Magnetic resonance imaging (MRI) is a type of scan that has a high level of demand and has a capacity for diagnostics. Yet, more often than not, it is difficult to get rapid access to the state-of-the art equipment. Patients are having to wait up to several months for routine MRI scans. The Pirogov Clinic of High Medical Technologies at St Petersburg University offers patients rapid access to the MRI scans and results. This enables diagnosing cancer earlier and faster.
This year, the Clinic has performed 4,255 MRI screening tests, with 48% of them as part of the Compulsory Medical Insurance (CMI). In 2019, according to the targeted plan on the MRI scanning tests covered by the CMI in St Petersburg, the University must perform 1,310 screening tests with an estimated cost of about 4.8 million roubles. By late September, it reached 78%.
of the MRI screening tests were done in 2019.
In the University Clinic, you can have quick access to the MRI scan. The waiting time is about 7 or10 days after booking an MRI appointment for the citizens of St Petersburg, while in other hospitals and clinics in St Petersburg the patients face a several-month wait for an MRI scan. What is more, the waiting time for the patients from other regions in Russia is only three days. During week days, the Clinic provides the MRI services during 9 or 12 hours and 6 hours on Saturdays. Yury Fedotov, Director of the Pirogov Clinic of High Medical Technologies, says, if the Clinic had two rooms for the MRI scanners, we would be able to hit the target of the annual plan in two or three months.
Currently, the Clinic has two MRI scanners. Since 2009, the routine MRI scans of the brain, spinal cord, and large joints have been performed on the Toshiba Optivantage 1.5 T. In November 2018, the Clinic obtained the Discovery 3.0 T for the MR-guided surgery. This state-of-the-art MRI-scanner is particularly good for cancer patients. In these cases, the MRI can be used for surgical planning, checking how well the chemotherapy is working, and for diagnosis of a locally recurrent disease. This MRI system allows for the acquisition of data with higher spatial resolution and accurate disease characterisation.
The Clinic provides a wide range of the diagnostic tests and treatment for cancer.
Breast screening is particularly good for breast-conserving surgery in early detection of seeding metastases and tumour in the contralateral breast during an oncologic follow-up. It is also used for differential diagnosis of palpable abnormalities. It detects oedematous-infiltrative breast cancer and recurrent disease, which may be caused due to the post-surgical breast scar. It is also helpful for imaging neoadjuvant chemotherapy response in breast cancer.
It is used for differential diagnosis of benign and malignant liver tumours and imaging biliary ducts.
The Clinic performs MRI scans for bladder cancer to get accurate information about whether the cancer has spread into the thick muscle wall of the bladder and beyond. MRI might be done to help locate and target areas of the prostate that are most likely to contain cancer. MRI can be used during a prostate biopsy to help guide the needles into the prostate. MRI produces detailed pictures of your small intestine and provides information on whether the cancer has spread into the intestinal wall and plays an instrumental role in determining appropriate patient treatment (medical versus surgical).
The uses of the MRI in gynaecology include benign and malignant tumour detection in endometrium and ovaries. It includes preoperative staging and identifies metastatic lymph nodes caused by gynaecological cancers. It helps in planning radiation therapy and chemotherapy. In infertility, MRI is the most useful technique for determining the extent of endometriosis. It can aid in the diagnosis of ovarian endometrioma, retrocervical endometriosis, intestinal endometriosis, infiltration in the uterosacral ligament, and adenomyosis. It is also used for imaging the localisation of the benign, monoclonal tumours of the smooth muscle cells of the myometrium, assessing the risk of malignisation and planning conservative surgery.
WH-MRI is commonly used to image cancer patients to evaluate the presence of metastatic lesions.
The Discovery 3.0 T produces detailed pictures of the brain, spinal cord, large and small joints. It delivers exceptional quality in these routine screenings. In the brain MRI screening, the pulse sequence in 3D-imaging provides sufficient perfusion signal to reveal even the tiniest brain lesions. It plays a role in diagnosing the demyelinating diseases, for example, multiple sclerosis, and brain metastases. The SWAN-pulse sequences used in the standard MR protocols are sensitive in the identification of cerebral haemorrhage, calcifications, and angiomas. It is of high importance in treating the patients with a cerebrovascular accident, when the ischemic stroke is accompanied by the small haemorrhage. Moreover, the Discovery 3.0 T produces scans of the orbits in thyroid eye disease and orbital tumour. It also produces 2-mm scans of the hypophysis to identify pituitary microadenoma.
Rapid access to the scan archive is provided by the Radiological Information System at the Clinic. It ensures data exchange and rapid access within all Clinic’s subdivisions and offices. Thus, the scans made in the office in the Korablestroitelei Street can be accessed through the database in the main office. Since this database was introduced, the treatment dynamics can be assessed within as many as ten years.