Frequently Asked Questions

Want to learn more about the Embrace® Neonatal MRI System? We’ve compiled the following list of the most commonly asked questions to give you more information. If you have additional questions, feel free to
contact us via email.

 

Q. Is Embrace® FDA cleared?

A. Yes, Embrace® is FDA cleared.

Q. Why does the Embrace® only image brains?

A. The Embrace® system was designed to meet the needs of approximately 90% of NICU cases – the brain. The Embrace® is currently constructed to image the neonatal head and is designed with a dedicated RF head coil. We are presently reviewing next generation options to expand this amazing technology to other areas of interest.

Q. What makes Embrace® different from other scanners?

A. The Embrace® Neonatal MRI System is designed specifically for imaging the neonatal brain inside the NICU, eliminating the risks and stress associated with transporting the baby out of the NICU to the Radiology department, without compromising image quality necessary to make accurate clinical diagnoses which inform clinical care decisions.

Q. Can the Embrace® help make clinical treatment decisions?

A. In a retrospective study published in 2014, the clinical and radiological aspects of 129 neonatal MRI examinations during a 3-year period were analyzed. MR-based changes in clinical management were initiated in 58% of cases. The most common change in management was an influence on the initiation or termination and choice of long-term anticonvulsive therapy or anticoagulation, operative decision-making, or antibiotic treatment [Z. Rona et al European journal of pediatric neurology 1 4 (2010) 410-417].

Site Planning & Placement 

Q. Are there any restrictions on where the Embrace® can be placed inside the NICU?

A. No. The Embrace® Neonatal MRI system is designed to be installed in any available space near or within the NICU. A space similar in size to a private patient room is the perfect location for the Embrace® system.

Q. Does the Embrace® require a separate RF shielded room?

A. No. The magnet is fully self-shielded. The low magnetic field of the 5 Gauss line is contained within the system cover eliminate the need for perimeter barriers 10+ feet away from the scanner. Medical equipment, such as standard ventilators, oxygen tanks, and IV pumps/poles can be placed next to the scanner and close to the patient. This is not possible with whole body MRI scanners..

Q. Does the Embrace require backup electrical supply?

A. No, the system does not require a backup electrical power source. When the system is not in use, it does not require any electrical power.

Q. What is the electrical power requirement?

A. Compared to superconducting MRI systems, the Embrace® requires a 15 ampere 240-volt single phase connection, like an electric stove. When the scanner is running, it uses 2200 watts which is less energy than required to power two 1500-watt hair dryers. When the Embrace® is not in use, the electronics rack is turned off completely – removing the need for a standby mode on the Embrace MRI scanner.

Q. What are the power requirements for the electrical cabinet?

A. 200 – 240 VAC, single phase, 12 A 50/60 Hz

Q. What are the room size requirements for the Embrace®?

A. The minimum room requirement is 18 x 14 feet, which are similar dimensions to standard private patient rooms in most hospitals. This is the total space required for the magnet, electrical cabinet and MR Technologist workstation. Everything can be placed in the same room.

Q. Does the magnet require cryogenic cooling?

A. No, the system does not require a cooling system.

Q. What are the weight considerations when siting the Embrace®?

A. The magnet weighs 5,500 kg/12,000 lbs. The floor may need to be reinforced to support the weight of the scanning unit. This is the only consideration that must be considered when selecting the location for the Embrace®.

Q. What is the maximum power dissipation?

A. The maximum power dissipation is less than 2.7 KW.

System Operation

Q. What are the sound levels of the Embrace compared to conventional MRI?

A. The Embrace® is silent when not in use. During scanning the sound level in the MR suite is 69 dB(A). During scanning, sound levels inside the magnet average 85 dB with a peak level at 87 dB. Traditional MRI scanners typically have sound levels in the 95-100 dB range in the MR suite. During scanning, sound levels in a traditional magnet can reach 120-125 dB.

Q. Does the patient bed provide humidity?

A. No. The patient bed does not deliver supplemental environmental humidity. Swaddling with blankets is recommended which can reduce transepidermal water loss (TEWL) for premature infants for the short duration of the scan. There is no contraindication to using polyurethane plastic wraps if desired by the medical team.

Q. How are the images sent to PACS? Do you have a Modality Work List?

A. The system supports MWL and multiple PACs servers and enables a seamless connection to all HIS/RIS/EMR systems.

Q. How do we control the temperature inside the patient bed?

A. The air temperature inside the patient bed is controlled via a closed-loop air circulation heating system. The desired air temperature inside the Embrace patient bed is set manually by the health care providers, based on the needs of the patient. Adjustments to the air temperature can be made quickly and easily using the touch screen panel located on the patient bed.

Q. What kind of coils come with the Embrace®?

A. Currently there is only a head coil, but multi-channel coils are under consideration to cover other areas of interest.

Scanning & Image Quality

Q. Which pulse sequences are available?

A. The Embrace® is pre-loaded with standard imaging sequences, such as SE, FSE, GRE, and DWI. All sequence parameters can be adjusted by the application specialist.

Q. What is the typical time for a scan?

A. A typical clinical scan time for diagnostic purposes is ~ 20 minutes
Gradient scan time of 2D sequences (SE, FSE) is ~ 3 minutes
Gradient scan time of 3D sequences (3D GRE) is ~ 5 minutes
Gradient scan time of DWI/ADC map sequences is ~ 7 minutes
Scan time may change in case the number of slices is increased (which may require increasing the TR), or if more averages are needed to increase SNR.
The entire procedure – from initial preparation, through scanning, until the patient is returned to bed – typically takes less than an hour.

Q. What slice thickness do you typically use?

A. Typical clinical T1 and T2 scans are done at 3 mm with a 0 or 1 mm slice gap. 3D-T1 protocols have slice thickness of 0.7-1 mm. Diffusion protocols use slice thickness between 3-5 mm. Typical b-values are 700-1000 s/mm2.

Q. How does the image quality compare to other high-field scanners?

A. When comparing the images created by the Embrace® MRI scanner to images acquired by both 1.5 and 3.0T conventional whole-body scanners, our clinical and research users have found the Embrace® images to be comparable and have been able to use them with confidence to make clinical diagnoses. Click to view image comparisons in our image library.

Q. Can we program our own sequences?

A. The Embrace® is pre-loaded with standard imaging sequences, such as SE, FSE, GRE, and DWI. All sequence parameters can be adjusted by the application specialist.

Q. What are the typical clinical imaging resolutions?

A. It is possible to acquire 2D and 3D sequences with a resolution of 0.3 mm. For clinical purposes, the typical resolution parameters for the neonatal brain are as follows:

2D sequences (FSE, SE): 0.8 x 0.8 x 3 mm3
3D sequences (GRE): 1 x 1 x 1 mm3
ADC map: 2 x 2 x 4 mm3

For research studies that require higher resolution, the Embrace can match maximum resolution found on 1.5T whole body MRI scanners.

Q. How are the images sent to PACS? Do you have a Modality Work List?

A. The system supports MWL and multiple PACs servers and enables a seamless connection to all HIS/RIS/EMR systems.

Q. Do you have supporting materials comparing the Embrace® to other magnets for image quality or diagnosis?

A. Yes we do. Explore our image library, including comparison images from a traditional 1.5T scanner.

Patient Care & Safety

Q. Which patients can be scanned on the Embrace®?

A. The Embrace® is designed for babies weighing between 1 kg and 4.5 kg with a head circumference up to 38 cm. However, our research partners have scanned babies larger than 4.5 kg when clinically required. The head circumference seems to be the limiting factor more than the weight.

Q. How is the temperature of the baby measured?

A. The temperature of the baby can be measured via an MR Safe surface temperature sensor connected to external MR-conditional (patient) monitor.

Q. Can you image babies who need respiratory support or are intubated?

A. Yes. The RF head coil is designed with an opening above the mouth area to accommodate an ET tube, CPAP apparatus, and the ventilator circuit tubing. Additionally, the patient bed has access ports and grommets to manage all patient equipment, including IV tubing and monitoring leads, preventing them from getting pinched, twisted or snagged.

Q. Does the Embrace® come with a way to view the baby during the scan?

A. Yes. This is one of the unique features of the Embrace® Neonatal MRI. This system provides, for the first time, real-time video monitoring capabilities for the clinical NICU team to watch the baby during the scan to observe for distress, breathing issues and movement. Providing a video stream of the baby also provides peace of mind for the parents that may accompany their baby to the MRI suite for a scan.

Q. Is infant motion different for NICU patients than research subjects in conventional MRI?

A. There’s no difference for NICU patients. The feed and wrap technique done properly creates minimal movement and reducing transit time lets you take advantage of peak post-feeding coma time and lets the baby settle in during the scan, minimizing the risk for sedation and motion which impacts the image quality.

Q. Do you need to use MR Safe equipment in the MRI suite?

A. No. The permanent magnet is fully self-shielded with the 5 Gauss line completely contained within the housing of the magnet itself which allows oxygen canisters, infusion pumps, ventilators and other standard NICU equipment to be placed right next to the magnet. The only MR Safe equipment required when using the Embrace MRI scanner is for items that are placed inside the magnet with the baby, such as SpO2 sensors, ECG leads, or temperature probe.

Q. Is sedation required to scan babies?

A. In the over 200 scans that have been performed using the Embrace MRI scanner in the last two years, additional sedation has not been required to reduce motion artifacts. A simple feed-and-swaddle technique has been used and due to the close proximity of the magnet to the patient room, there is minimal transport and wait time. On average the baby is back to their bed in about 1 hour. Also, the Embrace keeps the baby warm in the temperature- controlled bed throughout the scan which keeps the babies more comfortable and asleep.

Q.How are you managing infection control?

A. Keeping MRI inside the NICU minimizes the risk of exposure to circulating pathogens by eliminating off-unit transport and contact with equipment that may be used for all patient populations in the hospital. In-NICU MRI scanning is now more important than ever due heightened concerns of COVID-19. Cleaning procedures and recommended cleaning agents are clearly outlined in the Embrace Operator Manual.

Q. What if the baby moves?

A. Movement during a MRI scan is a normal occurrence, and can cause a motion artifact which makes the images difficult to interpret. If this occurs during the scan, and the nursing or medical team needs to reposition or console the baby, the Embrace® Patient Bed can be quickly removed from the magnet and the baby accessed in less than 10 seconds.

Q. Do you need a separate control room to operate the MRI system?

A. No. All components including the electronics cabinet and MR Technologist’s console are located in the same room as the MRI scanner.

Q. What are your cleaning protocols?

A. The Embrace® Patient Bed, magnet bore, and magnet covers may be cleaned with either an alcohol-free dual quaternary ammonium (e.g. Sani-Cloth® AF3 by PDI®, Virex II 256 by Diversey) or an approximate concentration of 1000 ppm solution of Effervescent NaDCC (e.g. Defender™ by TrustMedical – 1076 ppm, Actichlor™ Plus by ECOLAB – 1000 ppm). The cleaning solutions have been tested to comply with conventional cleaning agents used within a healthcare facility. As with all cleaning guidelines, please refer to your facility’s environmental affairs department to ensure that use of these cleaning agents is performed in accordance with your local safety standards.

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About Aspect Imaging:

Aspect Imaging is a global leader in the design and development of compact, MR imaging systems for Pre-Clinical and Medical applications. Through state-of-the-art technology, Aspect Imaging offers innovative point-of-care MRI solutions, including the Embrace® Neonatal MRI System, which is designed to facilitate enhanced patient-centered diagnostic capabilities inside the NICU. 

For more information, visit our website at www.aspectimaging.com.

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