title: Location of core diagnostic information across various sequences in brain MRI and implications for efficiency of MRI scanner utilization.
abstract: OBJECTIVE
  Targeting redundancy within MRI can improve its cost-effective utilization. We sought to quantify potential redundancy in our brain MRI protocols.
  
  
  METHODS
  In this retrospective review, we aggregated 207 consecutive adults who underwent brain MRI and reviewed their medical records to document clinical indication, core diagnostic information provided by MRI, and its clinical impact. Contributory imaging abnormalities constituted positive core diagnostic information whereas absence of imaging abnormalities constituted negative core diagnostic information. The senior author selected core sequences deemed sufficient for extraction of core diagnostic information. For validating core sequences selection, four readers assessed the relative ease of extracting core diagnostic information from the core sequences. Potential redundancy was calculated by comparing the average number of core sequences to the average number of sequences obtained.
  
  
  RESULTS
  Scanning had been performed using 9.4±2.8 sequences over 37.3±12.3 minutes. Core diagnostic information was deemed extractable from 2.1±1.1 core sequences, with an assumed scanning time of 8.6±4.8 minutes, reflecting a potential redundancy of 74.5%±19.1%. Potential redundancy was least in scans obtained for treatment planning (14.9%±25.7%) and highest in scans obtained for follow-up of benign diseases (81.4%±12.6%). In 97.4% of cases, all four readers considered core diagnostic information to be either easily extractable from core sequences or the ease to be equivalent to that from the entire study. With only one MRI lacking clinical impact (0.48%), overutilization did not seem to contribute to potential redundancy.
  
  
  CONCLUSIONS
  High potential redundancy that can be targeted for more efficient scanner utilization exists in brain MRI protocols.
authors: 1 Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 S Kingshighway Blvd, St. Louis, MO 63110.
authors: Aseem
authors: A
authors: Sharma
authors: Arindam
authors: A
authors: Chatterjee
authors: Manu
authors: M
authors: Goyal
authors: Matthew S
authors: MS
authors: Parsons
authors: Seth
authors: S
authors: Bartel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies
keywords: MRI; cost-effectiveness; health care costs; neuroimaging; resource utilization