Report our experience launching Hyperfine portable bedside low-field magnetic resonance imaging (pMRI) in our academic comprehensive stroke institution.

The Hyperfine pMRI (0.064 Tesla) was FDA approved in 2020. pMRI has been studied in ICU settings, and there’s interest in expanding this technology in floor level status stroke patients.

Report our institutional experience launching pMRI in non-ICU settings. From September 2021 to March 2022, 24 pMRI scans were performed. Our pMRI protocol includes localizer, DWI/ADC, and FLAIR (24 minutes).  Good head position (GHP) was defined as the vertex abutting the top of helmet insert. Complete scans were defined as including all sequences and Partial scans included DWI/ADC.

Among 24 scans, 17/24 (70.8%) were Complete and 2 scans aborted after localizer. Five scans were Partial due to discomfort in 4, and 1 technical issue. Among 22 Partial or Complete scans, 6 scans had poor head positioning. We noted that although initial GHP, the head could shift out due to gravity or patient self-adjustment from discomfort. The shift issue was combatted by placing bed in slight reverse Trendelenburg. Wedge padding was implemented to improve lower back comfort. After scan #11, re-training was performed to include GHP updates.  Before re-training, 6/11 (45.5%) had GHP, and afterwards, 11/11 (100%) had GHP. Our quality review also noted DWI/ADC artifact mimicking restricted diffusion could be seen in the internal capsule and corpus callosum.

pMRI use in non-ICU settings is feasible. Our institutional QI experience suggests that patient selection and technical skill in GHP is a consideration. After protocol adjustment, GHP rate increased from 45% to 100%.  Clinical teams also need to be aware of artifact mimicking restricted diffusion in areas of tightly bound white matter tracks. Further studies are warranted to maximize pMRI and understand the logistical barriers to successful implementation.