Bringing MRI to low- and middle-income countries: Directions, challenges and potential solutions

Sanjana Murali; Hao Ding; Fope Adedeji; Cathy Qin; Johnes Obungoloch; Iris Asllani; Udunna Anazodo; Ntobeko A B Ntusi; Regina Mammen; Thoralf Niendorf; Sola Adeleke

doi:10.1002/nbm.4992

Bringing MRI to low- and middle-income countries: Directions, challenges and potential solutions

NMR Biomed. 2023 Jul 4:e4992. doi: 10.1002/nbm.4992. Online ahead of print.

Authors

Sanjana Murali¹, Hao Ding¹, Fope Adedeji², Cathy Qin³, Johnes Obungoloch⁴, Iris Asllani⁵, Udunna Anazodo^{6

7}, Ntobeko A B Ntusi^{8

9}, Regina Mammen¹⁰, Thoralf Niendorf¹¹, Sola Adeleke^{12

13}

Affiliations

¹ School of Medicine, Faculty of Medicine, Imperial College London, London, UK.
² School of Medicine, Faculty of Medicine, University College London, London, UK.
³ Department of Imaging, Imperial College Healthcare NHS Trust, London, UK.
⁴ Department of Biomedical Engineering, Mbarara University of Science and Technology, Mbarara, Uganda.
⁵ Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, New York, USA.
⁶ Department of Medical Biophysics, Western University, London, Ontario, Canada.
⁷ The Research Institute of London Health Sciences Centre and St. Joseph's Health Care, London, Ontario, Canada.
⁸ Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
⁹ South African Medical Research Council Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, Cape Town, South Africa.
¹⁰ Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, UK.
¹¹ Berlin Ultrahigh Field Facility (BUFF), Max-Delbrück Centre for Molecular Medicine in the Helmholtz Association, Berlin, Germany.
¹² School of Cancer & Pharmaceutical Sciences, King's College London, London, UK.
¹³ High Dimensional Neuro-oncology, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.

PMID: 37401341
DOI: 10.1002/nbm.4992

Abstract

The global disparity of magnetic resonance imaging (MRI) is a major challenge, with many low- and middle-income countries (LMICs) experiencing limited access to MRI. The reasons for limited access are technological, economic and social. With the advancement of MRI technology, we explore why these challenges still prevail, highlighting the importance of MRI as the epidemiology of disease changes in LMICs. In this paper, we establish a framework to develop MRI with these challenges in mind and discuss the different aspects of MRI development, including maximising image quality using cost-effective components, integrating local technology and infrastructure and implementing sustainable practices. We also highlight the current solutions-including teleradiology, artificial intelligence and doctor and patient education strategies-and how these might be further improved to achieve greater access to MRI.

Keywords: Affordable; MRI; global health; low field; macroeconomics; microeconomics; sustainable; technology.