Mini-MRIs arrive in Canada, assist at point of care

MOOSE FACTORY, ONT. – The Weeneebayko General Hospital, serving patients at James Bay and Hudson’s Bay, has become the first hospital in Canada to implement a portable MRI scanner for a project assessing the technology in a clinical setting. The hospital went live with the Hyperfine Swoop, a scanner that can be wheeled to the bedside and plugged into a standard electrical outlet. It is operated remotely through an accompanying iPad.

The Hyperfine Swoop was recently approved for use by Health Canada and is designed for neurological exams. It can detect in minutes whether the patient has suffered a stroke, can identify the type of stroke – ischemic or hemorrhagic – as well as other problems, such as swelling of the brain.

“We’re using the scanner so that we can care for patients right here on our site, instead of sending them for MR scans by Medevac to Timmins,” said Dr. Elaine Innes, chief of medical staff at Weeneebayko Area Health Authority. While the hospital offers many services, from emergency care to surgery, it doesn’t have an MR scanner and has needed to transport patients to Timmins or Kingston when this kind of exam was required.

That’s disruptive for the patients and their families, and expensive for the healthcare system. Now, with the portable MR scanner, patients with neurological issues can stay in Moose Factory and the surrounding area.

As there are no radiologists at the Weeneebayko General, the hospital has established a partnership with Queen’s University and the Kingston Health Sciences Centre for neuroradiologists there to interpret the exams. The files are sent over a secure, high-speed network without any trouble and are received by the doctors in Kingston within seconds.

Dr. Omar Islam, head, Department of Diagnostic Radiology at Queen’s University, said the Weeneebayko General Hospital expects to scan up to 200 patients in 2022, with the exams read by radiologists in Kingston, about 500 miles away. Not only will that save these patients the disruptive trip to another city, but the diagnosis will be made much faster and any treatment required can be instituted immediately.

“Once we receive the images, the exam can be read in a few minutes,” said Dr. Islam. “There is an approximate 10-to-15-minute turnaround time.” Neuroradiologists in Kingston are available, moreover, to read the images day and night.

Knowing the diagnosis, doctors at the Weeneebayko General Hospital can then treat the patients much faster – with results coming back in minutes instead of waiting for the patient to be transported by aircraft to another medical centre.

Dr. Islam noted the Hyperfine Swoop is a low-field MRI, with a field strength of 64 milliTesla. That compares with the 1.5T and 3T field strength of the magnets used in conventional MRIs.

“This won’t replace a conventional MRI machine,” he said. “But it does give you images that allow you determine whether there is a stroke or swelling of the brain. It’s a very useful tool, and it enables earlier diagnosis.”

Dr. Innes said the hospital has been training its doctors to use the Hyperfine MRI with patients. It is also training nurses, in case physicians are unavailable.

The Weeneebayko General has most other imaging modalities, including a CT scanner, as well as ultrasound, mammography, and general X-ray. These images are read by radiologists in Timmins.

For the new MRI system, the readings are being done in Kingston, which also has a long-standing relationship with the Weeneebayko region. “Many of their patients come to us for care,” said Dr. Islam.

The Swoop portable MRI was created in the United States by Hyperfine, a company led by entrepreneur/inventor Dr. Jonathan Rothberg. He is also behind the Butterfly iQ, said to be the world’s best-selling point-of-care ultrasound (POCUS), and is the creator of a form of high-speed DNA sequencing.

Dr. Rothberg was awarded the National Medal of Technology and Innovation by U.S. President Barack Obama. He earned his PhD at Yale University.

The Hyperfine Swoop exams take five to 30 minutes to complete, depending on how many sequences are conducted. It’s not difficult for adults to remain still for this long, but it is challenging for pediatric patients, said Scott White, chief commercial officer for Hyperfine.

However, he said the company is working to reduce the time needed for exams. It’s implementing artificial intelligence, as well, to speed up the reconstructions of images.

Casey Newhouse, the business development manager for Hyperfine, noted that the low-field Swoop is not a replacement for standard MRIs. But he said it’s a valuable and affordable tool that can reduce wait times for MRI exams in many hospitals, both rural and urban.

Hyperfine is working with a Canadian commercial partner, UpCare Partners & Associates, to provide delivery, training, and support of the Swoop. “We needed someone with experience in neurosciences,” said White. “UpCare understands the rural and metropolitan hospital markets, and we believe they will be a great partner for us.”

UpCare was launched by Benoit Sai and Olivier Poitier, both of whom have worked in the medical imaging sector for many years. “We’ve been in healthcare for 20 years and in neuro for 10 years,” said Sai. “We’ve both seen so many bottlenecks that we want to alleviate.”

To this end, UpCare has been bringing innovative technologies into Canada in the areas of neurology, cardiology and women’s health.

The Hyperfine Swoop could be a game-changer, Poitier believes, as it has the potential to dramatically speed up access for patients with neurological pathologies and reduce wait times – which have become alarmingly high for MRIs.

He pointed to a recent Conference Board of Canada study which predicts the average wait time for an MRI in Canada to rise to 133 days in 2022 from 89 days before the COVID pandemic. For reference the Canadian Wait Time Alliance recommendation is a 30-day wait time.

A device like the Hyperfine Swoop, he noted, can be used to quickly provide extra capacity in the healthcare system, at much lower cost than a conventional MR scanner.

“We estimate that a standard, 1.5T MR scanner will cost over $4 million to acquire and operate over 10 years,” said Poitier. He said this type of equipment requires substantial renovations – overall, the acquisition is a long and elaborate process which involves a significant amount of human resource.

By contrast, the Hyperfine device can be up-and-running in half a day. “Swoop is free of renovations and shielding, with limited human capital,” said Poitier.

UpCare is providing a complete suite of services with the Hyperfine Swoop from the installation to the forward-looking customer service support, as well as continued education.

In December, UpCare and Hyperfine showcased the Swoop at St. Michael’s Hospital, in Toronto, providing doctors, nurses and other clinicians with a look at the machine. They also provided an educational session about the device’s capabilities and operation.

“It attracted a crowd of doctors and nurses,” said Sai. “In all my years of doing presentations, I’ve never experienced such a welcoming and heartwarming event.” Clinicians from the ICU, surgical department, radiology and others came to see the unique machine, and at one point, began clapping. “They saw this as a real solution to their challenges.”

Following this event, doctors began to identify a large number of head exams that have the potential to be done at the point-of-care, diverted from conventional MR and freeing time for other patients, said Sai.