MR equipment acquisition strategies: low-field or high-field scanners

Magnetic resonance (MR) field strength is one of the key aspects to consider when purchasing MR equipment. Other aspects include the gradient system, coil design, computer and pulse sequence availability, purchase cost, local reimbursement policies, and current opinion within the medical community. Our objective here is to evaluate the decision-influencing aspects of the MR market, with a focus on some specific areas such as high resolution studies, examination times, special techniques, instrumentation, open design magnets, costs and reimbursement policies, academic and industrial interests, contrast media, clinical efficacy, and finally, clinicians' preferences. Certainly the advantage of high-field is a higher signal-to-noise ratio and improved resolution. With a high-field unit, higher spatial resolution images and higher temporal resolution images can be obtained. Typical imaging times needed to produce clinically diagnostic images are about 3 times longer at 0.1 T than at 1.0 or 1.5 T. High-field-related advanced techniques, such as functional imaging, spectroscopy and microscopy, may become clinically useful in the near future. As long as there is an unlimited demand for MR examinations, it appears financially profitable to run a high-field system, despite the associated higher costs. However, if demand for MR becomes saturated, low-field systems will cause less financial strain on the reimbursement organisation and service provider. Recent emphasis on cost containment, the development of interventional techniques, the increased use of MR for patients in intensive care and operating suites, the deployment of magnets in office suites, and the development of new magnet configurations, all favour the supplementary use of low-field systems. Hence, MR units of all field strengths have a role in radiology.