Comment by lostlogin

I manage an MR service. Not a large one, but it keeps me busy.

>A mid-range scanner costs $500k, the room itself indeed might cost more. Just as real estate.

The room is about $250k to get it fitted out and the Faraday cage built.

> Scanners are just not scarce anymore, there are even sites that sell used ones: https://prizmedimaging.com/collections/mri-equipment (I now want one in my backyard...) You can lease a new top-level device at around $30k per month: https://www.meridianleasing.com/equipment/medical/mri-machin...

The Skyra is end of life and the ones I know of are getting pulled out. Too old. The generation after it is getting on too. The new generation will appear next year. Likely ‘dry’ magnets - low helium usage. The Siemens 1.5T has already had this upgrade.

> So you're looking at maybe $1k a day that you need to pay towards the device cost. The consumables (helium) are pretty negligible.

A service contract is expensive and also required. I’d expect them to be up to about US$75-100k a year. Coils are US$10-20k each and a scanner has about 10 different ones. We blow about one a month across our scanners and get them replaced. Various things break, and it comes in waves. In recent months: the body coil blew (this is a big deal, $150k?), gradient amp, amp cables, helium expansion vessel, vacuum pump, bore screen, knee coil, another knee coil. The service contract covers all the repairs.

>A full-body scan is about 1 hour. You can do them in 30-45mins, improving the business case.

But for a follow-up you will need to focus only on a few areas, reducing that to maybe 20 minutes.

Doing a real scan of a body site is vastly better, and is about 20 mins per region.

> So one device can feasibly do 10 primary scans a day and 20-30 follow-ups. So the cost of the device itself becomes on the order of $100 per imaging session. This is literally in the "blood test" expenses range.

We get around that number out of our scanners doing real scans and our costs are a lot more than that.

I don’t see staffing mentioned? A good tech will improve throughout, and you need more than one. A good operation will have several per scanner. They reduce the ever present danger and keep the operation running smoothly. I’m biased, I’m a tech.

Another thing missing - liability. I work in a country that isn’t quite as full of lawsuits as the US. Whole body scans are a glorious way of collecting liability. Poor quality images of everything in ‘well’ patients. As a rule in imaging, ask a good question get a good answer. When you’re searching the whole patient for something’s it’s easy to miss something.

> How can we imagine that people will have computers on their _desks_ when even a small IBM takes half a building? Mass production happened. And this time it has taken the industry completely by surprise.

The radiologist needs to be onsite. We give drugs. They inject things, they biopsy, they are doing stuff.

Yes, lots of stuff can be done remotely and AI assisted. Assuming they can all be replaced assumes a role that the radiologist had a long time ago, or maybe never had.

There are a lot of efficiencies that can be made, and radiology needs all the help it can get, but it isn’t a ludicrously inefficient or stuck in the past.