by
John R. Fischer, Senior Reporter | November 26, 2018
A study completed by Halperin at the end of last year found that such safety extended to “legacy” pacemakers and defibrillators, finding that anyone implanted with these devices, under few restrictions, could undergo an MR scan without incurring adverse effects.
This, along with other findings, led CMS in April to expand coverage to implanted pacemakers, implantable cardioverter defibrillators, cardiac resynchronization therapy pacemakers, and cardiac resynchronization therapy defibrillators.
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Halperin says that the expansion opens up greater access to necessary procedures for patients that were once deemed high-risk for MR exams due to their implants, and that the change has been received well within the cardiology community. Such a switch, though, will take a while for radiologists to come around to, he warns.
Though expensive, MR can be cost effective when ruling
out or diagnosing diseases earlier and more accurately.
“When radiologists were trained years ago, they were taught that it was unsafe and dangerous to do MR scans in patients with pacemakers and inflammable defibrillators. Now, they have to kind of ‘unlearn’ that or evolve with the current thinking,” he said. “They just need to be made more aware of the current literature. This data has been published only in the last year, and it may not be disseminated to people so quickly. I think the radiologists are little bit behind on that but slowly catching up.”
The bottom line
Increasing coverage of implants, along with AI, the cloud and gadolinium reduction are all expected to act as drivers in the increasing utilization of MR, along with increases in labor, consumable costs and services. The advent of new technologies such as higher strength magnets, nanotechnologies, and wide-bore and lighter-weighing systems will also make their mark, helping to drive the MR market from its current value of $5.8 billion at a rate of 3.9 percent annually.
“MR will always be a costly test,” said James Laskaris, a clinical strategist for MD Buyline. “But the key is it will be a cost avoidance technology by either ruling out or diagnosing a disease earlier and more accurately.”
Echoing this sentiment is Dr. Sriram Mannava, quality improvement and safety officer at Columbus Radiology Corporation, a Radiology Partners practice, who perceives utilization continuing to increase outside of outpatient settings and in ways in which MR is applied to those who require it.
