One whole-body MRI could replace multiple cancer scans • Hacker News Board

Re: One whole-body MRI could replace multiple cancer scans

#231

Post by ohithereyou » Tue, May 21, 2019, 11:01 PM UTC

lostlogin wrote: post #227

ohithereyou wrote: post #186

Earlier quoted context omitted.

Don't forget the price increase when the MR software developers sprinkle in the machine learning pixie dust! (Source: am a MR software developer)

I’d love there do be more interaction between radiographers and devs. There are some strange bugs on all the major platforms (my GE experience is now probably too old to be relevant) and removing them would be so excellent. What is your area/role?

Without outing my specific company and location: I do primarily operating system and associated plumbing level development for a platform supporting MR applications as well as some application work atop that.

Re: One whole-body MRI could replace multiple cancer scans

#232

Post by internet_user » Tue, May 21, 2019, 11:34 PM UTC

arkades wrote: post #78

internet_user wrote: post #60

Earlier quoted context omitted.

> statistically appropriate call. but factually incorrect call is apparently OK, because they are treating "median person", and not the actual patient. This has to do with money - and nothing else.

No, it has to do with avoiding harm to patients. I don’t make one red cent more or less from sending someone to an MRI or not. I do care about wasteful testing that is more likely to stress out a patient and send them down a rabbit-hole of follow-up tests with potential complications and costs (to them), if there’s not a reasonable chance of an outweighing clinical benefit for them. And of course we make statistical…

> judgment

> make statistical calls!

Really? Your fuzzy feels are not statistics.

Do you even at least try to know how large is the type 2 error in your guesswork? Is it better than flipping a coin?

Re: One whole-body MRI could replace multiple cancer scans

#233

Post by D_Alex » Wed, May 22, 2019, 4:14 AM UTC

mattkrause wrote: post #213

D_Alex wrote: post #207

Earlier quoted context omitted.

$98/scan in Japan. https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/...

The doctor gets $98. The $550/hr price I quoted is for a research scanner where no one is even trying to turn a profit; they just want to pay off the machine and its operating costs. The machines themselves are not magically cheaper in Japan; they're just being paid for through some other route. If the scanner were somehow free (gov't grant?), 98$ seems pretty reasonable for the labor.

A medical grade MRI scanner costs around $1 million, and maintenance costs are circa $100,000/year. With good utilisation, say 3000 hrs/year, the machine costs might be around $70/hr.

The $550/hr you are paying may be because you are using a particularly fancy scanner, or because utilisation rate is low, or because the amount is loaded with overheads, or w/e.

Re: One whole-body MRI could replace multiple cancer scans

#234

Post by mattkrause » Wed, May 22, 2019, 9:25 AM UTC

D_Alex wrote: post #233

mattkrause wrote: post #213

Earlier quoted context omitted.

The doctor gets $98. The $550/hr price I quoted is for a research scanner where no one is even trying to turn a profit; they just want to pay off the machine and its operating costs. The machines themselves are not magically cheaper in Japan; they're just being paid for through some other route. If the scanner were somehow free (gov't grant?), 98$ seems pretty reasonable for the labor.

A medical grade MRI scanner costs around $1 million, and maintenance costs are circa $100,000/year. With good utilisation, say 3000 hrs/year, the machine costs might be around $70/hr. The $550/hr you are paying may be because you are using a particularly fancy scanner, or because utilisation rate is low, or because the amount is loaded with overheads, or w/e.

What does “medical grade” mean?

That’s in the ballpark for a 1.5T, but those are fairly old. About $1M per Tesla used to be a decent rule of thumb, but it’s come down a little at the low end. Still, I would be amazed to see a 3T for anything below $2M.

As for the $550/hr, it’s probably true that research scanners have lower utilization and higher costs to support all the weird stuff researchers want to do. An outpatient clinic specializing in knees can run much leaner. That said, that rate seems to be pretty standard across universities and I maintain that it's a very reasonable estimate of the cost. For example:

* Hopkins $668/hr (3T) or $538 (1.5T) during prime time; cheaper nights and weekend http://www.mri.jhu.edu/div_mri_res/ServCentPolicyFY17.pdf

* Yale: $539/hr (3T) https://medicine.yale.edu/mrrc/users/charges.aspx

* Harvard/MGH: $640/hr https://www.nmr.mgh.harvard.edu/core

* WUSTL: $710/hr (3T) https://www.mir.wustl.edu/Portals/0/Documents/Uploads/CCIR/F...

* McGill: $500/hr (3T) or $500-700/hr (7T) https://mcgill.ca/bic/files/bic/bic-rates-03052018.pdf

Most of these do not include F&A. It’s already coming out of the grants and external users pay a "Dean's Tax" on top of that to cover the missing overhead (which can often double the price).

Re: One whole-body MRI could replace multiple cancer scans

#235

Post by [deleted] » Wed, May 22, 2019, 9:27 AM UTC

D_Alex wrote: post #233

mattkrause wrote: post #213

Earlier quoted context omitted.

The doctor gets $98. The $550/hr price I quoted is for a research scanner where no one is even trying to turn a profit; they just want to pay off the machine and its operating costs. The machines themselves are not magically cheaper in Japan; they're just being paid for through some other route. If the scanner were somehow free (gov't grant?), 98$ seems pretty reasonable for the labor.

A medical grade MRI scanner costs around $1 million, and maintenance costs are circa $100,000/year. With good utilisation, say 3000 hrs/year, the machine costs might be around $70/hr. The $550/hr you are paying may be because you are using a particularly fancy scanner, or because utilisation rate is low, or because the amount is loaded with overheads, or w/e.

[deleted]

Re: One whole-body MRI could replace multiple cancer scans

#236

Post by Aeolun » Wed, May 22, 2019, 11:43 PM UTC

mattkrause wrote: post #218

Aeolun wrote: post #194

Earlier quoted context omitted.

6B per year to figure out which cancers are malignant with one scan seems like a fairly decent price.

For comparison, the entire NSF budget for next year is around $7B. That would just about cover the imaging component of building a speculative and ethically-questionable data set, assuming someone else pays for the biopsies, analysis, and staff. (The NIH does have more money, but also funds trials, vaccines, and other stuff that we probably don't want to cancel for a century).

Why would this be ethically questionable? It is not as if you are scanning people against their will.