Health
New techniques in medicine
Elaine Flynn: Few minutes in old scanner felt like hours
Light at the end of the tunnel
Faced with being fed into a narrow tunnel for around 40 minutes to be scanned,
some patients get so stressed they can’t go ahead, writes Judy Hobson
M
AGNETIC RESONANCE Imaging
(MRI) is a wonderful diagnostic tool,
providing detailed images of the brain,
spine, pelvis and joints. However, it is estimated
that 15 per cent of those sent for an MRI scan
experience feelings of claustrophobia on
seeing the enclosed tunnel-shaped scanner.
They either leave the room immediately or
press the alarm bell to get out within minutes.
Claustrophobia can result in panic
attacks, hyperventilation, sweating and
nausea. For some, the prospect of having
to lie flat in a narrow enclosed tunnel can
trigger the phobia for the first time.
However, there is good news for these
patients as well as for those too obese to fit
into a conventional scanner. Scientists
have designed a new type of open upright
scanner. This allows patients to be
scanned sitting down or standing. They
can even watch their favourite DVD on a
plasma TV screen while the images are
being taken.
Not surprisingly, patients feel much
more relaxed and reassured in a scanner open
to the environment, and this contributes to
the quality of the images. In September
a state-of-the-art upright MRI centre
opened in Leeds. It is the second of its
kind in Britain. The first opened in
London’s Newman Street six years ago.
A bonus, radiologists are finding, is that
upright scanning answers some of the
questions conventional scanning does
not. This is because it allows all parts of
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ILLUSTRATION BY MICHAEL ROSCOE
The new upright MRI scanner
the body, particularly the spine and joints,
to be scanned in a weight-bearing
position showing the effects of gravity.
Dr Ben Timmis, joint director of the
London Upright MRI Centre, explains:
“If we remain upright, the loading on our
spine is greater. As a result we can see
problems in patients’ backs that aren’t
revealed when they’re lying down during
a conventional scan.
“Some people get pain when they find
themselves in certain positions. With this
new technology we can scan them while
they’re in those painful positions and
discover the cause of their pain. Often
this isn’t revealed when they lie flat
CHOICE FEBRUARY 2013
during a conventional scan. Knees, for
example, have a different appearance
when someone’s putting weight on them.
“MRI scanning has revolutionised
diagnosis by showing us what is going on
internally. It was a great shame for radiologists
like me to find that 15 per cent of those
who came for a conventional MRI scan
just couldn’t go through with it. This is
where this new technology comes into its
own. Since we started using the open
system in 2006, not a single patient has
walked away. We scan 60 patients a week.
More than half are claustrophobic.”
Psychotherapist Andrea Perry, author of
Claustrophobia – Finding Your Way Out,
adds: “The open upright MRI scanner
has been developed specifically with
claustrophobic patients in mind. It is
completely open above the head and
in front, therefore it is ideal for those
who don’t like confined spaces and
means MRI scans are now accessible to
more people.”
Despite extending its opening hours,
the London centre’s waiting list is
growing rapidly with people travelling
long distances. It was this that prompted
the centre to establish a sister site in
Armley Road, Leeds.
However, Dr Timmis points out, the
revolutionary new method is not in
competition with the conventional
procedure provided by the NHS which is
suitable for 85 per cent of patients.
“What we’re offering is complementary.
We’re giving patients unable to
undergo a conventional MRI an
alternative means of being scanned. We
see NHS patients funded by their
individual primary care trusts as well as
private patients. It costs more than £1m to
install and equip an upright open scanner
so you can’t expect the cash-strapped
NHS to provide them.”
Obese patients have great difficulty not
only fitting into the conventional tubular
scanners but also in lying flat. The
scanner, Dr Timmis says, is ideal for
them, too, because it allows them to sit
and be scanned from the side.
While conventional tunnel MRI uses a
high-field magnet with a strength of 1.5
Tesla to provide good image quality, the
upright centres in London and Leeds use
FEBRUARY 2013 CHOICE
As soon as Elaine Flynn saw the
solve her problem and so she started
tunnel-shaped MRI scanner, she felt like
searching the internet to see if there were
running away. Instead, the 47-year-old
other types of scanner.
mum-of four gritted her teeth and got in, but
“Some centres claim to have an open
within minutes she was pressing the alarm
scanner but when you investigate further
buzzer and shouting “Get me out of here.”
the scanners aren’t truly open because
Elaine, who lives with husband Aidan and you’re sandwiched between two metal
their children in Wetherby, West Yorkshire,
plates with just a little space on either side.”
says: “Lying in that tiny, narrow space and
Eventually she discovered that an
not being able to move, I started getting
upright MRI scanner open at the front had
very sweaty and growing
been installed in London. In
more and more anxious. “I would recommend February 2011 she went along
Those few minutes felt
it to anyone who for her second attempt.
like hours.
“There must be a lot of
needs an MRI scan” people
“I’m not a wimp. I’ve
like me who hadn’t
had four children. In the past claustrophobia known what to expect because there’s no
has not been a major problem but I admit I
picture of the machine included with the
don’t like being in a lift on my own. The
appointment letter. This time I knew what to
hospital staff didn’t seem able to
expect. I felt so much happier and more
understand how I was feeling and when I
relaxed. The staff were friendly and this
got out I felt very humiliated.”
made the whole thing less intimidating.
Elaine’s doctor had sent her to Harrogate
“I would recommend anyone who needs
District Hospital for an MRI scan in the
an MRI scan to opt for this sort. The whole
autumn of 2010 to discover what was
thing is so much more pleasant and
causing the niggling pain in her hips. After it comfortable.”
was abandoned, the doctor suggested
Elaine’s scan revealed she had
Elaine try again but this time to take
early-stage osteoarthritis. When she needs
sedatives before going along.
a follow-up, she will be able to go down the
However, Elaine didn’t think pills would
road to the new Leeds Upright MRI Centre.
only a mid-field strength of magnet, 0.6
Tesla and 0.5 Tesla respectively.
Dr Timimis says: “People used to think
the bigger the Tesla the better picture you
got, but this just isn’t true any more. Due
to advances in software the gap has closed
and the overall difference is pretty
minimal. Indeed, the majority of
The
radiologists wouldn’t be able to
fee for an open
distinguish between the two.”
upright MRI scan
Watching a DVD provides
is around £600,
patients with a distraction and
depending on what
reduces their anxiety.
kind of scan is
This Morning TV doctor
requested
Chris Steele says: “Upright open
MRI is the future of MRI scanning.
This new technology means patients
need not put off having MRI scans due to
anxiety or claustrophobia. It’s fantastic
to now have a centre for patients in
the North.”
Find out more
■ Website: (www.uprightmri.co.uk).
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