While CT provides good spatial resolution and hard tissue visualization with a
fast acquisition time, MRI allows comparable resolution with better contrast resolution (the ability to distinguish differences between similar but not identical tissues)
requiring longer acquisition time. This MRI ability is directly linked to the complex
library of parameters (mainly pulse sequences), each of them being optimized to
provide image contrast of a specific chemical component of the body. For instance,
depending on the choice by the operator of specific values, for a given sequence
(namely T2-weighting), water-containing tissues are bright, whereas fat-containing
tissues are dark. In contrast, with another sequence (namely a fluid-attenuated
inversion recovery sequence), water-containing tissues are now dark, but damaged
tissues developing edema remain bright. Consequently, by variation of MRI scanning parameters (nearly an infinite variety of possibilities), tissue contrast can be
altered or enhanced in various ways to detect different features.
5 Alternatively, CT
using X-ray attenuation to generate image contrast (Hounsfield units measuring the
differences of physical density within the body) is an adequate imaging device for
bone and calcification visualization, vessel structure, and blood flow if contrast
agents are injected (bolus tracking).
Both imaging techniques are characterized by high versatility in terms of clinical
applications and visualization capability (2D or 3D reconstruction from projections).
Both devices bear close similarities in terms of data gathering and data processing
that can be translated for physicians in their medical practice. In the case of CT, our
field study shows a correlated clinical improvement with respect to the enhanced
technological capabilities, in terms of accuracy and timeliness as shown in Table 1.
6
This technological evolution embraces significant clinical improvements, such as
CT cardiac imaging capabilities. In medical technology, long-term shifts in the
understanding of medical diseases (e.g., cardiac diseases) trigger exploration of
new diagnostic avenues (e.g., CT cardiac imaging), and when successful this clinical
experimentation generates pressure on the existing set of practices and technologies.
A stimulating factor for innovation in medical technology lies in the permanent
search to meet clinical needs in terms of improving patient outcomes, providing
safety, increasing utility, and saving time (Metcalfe et al., 2005). Demand by patients
and their advocacy group (Callon & Rabeharisoa, 2008) fuels public acceptance of
medical innovation. Advocacy organizations in some countries have become a
potent force in influencing physicians to provide treatments, third-party payers to
cover these procedures, and regulators to support access to them. In generating
public acceptance of medical innovation, it is difficult to underestimate the impact
of access to the Internet as a growing force in the dissemination of information.
5 Ibid.
6 This table is a compilation of data coming from company press releases and company product
datasheets, accessed at (alphabetical order): www.gehealthcare.com, www.medical.siemens.com,
www.medical.toshiba.com, www.healthcare.philips.com, in the past few years (2006–2016). These
data have been cross-checked with the medical imaging community website: www.auntminnie.
com, during the same period.
Health Informatics and Co-Innovation: Connecting Patients, Clinical Practice,. . .
105
fast acquisition time, MRI allows comparable resolution with better contrast resolution (the ability to distinguish differences between similar but not identical tissues)
requiring longer acquisition time. This MRI ability is directly linked to the complex
library of parameters (mainly pulse sequences), each of them being optimized to
provide image contrast of a specific chemical component of the body. For instance,
depending on the choice by the operator of specific values, for a given sequence
(namely T2-weighting), water-containing tissues are bright, whereas fat-containing
tissues are dark. In contrast, with another sequence (namely a fluid-attenuated
inversion recovery sequence), water-containing tissues are now dark, but damaged
tissues developing edema remain bright. Consequently, by variation of MRI scanning parameters (nearly an infinite variety of possibilities), tissue contrast can be
altered or enhanced in various ways to detect different features.
5 Alternatively, CT
using X-ray attenuation to generate image contrast (Hounsfield units measuring the
differences of physical density within the body) is an adequate imaging device for
bone and calcification visualization, vessel structure, and blood flow if contrast
agents are injected (bolus tracking).
Both imaging techniques are characterized by high versatility in terms of clinical
applications and visualization capability (2D or 3D reconstruction from projections).
Both devices bear close similarities in terms of data gathering and data processing
that can be translated for physicians in their medical practice. In the case of CT, our
field study shows a correlated clinical improvement with respect to the enhanced
technological capabilities, in terms of accuracy and timeliness as shown in Table 1.
6
This technological evolution embraces significant clinical improvements, such as
CT cardiac imaging capabilities. In medical technology, long-term shifts in the
understanding of medical diseases (e.g., cardiac diseases) trigger exploration of
new diagnostic avenues (e.g., CT cardiac imaging), and when successful this clinical
experimentation generates pressure on the existing set of practices and technologies.
A stimulating factor for innovation in medical technology lies in the permanent
search to meet clinical needs in terms of improving patient outcomes, providing
safety, increasing utility, and saving time (Metcalfe et al., 2005). Demand by patients
and their advocacy group (Callon & Rabeharisoa, 2008) fuels public acceptance of
medical innovation. Advocacy organizations in some countries have become a
potent force in influencing physicians to provide treatments, third-party payers to
cover these procedures, and regulators to support access to them. In generating
public acceptance of medical innovation, it is difficult to underestimate the impact
of access to the Internet as a growing force in the dissemination of information.
5 Ibid.
6 This table is a compilation of data coming from company press releases and company product
datasheets, accessed at (alphabetical order): www.gehealthcare.com, www.medical.siemens.com,
www.medical.toshiba.com, www.healthcare.philips.com, in the past few years (2006–2016). These
data have been cross-checked with the medical imaging community website: www.auntminnie.
com, during the same period.
Health Informatics and Co-Innovation: Connecting Patients, Clinical Practice,. . .
105