PhenoMx is bringing MRI to the masses

According to the World Health Organisation, as much as two thirds of the world’s population does not have access to basic radiologic services, such as X-ray-based examinations. Even when it is available, the quality of such procedures can be questionable. As a result, the applications of radiology have remained primarily in diagnosis, leaving its tremendous potential as a preventative tool largely untapped.

Digital healthcare solutions can revolutionise patient-to-provider encounters by enabling automated processing and analysis techniques such as AI, which transform data into meaningful results. For imaging data, AI-based processing and analysis yields simplified workflows, definitive diagnoses and predictive disease biomarkers.

Autonomous precision imaging
The digital nature of the data from most imaging modalities – if not all in the near future – means automated analysis can be used to obtain valuable information beyond raw images. Today, AI-based solutions – particularly deep learning techniques – have allowed the entire field of medical image analysis to evolve.

Magnetic resonance imaging (MRI) is an excellent non-invasive, non-ionising method for assessing a patient’s health status. For MRI to serve as an accessible screening tool, automation needs to be implemented throughout the imaging pipeline. This can be achieved by putting three elements in place: first, by decoupling data acquisition protocols from hardware implementation, MRI solutions can be made more flexible as they can be executed on different hardware platforms.

AI-based solutions, particularly deep learning techniques, have allowed the entire field of medical image analysis to evolve

Second, multiparametric solutions can be used. For example, magnetic resonance fingerprinting is an accelerated acquisition and reconstruction method that simultaneously generates multiple parametric maps. Third, automated processing methods that are embedded in the imaging pipeline can recognise the scan taking place and trigger the appropriate post-processing or analysis methods. This speeds up clinical decision-making.

Often, precision medicine is associated with genotyping – identifying DNA sequences. While genotyping can create a baseline view of an individual’s physical make-up, imaging observes – or phenotypes – the physical manifestations of a disease.

An accessible MRI solution with deep data analytic capabilities would allow health professionals to peer into an individual’s body to evaluate their health, understand behavioural characteristics and predict disease risks. PhenoMx has created a digital physical examination using MRI to measure the body’s major vital organs and tissues so personalised wellness solutions can be developed. This means MRI can be used as a comprehensive screening tool, paving the way for affordable and actionable annual health exams.

With a mere 20 to 30 minute scan, a detailed fingerprint of the body’s structure, composition, and function in health and disease can be determined. Tracking, monitoring and evaluating tissue distribution with respect to an individual’s baseline or a demographic population can provide insight into metabolic anomalies, which can serve as a biomarker for diseases such as obesity, diabetes and cachexia, to name a few.

Holistic healthcare
The rapidly changing digital healthcare landscape should be driven by one goal: to connect the greatest number of patients with medical providers by using an intuitive platform that optimises the efficiency of healthcare services and the quality of the patient’s experience. Fuelled by global advances in digital healthcare technology, the creation of a standardised, cloud-based personal health record is a logical next step in patient care.

Key elements of such a platform include: compiling genomic information that describes an individual’s make-up and inherent disease risks; obtaining observable physical and behavioural characteristics via medical imaging to better understand the impact of lifestyle and environment on the body; and viewing the patient from a holistic instead of reductionist perspective to deliver on-demand, patient-centric information.

The emergence of personal health record services has given rise to the ‘concierge medicine’ model, where patients pay an annual retainer fee in exchange for enhanced care. Providers are principally committed to reducing patient loads, ensuring availability and increasing patient contact time. MRI-based phenotyping provided by PhenoMx can play an integral role within this framework.

Workplace wellness
Quantitative personalised solutions are also transforming employer-sponsored healthcare through primary care and workplace wellness programmes. A case study conducted at a Wisconsin printing company showed that worksite health clinics that focus on comprehensive primary care and wellness have lower costs and better outcomes for employees. This approach transforms the role of employers from mere purchasers of health insurance to fully invested stakeholders in employee health and productivity.

Accessible MRI can serve as a screening tool for wellness programmes, as most of the technical requirements for a meaningful screening procedure are already established. Example screenings could include a whole-body magnetic resonance (MR) composition evaluation. Systematic screening for common malignancies could lead to the discovery of hidden diseases or enhanced therapeutic options for early disease management. For example, when combined with dedicated cerebral and cardiac MR, a comprehensive screening protocol for atherosclerosis may significantly reduce stroke and heart attack incidences.

By incorporating such services in employee wellness and health programmes, the employer establishes a virtual primary care (VPC) model. VPC doctors will be able to diagnose and manage approximately 95 percent of the conditions a traditional primary care physician can manage. Employers could save up to 12 percent on claims costs, as well as being able to attract and retain talent, improving productivity.

Population health
With time, personalised medical solutions and wellness screenings can be extended beyond the workplace to positively impact entire populations. In a report by healthcare company Premier, patients with asthma, chronic obstructive pulmonary disease, hypertension, heart failure, diabetes or behavioural health issues were assessed. Researchers found that nearly 60 percent of all annual visits, comprising 24 million emergency department visits at 750 hospitals, included one of these conditions. Of these visits, more than 4.3 million were avoidable. Personalised medical solutions, such as those provided by PhenoMx, aim to reduce the burden of these unnecessary emergency department visits.

Diabetes represents one of the major causes of morbidity and mortality worldwide. By 2025, the global prevalence of pre-diabetes will include nearly 419 million patients. Diabetic complications can impact neurological, renal and cardiovascular systems, and not only significantly reduce the patient’s quality of life, but can also be life-threatening. Additionally, pre-diabetes is an independent risk factor for vascular, cardiac and metabolic changes. Measuring pre-diabetic patients with MRI uncovers ample evidence for increased subclinical disease burden.

As a systemic physiological state, pre-diabetes impacts multiple organ systems. Morbidity becomes increasingly evident under MRI with disease progression. Whole-body MRI represents an imaging modality with the capacity to detect early functional and structural complications in pre-diabetic patients, with greater precision for risk stratification.

A digital imaging examination can facilitate improvements in the healthcare ecosystem through its use in concierge medicine, employee and executive healthcare plans, and public wellness screenings. Successful large-scale adoption of this solution would provide an opportunity to test multiple hypotheses on biomarkers of health and disease, as well as facilitating affordable and accessible preventive and interceptive healthcare. This would lead to critical medical discoveries that could inform global policy decisions and have a significant impact on how healthcare is received.