REMAINING at the top of your
field means keeping up to date
with the latest technology
available. Southern Counties
Veterinary Specialists (SCVS)
recently decided to improve its
provision of care by installing a state-of-the art
magnetic
resonance
imaging
(MRI)
scanner.
Installing
six tonnes of magnet, cooling system and
electronics was not a decision to be
taken lightly. It was after months of
planning and deliberation that, in
September 2013, the scanner arrived
at the referral-only practice in the
New Forest. Such a specialised
veterinary high field system can
image hundreds of slices through
bone and soft tissue in less than an
hour, revolutionising neurological
diagnosis.
This particular MRI is produced
by Hallmarq Veterinary Imaging, a
company already well-known in equine circles for its work producing
the Standing Equine MRI. The new
system – known as the PetVet – has
the distinction of being the world’s
only veterinary-specific high-field
MRI.
Until now, practices not wishing to purchase a brand new high-field
system designed specifically for
human hospitals had two main
options: a low field vet-specific
system or a high field reconditioned
human magnet. High field gives
images that are better suited to
diagnosing the range of conditions
seen in small animals and it collects
them in a shorter scan time.
However, the advanced
technology required makes it more
expensive to purchase and run than
low field systems. The overall costs
of second-hand high-field machines are further increased as they have a
shorter life span, greater power
consumption and require frequent
helium top-ups. The PetVet has now
presented a third option: offering
high-quality images with better
energy efficiency and no routine
helium refills.
For many practices, using a
visiting MRI service is a viable and
low-commitment way of offering
patients advanced diagnosis.
Traditionally, installing an MRI has
required a large sum of capital, both
to purchase the machine and to build
a room shielded from radio-
frequency waves.
SCVS’s collaborative agreement
with Hallmarq removed the need to
buy the system outright, and the fact
that the PetVet’s design incorporates
the necessary RF shield means that
about £100,000 was shaved off the
room build cost.
Installing the MRI was a big step
to take but the decision was balanced
by the practice’s existing caseload and
commitment to patient care.
Before the PetVet landed, SCVS had
been using a visiting high field MRI system on a lorry which parked up at
the practice for one day a week.
Having MRI permanently on-site has
since improved the quality of care.
“Probably 50% of the neurology
cases that we see are emergencies,”
says Harry Scott, neurology and
orthopaedics specialist at SCVS.
“Before the MRI was installed, if a
vet phoned up with an emergency
case you had to decide whether you’d
see the patient and assess it and
maybe have to hospitalise the patient
for three days before scanning it, or
send the case somewhere else for an
urgent scan. Making the best decision for the patient was quite stressful.
Now, though, we can see the dog in a
couple of hours and, if necessary
we’ll do a scan that day.”
According to Harry, the
installation of the MRI is putting the
expertise of the clinic’s radiologists
to even better use: “Now that our
radiologists are operating the scanner
I think they’re actually getting better
images than the radiographers [who
ran scans on the visiting MRI]
because now they can pick and
choose the sequences.”
Manuel Pinilla, diagnostic imaging
specialist at SCVS, concedes that
MRI was not his main area of
knowledge before the scanner was
installed, but training provided by
Hallmarq has quickly filled any gaps.
“They’ve made it very easy for me,
and the software is very user-
friendly,” he says.
Easier positioning
Training also introduced the PetVet’s
set of veterinary-specific RF coils,
designed to better fit a small animal’s
anatomy. “The coils and V-shaped
patient bed make positioning much
easier, because the dog stays
straighter,” Manuel explains;
“whereas if you’re doing it on a flat
bed it’s more difficult to get the dog
in the right place.”
An exciting new application of
the MRI will utilise one of SCVS’s other cutting-edge pieces of
kit. Its Brainsight 2
Neuronavigation System is
the only one in private
practice in the UK and it
offers the potential of
diagnosing and treating
previously inaccessible brain tumours.
The system aligns CT, MRI and
photographs of the
head to plan the best
access route to the
lesion. Francesca
Raimondi, neurology
specialist at SCVS, is
very enthusiastic
about the system and
the kind of cases it
will be able to help,
such as unspecified
gliomas.
“With MRI it is
not possible to
differentiate between
low grade or high
grade glioma.” She
explains: “Surgery for
low grade glioma can
result in a complete
recovery, but
prognosis for high
grade glioma is poor
and radiotherapy is
ineffective.” The Brainsight system
will allow the vets to accurately
identify pathology and plan the most
suitable treatment.
Nadia Shihab, another neurology
specialist at the practice, believes that
a major benefit of the new MRI is
peace of mind for vets. “You don’t
have to make the patients wait,” she
says. “You don’t have to worry you’re
doing the right thing by taking the
case, because you know you’ve got
the facilities to give them the right
care.”
Harry agrees that it instils
confidence in the staff to be able to
offer “the best options for the client
and the best possible treatment for the patient”. This is a key value of
SCVS, says Harry: “It’s about doing
the best that we possibly can, that’s
the sort of philosophy that I think
permeates the whole practice. What
we try and do is treat all the animals
as if they were our own.”
