Improving the city’s imaging

Shaare Zedek Medical Center invested $5 million for Siemens machines and infrastructure for a new MRI center.

By JUDY SIEGEL
Dr. Yaakov Applbaum 521 (photo credit: Judy Siegel)
Dr. Yaakov Applbaum 521
(photo credit: Judy Siegel)
Starting next month, patients at Jerusalem’s Shaare Zedek Medical Center requiring a magnetic resonance imaging (MRI) scan will not have to wait until the MAR Institute medical imaging center’s mobile scanner arrives by truck once a week or be sent to Hadassah University Medical Center in Ein Kerem. SZMC has invested some $5 million for the purchase of two Siemens machines and infrastructure for a new MRI center. The facility, covering 600 square meters on the hospital’s third floor (one floor below the entrance level), is now being “run in.”
The center is headed by Dr. Yaakov Applbaum, who specializes in neuroskeletal imaging and left Hadassah to take up the new post. He is being assisted by nine radiographers (radiologic technologists). The 3-tesla device has a wider bore (“tunnel” where the patient lies) – 70 centimeters, which is large enough for very obese people (weighing up to 250 kilograms) who were previously unable to fit in and be scanned. It also makes it easier to scan children without having to give them general anesthesia so they won’t move during the procedure.
The tesla (symbol T), named for inventor and electrical engineer Nikola Tesla, measures magnetic flux density. The smaller 1.5-tesla MRI “does things that the 3-tesla machine can’t do,” Applbaum explained to In Jerusalem during a tour of the facility, “while the 3- tesla device does things the smaller one doesn’t.” The advanced machines will be used not only to diagnose disease but also to conduct research. The 3-tesla Siemens model is the only one in the country, but Assaf Harofeh Medical Center in Tzrifin has the same model in the 1.5 tesla version.
MRI is a medical imaging technique used in radiology to visualize detailed internal structures; it images the nuclei of atoms inside the body. An MRI machine uses a powerful magnetic field to align the magnetization of some atomic nuclei and radio frequency fields to systematically change the alignment of this magnetization. This causes the nuclei to produce a rotating magnetic field detectable by the scanner, and this data is recorded to construct an image of the scanned area of the body. As the technology supplies a good contrast between the different soft tissues of the body, MRI is very effective for imaging the heart, brain, muscles and tumors, compared with other medical imaging techniques such as computed tomography (CT) or X-rays. Unlike CT scans or traditional X-rays, MRI does not use ionizing radiation. Applbaum said that MRI technology is safe for repeated use “as far as we know.”
To control entrance to the facility, staffers must press their index finger on a biometric sensing device, and there are various zones inside. In the locker room, patients must completely disrobe, removing jewelry as well, and put on a hospital gown. As the MRI machine uses a very powerful magnetic field up to 30,000 times that of natural magnetism, anything metallic would fly around the room when the machine is on. Applbaum recalled that in New York State a few years ago, a child was killed when a metallic oxygen balloon was somehow “pulled” into an MRI room.
The Health Ministry requires medical and research institutions to receive a license for purchasing an MRI machine, Applbaum said, which is good because otherwise superfluous testing for a profit could result, as it does in the US. In Israel, of all types of imaging technology, only an ultrasound machine can be purchased without a ministry license. He noted that in a small radius where Cedars Sinai Medical Center in Los Angeles is located, there are 40 such devices, and private doctors there purchase them to make significant profits. Applbaum predicted that with Shaare Zedek’s new center, prices due to competition – paid for by the health funds – will eventually come down.