Health technology assessment of 3 Tesla vs 1.5 Tesla MRI to evaluate the impact of advanced imaging technology

Introduction: Magnetic Resonance Imaging (MRI) is a cornerstone of modern diagnostic radiology, offering detailed visualization of anatomical structures without ionizing radiation. Rooted in nuclear magnetic resonance (NMR) principles pioneered by Bloch and Purcell, and clinically advanced by Dr. Raymond Damadian, MRI has evolved significantly since its inception. While both 1.5 Tesla (T) and 3T systems are widely used, the latter promises superior imaging performance, albeit with higher operational demands and costs. This Health Technology Assessment (HTA) compares the diagnostic, technical, economic, and perceptual parameters of 1.5T and 3T MRI systems, particularly in the context of stroke imaging.Methodology: A mixed-method approach was employed. Quantitatively, 400 brain stroke MRI cases (200 for each modality) were analyzed using the T2 FLAIR sequence, focusing on Signal-to-Noise Ratio (SNR) and scan time. Non-parametric statistical methods (Wilcoxon and Shapiro-Wilk tests) were applied due to data non-normality. Additionally, a validated Likert-scale questionnaire was administered to 49 MRI technicians to assess perceptions on 10 parameters, using snowball sampling. A focus group discussion (FGD) with five radiologists explored qualitative insights regarding diagnostic value, workflow, and safety across modalities.Results: Statistical analysis revealed significantly higher SNR (mean 20.0 vs. 17.8; p < 0.001) and shorter scan times (mean 10.2 vs. 17.6 minutes; p < 0.001) with 3T MRI. Monthly scan volumes increased by 22.5% post-upgrade from 1.5T to 3T. Power consumption and operational costs were also higher with 3T, requiring enhanced electrical infrastructure and cooling systems. Technician feedback revealed high agreement on superior image quality and faster scan times with 3T MRI. However, lower scores were noted for patient comfort, contrast usage, and downtime. Median scores for key parameters such as diagnostic confidence and SNR were ≥ 4, indicating strong preference for 3T MRI. Thematic analysis of the FGD underscored diagnostic advantages of 3T in neurology and musculoskeletal imaging, tempered by concerns about RF heating, noise, and higher costs.Discussion: 3T MRI systems offer notable clinical advantages—higher image resolution, greater diagnostic accuracy, and improved efficiency. These are especially valuable in acute neuroimaging, where clarity is crucial. Despite higher installation and operational demands, the overall return on investment is supported by increased throughput and diagnostic confidence. Technician and radiologist feedback corroborate objective findings, though safety in patients with implants, and operational challenges like noise and RF heating, remain concerns.Conclusion The HTA supports the adoption of 3T MRI in tertiary care settings for its superior diagnostic and operational performance over 1.5T systems. While higher energy consumption, cost, and patient discomfort are valid considerations, the benefits in image quality and scan efficiency justify its strategic integration into advanced neuroimaging protocols. Balanced deployment, with continued use of 1.5T for certain patient subsets, is recommended to optimize clinical outcomes and resource utilization.