The Biggest Devices for the Smallest Kids

Author: Mag. Arne Johannsen | Photos: Georg Lembergh, Alexander Witsch

|2020-02-29

A large, bearded character, pediatric radiologist and amateur rock musician Professor Erich Sorantin from Graz stands up for equal rights of children in imaging – also in MRI. In terms of technology, he relies on precision equipment from Siemens Healthineers.

Whether it’s Maya the Bee or some other animated character, a talking car or fish – the pediatric radiology department at University Hospital Graz lets the children1 decide. The chosen movie is then not only projected onto the MRI system itself but is also shown on a large screen. Thanks to a head mirror, the young patient can continue to watch the movie even during the examination.

And this is just one of the special features offered by Professor Erich Sorantin and his team. "The empathy shown by the entire team is key," says the experienced pediatrician and radiologist. This means taking the time to explain to the children what exactly happens during an MRI examination and how it is performed. No one is called up over loudspeaker, each child is met personally in the waiting room.

The demands on a pediatric radiology are high and extremely diverse. Children aged from birth to 18 years are examined, sometimes older and sometimes even before birth. “We also provide pregnant women with diagnoses of malformations in babies still in the womb,” explains Professor Sorantin. Patients with specific diseases such as congenital heart disease or cystic fibrosis continue to undergo scans even after the age of 18, when they are no longer children.

The most common cases in the infant radiology department at Graz are follow-up care for childhood cancer, sports injuries involving the muscles or bones, epilepsy, and other disorders of the central nervous system, as well as vascular malformations. And the instruction is always the same: lie still, stay calm, do not panic in the bore even if the examination takes longer than 30 minutes, which can often happen. “This is almost impossible for children under four,” says chief radiology technologist Sabine Pfandl. That's why the department dedicates two days a week to examinations under anesthetic.

Adapted from Waldemar Bonsel's "Maya the Bee"
Adapted from Waldemar Bonsel's "Maya the Bee" © Studio100Media.
Courtesy of Studio100Media, Munich, Germany

Nevertheless, not every problem can be solved with sedation. “Depending on the age of the infant, the delivery of oxygen varies, which again affects the image quality at certain sequences,” Pfandl explains. Even the cardiac rhythm of an extremely young heart is a challenge: “The heart of a newborn beats twice as fast as an adult heart,” says Professor Sorantin, “the scan therefore requires a significantly higher temporal resolution.”

His conclusion after many years working as a pediatric radiologist: “The smallest kids need the biggest devices.” Unfortunately, this has not yet been recognized everywhere, which is why Sorantin is committed to equality in all circumstances. “It is still the case that the right to be imaged increases with body weight, which is complete nonsense."

Patients from various age groups and weight classes (in infant radiology from 3 kilograms up to 160 kilograms), examinations from brain tumors to deformation of the urinary tract, the consideration of implants of any kind – the variety of services provided is a challenge for the technology, as well. While looking for the best solution, Professor Sorantin found what he was needed at Siemens Healthineers – more precisely in MAGNETOM Sola, a 1.5-tesla MRI scanner. “Siemens Healthineers was the only supplier that met all of our requirements,” says the technology and DIY fan, who is reluctant to accept anything less than perfect.

In addition to its 70-cm open bore design and a respiratory sensor, MAGNETOM Sola also offers two new sensors: the Beat Sensor2 is seamlessly integrated into the new Body Coil and automatically detects motion of the heart. This eliminates the time-consuming and unpleasant process of attaching electrodes to the skin, especially for children," comments Pfandl on the great advantage of "a very large improvement when it comes to patient comfort.” “Moreover, Siemens Healthineers is one of the few suppliers that provides hardware and software acceleration algorithms for a whole range of sequences,” adds Professor Sorantin.

Along with the performance of the device, practical considerations literally carry weight. An MRI system like this has an empty weight of five tons. "You have to think very carefully about how the device gets into the room and whether the floor can support it,” says Professor Sorantin.

But in the end, it always comes back to empathy; sometimes even combined with a firm hand: “Although parents can stay with their child during the MRI examination,” says Professor Sorantin, “sometimes it’s better to send them out because they are often more nervous than their child.”

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