What Do We Have & What Do We Need? - MRI in Africa
Johnes Obungoloch1, Lukas Winter2, and Steven J Schiff3

1Biomedical Engineering, Mbarara University of Science & Technology, Mbarara, Uganda, 2Biomedical Magnetic Resonance, Physikalisch-Technische Bundesanstalt (PTB), Berlin, Germany, 3Engineering Science and Mechanics, The Pennsylvania State University, State College, PA, United States

Synopsis

The structural, technical and operational requirements of conventional high field MRI are very high. As a result, there are very few MRI units in developing countries especially Sub-Saharan Africa. In order to improve MRI distribution in such low resource countries, development of local technical capacity is very vital. This can only be possible in collaboration with the developing world where is already high technical capacity. The aim of this project is to develop a training software for MRI that will link developing and developed countries to promote MRI training and sharing of knowledge and data.

African MRI challenge – Open Source MR Training Software

The uptake of MRI in sub-Saharan Africa is very low because of the costs and expertise involved in acquisition and operation of MRI technology. MRI devices are very sparsely distributed in Sub-Saharan Africa [1]. For example, there are only four MRI scanners in Uganda for a population of 35 million people. For a similar population in the global north around 350 – 1750 MR scanners are available [2]. Even though Sub-Saharan Africa is undergoing significant social transformation and economic development, conventional MRI systems with their diagnostic benefits will not be widely available in the near future because the support structures such as technical expertise, infrastructure, energy and maintenance services are still lacking in many places [3]. Innovations such as low field MRI that are aimed at making MRI available in developing countries can make implementation of these support structures within reach, however the problem of maintenance and trained staff will persist. The development of local expertise is therefore very vital in making MRI available in developing countries. Many Universities in Sub-Saharan Africa are currently involved in training biomedical engineers, medical doctors, radiographers and imaging professionals in which MRI is one of the imaging technologies taught. However, due to scarcity of MRI knowledge and hardware, this training often lacks the hands-on experience necessary to build an intuitive understanding. Our challenge is therefore the development of training software to simulate MRI experiments and provide visual training tools to help understand MRI technology. The software should be a good way of starting to develop expertise and training that might provide support for the development, maintenance and operation of appropriate MRI devices for developing countries. It can be a standalone software package or a platform connecting MR experts, radiologists, students from global south with the global north. The software should be open source, licensed under a copyleft license and it should be accessible to anyone with an internet connection [4]. It might reuse existing open source software packages for e.g. simulation or reconstruction. The software should be targeted to the users’ educational experience and as such, should have a readily manageable GUI interface (fig. 1). One of the requirements is simplicity. The user should be able to learn the basics about MRI experimentation without the need to understand complex code, complex hardware or complex physics. Lastly, the software should be developed keeping in mind the potential for a paired, open-source, educational hardware system which is being developed and might be available in the future [5]. We think that the proposed software will promote intuitive MRI training and help build local MRI expertise in developing countries. It might be also a way to connect MRI individuals and institutions in the global south with the global north to develop the crucial support structure needed for sustainable use of MRI technology in resource scarce settings.

Acknowledgements

1. Lukas Winter and ISMRM junior fellow challenge organizers

References

1. Godwin Inalegwu Ogbole, et al., Survey of magnetic resonance imaging availability in West Africa. PanAfrican Medical Journal, 2018. 30(240).

2. WHO. Baseline country survey on medical devices, 2014 update: Medical Equipment-Total density per million population. 2014 [cited 2019 March 12]; Available from: http://gamapserver.who.int/gho/interactive_charts/health_technologies/medical_equipment/atlas.html.

3. Matthew T. Latourette, et al., Magnetic Resonance Imaging Research in Sub-Saharan Africa: Challenges and Satellite-Based Networking Implementation. Digital Imaging, 2011. 24(4): p. 729-738.

4. Wikipedia. Available from: https://en.wikipedia.org/wiki/Copyleft.

5. Felix Arndt, et al. Open Source Imaging Initiative-Update and Roadmap #4463. 2017 [cited 2019 March 12]; Available from: http://wwwuser.gwdg.de/~muecker1/ismrm17/ISMRM17_4463.pdf.

Figures

Training software user interface

Proc. Intl. Soc. Mag. Reson. Med. 27 (2019)