easing the healthcare burden — one protocol at a time
the accessibility of portable mris, both throughout a hospital and in remote areas, is potentially game-changing for a healthcare system needing to cut costs, while also boosting quality of care and saving lives.
6 minute read
this portable mri scanner can be controlled using a smartphone.
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i’m alison, brain canada’s evaluation and special projects lead. my role involves evaluating programs to inform decision-making and developing concept papers and action plans to support our strategic activities. it’s stimulating stuff. but between you and i, my absolute favourite duty is tracking down research impact stories and talking to our funded researchers about the various ways they’re working to improve brain health. so when an opportunity arose to meet a brain canada-funded researcher, a rising star in medical physics at the university of british columbia, my alma mater, about a recent trip to sub-saharan africa to conduct her research i took it straight away.
dr. shannon kolind is a 2020 future leader in canadian brain research and an expert on a technology referred to as low field, portable mri. if you’ve ever had an mri before this term might sound like a misnomer, but i can assure you after visiting dr. kolind’s lab that it’s not. these mri scanners use a very low magnetic field – almost 25 times weaker than the magnets in clinical mri scanners, basically only slightly stronger than a fridge magnet – and are roughly 1/5th of the cost. thanks to advances in magnetic coil technology and imaging algorithms, they’re small enough to fit through a doorway (with some modifications required in older buildings, as dr. kolind can attest!) and use less power than a cappuccino maker. they are also easy-to-use and can be operated by non-experts; in other words, no highly trained mri technologist on hand? no problem – specialized training is not required to operate the scanner.
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dr. kolind and her research team, including neale wiley (right), a fully trained and certified mri technologist.
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and as dr. kolind explained to me, low field mri scanners are still able to produce excellent, clinically useful images. the accessibility of this technology – both throughout a hospital and in remote areas – is potentially game-changing for a healthcare system needing to cut costs while also boosting quality of care and saving lives.
“the portable scanner is meant to act as a quick and low-cost screening tool, complementary to regular mris,” dr. kolind says. “it democratizes access to care, helping to even the playing field so that more people can get scanned – and get proper diagnosis and treatment.”
dr. kolind’s was one of the first teams in canada to receive one of these scanners and she and her team are working to optimize it for various purposes. simply put, they’re developing instructions they transmit to the device to help it detect certain brain features. dr. kolind’s brain canada-funded work is focused on developing protocols to detect and monitor the progression of lesions in the brain that are the signature of multiple sclerosis (ms). with her funding from the bill and melinda gates foundation as part of the unity (ultra-low field neuroimaging in the young) project, dr. kolind and her team are also developing protocols to study the effect of malnutrition on brain development and evaluate the efficacy of interventions in low- and middle-income countries. when asked if these projects are connected, dr. kolind nods profusely.
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dr. kolind has a strong team working alongside her to address these challenges, including phd student adam dvorak, who traveled with her to sub-saharan africa, and industrial collaborators at hyperfine, inc., the u.s.-based company responsible for manufacturing and continuously improving the scanner. as hyperfine inc.’s clinical scientist and biomedical engineer dr. megan poorman explained to me, it’s a mutually beneficial relationship; the company provides dr. kolind and her team with research tools, and in turn dr. kolind provides hyperfine inc.’s with data from their scans so that the company can improve its software.
dr. kolind’s various energetic graduate students bring expertise in physics, neuroscience, neurology, and computer science to the team. one of dr. kolind’s graduate students, neale wiley is a fully trained and certified mri technologist who knows all the ins and outs of scanning from a healthcare perspective. i use the term “energetic” to describe her team, because in that room with them and the scanner, the enthusiasm for working with each other and moving their science forward was palpable.
researchers and clinicians from blantyre malawi, one of the pioneering sites operating a hyperfine inc. scanner as part of the unity project, with visiting researchers from ubc and king’s college london, and representatives from hyperfine inc., the bill & melinda gates foundation, and the international society for magnetic resonance in medicine.
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“my future leader grant gave me a huge boost in productivity,” dr. kolind explains. “it allowed me to hire the people i needed to develop my research program and move it forward.”
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since she was awarded the grant in 2021, dr. kolind has:
- received additional funding to build on her work, including a $90,000 grant from michael smith health research bc to support post-doctoral fellow dr. hanwen (kevin) liu in exploring machine learning approaches with the scanner.
- hired 10 team members (e.g., graduate students, research assistants and technicians) to work on this project, three of whom are supported through her future leader grant funds.
- made 19 presentations, more than 40% of which were delivered by trainees and several of which required travel enabled by the grant.
- established a dozen new collaborations, including a new international working group she co-developed that brings experts on low field mri together, within the north american imaging in ms cooperative (naims). dr. kolind has also established collaborations with groups studying mood disorders, stroke, malaria, encephalopathy, alzheimer’s disease, motor neuron disease and more. she hopes to extend her research to include a vast range of neurological injuries and conditions.
- taken on the co-lead role for the imaging working group of canproco, a brain canada-funded platform focused on enhancing data collection for ms and improving our understanding of the factors involved in disease progression. the platform has enrolled close to 950 people living with ms across five canadian ms clinics. analyses are underway to thoroughly characterize the cohort and prepare for longitudinal analyses that will take place as more participants attend follow-up visits.
- developed a series of surveys for various stakeholders, including caregivers and clinicians, which will be distributed to solicit input on using low field mri for ms.
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“it’s still early days in terms of bringing this to bedside and rolling it out in remote communities, but that’s our goal. we’re testing our protocols and getting results, and there’s a lot of interest in what we’re doing; i’ve had conversations with several health authorities about using these scanners in practice,” says dr. kolind. vancouver general hospital, for example, recently purchased a portable scanner to test its use in the intensive care unit. these scanners are particularly useful for people who are claustrophobic; because only their heads need to be placed in the scanner, and the low field enables a faster scan, it’s a more comfortable experience. dr. kolind has been helping to train staff on the technology and determining best use in this setting.
dr. kolind explains the ins and outs of portable mri scanning to our evaluation and special projects lead alison palmer.
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i’m in the room while the research team tries a new protocol on a test patient. the scanner emits beep after beep of different length and frequency, and the team listens intently, staring at their laptop screens where the instructions they’ve just given the scanner are on display and the resulting brain image starts to take shape. the team knows what they should be hearing based on those instructions. i ask if they dream about those sounds (as i suspect i might tonight!), and they laugh but don’t say no.
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on a more serious note, i ask dr. kolind what motivates her.
“i’ve actually never taken a biology course,” she admits. “i wasn’t interested in medicine. it’s too squishy! but when my grandmother was diagnosed with dementia, the opportunity to apply my training in physics to imaging to be able to see what was going on in her brain, was game-changing.”
i nod. it’s also really rewarding to fund such important research.
dr. shannon kolind is the recipient of a future leader in canadian brain research grant. she is an associate professor and associate head (research) in the division of neurology, department of medicine at the university of british columbia (ubc), a member of the djavad mowafaghian centre for brain health and icord, and an mri physicist with ubc mri research.
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