Feasibility of and experience using a portable MRI scanner in the neonatal intensive care unit

Abstract

Objective: A portable, low-field MRI system is now Food and Drug Administration cleared and has been shown to be safe and useful in adult intensive care unit settings. No neonatal studies have been performed. The objective is to assess our preliminary experience and assess feasibility of using the portable MRI system at the bedside in a neonatal intensive care unit (NICU) at a quaternary children's hospital.

Study design: This was a single-site prospective cohort study in neonates ≥2 kg conducted between October and December 2020. All parents provided informed consent. Neonates underwent portable MRI examination in the NICU with support equipment powered on and attached to the neonate during the examination. A paediatric radiologist interpreted each portable MRI examination. The study outcome variable was percentage of portable MRI examinations completed without artefacts that would hinder diagnosis. Findings were compared between portable MRI examinations and standard of care examinations.

Results: Eighteen portable, low-field MRI examinations were performed on 14 neonates with an average age of 29.7 days (range 1-122 days). 94% (17 of 18) of portable MRI examinations were acquired without significant artefact. Significant intracranial pathology was visible on portable MRI, but subtle abnormalities were missed. The examination reads were concordant in 59% (10 of 17) of cases and significant pathology was missed in 12% (2 of 17) of cases.

Conclusion: This single-centre series demonstrated portable MRI examinations can be performed safely with standard patient support equipment present in the NICU. These findings demonstrate that portable MRI could be used in the future to guide care in the NICU setting.

Trial registration number: NCT04629469.

Keywords: Magnetic Resonance Imaging; intensive care units, neonatal; neurology; paediatrics.

Conflict of interest statement

Competing interests: The study was investigator initiated and no funding was provided by the company. HHH and JTP are both employed by Hyperfine.

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1

Photograph of a typical set-up of patient support equipment for NICU present during portable MRI system examinations performed in the NICU. Note that the portable MRI system is located near the neonate’s crib and the neonate would be transferred to the cradle for scanning. The yellow ring shows the Gauss Guard that delineates the 5-gauss area associated with the portable MRI system. In this photo, a crib, ventilator and intravenous (IV) infusion pump, and IV pole (ie, standard device, not MR conditional) have been placed in their typical positions during neonate scanning. The custom neonatal cradle and an immobilisation device (blue equipment) are shown in their typical positions during MRI scanning of neonates’ brains. NICU, neonatal intensive care unit.

Figure 2

(A) Five-day-old baby boy with intraparenchymal haemorrhage in the anterior right temporal lobe on an ultrasound examination. (B) The conventional MRI examination demonstrated the intraparenchymal and subpial haemorrhage well on the T2-weighted images. The portable MRIs also showed the extent of the intraparenchymal and subpial haemorrhage in the right temporal lobe on the T1-weighted (C) and T2-weighted images (D).

Figure 3

(A) An 88-day-old baby girl with hydrocephalus with dilated lateral ventricles with an intraventricular catheter in place shown on head ultrasound. (B) The conventional MRI examination showed severe dilation of the bilateral lateral ventricles on the T2-weighted images with hemosiderin staining of the right lateral ventricular lining. This portable MRI also showed similar dilation of the bilateral lateral ventricles on FLAIR (C) and T2-weighted images (D). The hemosiderin staining of the ventricular lining is not imaged well on the portable MRIs. FLAIR, fluid-attenuated inversion recovery.