI?

WG: Well traditional MRI looks at brain structure based upon different relaxation characteristics of the brain. Functional MRI looks at how the brain is utilizing oxygen. It’s a perfusion test where we look at the conversion of deoxyhemoglobin, or oxyhemoglobin to deoxyhemoglobin. And in areas of the brain that are actively being utilized and there is a higher percentage of oxyhemoglobin. So, standard MRI is static. But functional MRI, we are looking over time. So it’s really more of a time domain imaging. And we look, uh we have to scan very quickly as someone performs a task. So it’s primarily using echo-planar imaging. Those images tend to be very noisy, but they’re very fast. And so traditional MRI looks at structure and functional MRI looks at how the brain changes over time in a very sensitive way to look at their areas of profusion of the brain.

HCB News: Can you speak to the factors that influenced your investment in a particular make or model of fMRI equipment?

Well any MRI scanner that’s 1.5 or 3 tesla or higher can be used for functional MRI. We have used components from different vendors. So we have virtual reality goggles that we already had for patient comfort so we tied that in to our functional system. And then, of course, the functional processing software which is really the heart of the functional came from Novarad Corporation. And the reason we chose Novarad is because it was much more advanced than the other systems that we saw there and much easier to use.

HCB News: What kind of patients and diagnoses are best served by functional MRI?

WG: The most common patient that we get would be someone who was involved medical legally - usually an auto accident or other injury case where people are looking for objective evidence of injury or no injury. It’s hard to fake a functional MRI. So the typical case would be a cash pay patient with a medical legal claim. But we’ve done a wide variety of cases. We had a couple of patients a few years ago that were exposed to the sarin nerve gas at the Tooele Army Depot. They claimed they were injured. The question is, were they or not? We’ve had patients with childhood illnesses, psychiatric illnesses, dementias. We get some preoperative cases where they want to know if a tumor involves a critical area of the brain or not. We test different functions of the brain around it to determine whether or not the tumor can be safely resected.

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