Hospital gets new spin on MRI treatment

Hot Springs County Memorial Hospital recently upgraded its magnetic resonance imaging (MRI) capabilities, and though the system is not yet usable for patients it certainly means a lot in terms of the hospital's ability to serve the community.

Director of Diagnostic Imaging Daryl Mathern said the former MRI was 15 years old and far beyond its longevity. There were issues getting parts for the aging equipment, but it was also not up to today's standard of care.

Though the hospital board made the decision to purchase the new MRI in August, Mathern said the footwork began nearly a year before, when the idea was first proposed. In that proposal, Mathern stated traveling doctors and orthopedic groups didn't like to use the old machine. Most importantly, he noted, was an upgrade would be more accommodating to the local population and physicians.

Mathern spent the next several months gathering information and specifications on replacement options before bringing a proposal, later approved, to the board.

The equipment itself cost $1.2 million, but renovations brought the total in at around $1.5 million.

Looking at how the two machines compare, Mathern explained the old MRI ran at a power of one Tesla. The new system uses 1.5 Teslas, which required some new wiring to handle the increased power usage.

Getting the new machine into the building wasn't an easy task. Walls and doors had to be taken out or torn down to get the new MRI into the building, but they have since been reinstalled and replaced with barely noticeable differences.

Looking ahead at the possible expansion of the hospital. Mathern has no plans to move the MRI. However, if another upgrade is warranted in coming years, he would like to see it moved to an outer wall rather than the middle of the building.

The new MRI is also more accommodating with a 70-centimeter bore, compared to the old 60-centimeter one. This bore is where the patient is moved in and out, so a larger space means better accommodation for larger or more claustrophobic patients.

Also getting an upgrade is the image quality and speed. Mathern said the outgoing MRI used a one-channel system, where the new has a total of 48. He noted more channels mean better resolution of images. While all 48 might not be used at the same time, the availability of multiple channels decreases patient time on the machine significantly. For instance, an image of a person's head that once took 45 minutes could now take only 15.

The additional channels will also allow doctors to capture a heart beating and gather ejection fractions, which are measurements of how much blood is pumped out of the heart and are commonly used to look at cardiac function. Abdominal scans can also be performed, with a patient holding a breath for a short time.

Doug Patterson, a service engineer out of Casper, explained a bit on the operation of the machine, which uses liquid helium as a core component. Current moves faster in environments that are closer to absolute zero, or zero degrees Kelvin, he said. Absolute zero itself a theoretical temperature currently unable to be reached, but liquid helium comes very close to it at four degrees Kelvin, allowing the electrical current to move with the necessary speed to run the magnet.

Patterson further explained once the magnet is "ramped up" to operating speed, the circuit is closed with the current still able to run continuously, even if power is interrupted.

As to why the new machine was brought here, Mathern explained there is a young, aggressive medical staff and new equipment allows them to continue their practice. He noted the MRI unit is one of five across the state; the others are at Gillette, Casper, Cheyenne and Jackson. Having the unit locally also means the older population does not have to travel for quality MRI procedures.

As a county community hospital, Mathern said it's important, when purchasing equipment, to make sure it will last for a long time.

Mathern chose to go the route of MRI, as it doesn't involve any radiation to allow doctors to perform diagnostic imaging on patients. "It's the modality of the future," he said, and as exemplified by the hospital's upgrade it's a technology that will continue to get bigger, better and faster.

With construction complete, Mathern is waiting on the final inspection from the state, which should happen in the first week of April. Staff training on the new machine is also a requirement, though Mathern plans to have the MRI available for patient use in mid-April.