A Closer Look at the NFL Combine
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Running the Numbers
Neurognostics and Medical Numerics Join Forces for fMRI
MRI Suite Safety Found in Four Zones
Siemens, IMRIS Offer Ceiling-Mounted MRI

A Closer Look at the NFL Combine

by Dana Hinesly

Mike Bortone, RT, (standing) demonstrates the 3T MRI scanner with the help of "patient" Jim Braswell, RT.

For National Football League (NFL) hopefuls dreaming of a career under the stadium lights, the biggest hurdle to success might not be their on-field stats. Every year, the NFL invites a select group of college players for intense medical, physical, and psychological evaluations known as the NFL Combine.

The 2006 Combine marks the 20th year it has been hosted by Methodist Hospital (Indianapolis), a member of Clarian Health Partners.

"It used to be that if teams were interested in a college player, they would test him individually," said John Dickey, radiology manager at Methodist Hospital. Dickey oversees the coordination of all diagnostic testing at the hospital and has been involved with the Combine since its beginning at Methodist Hospital. "It reached a point where a player would travel to five or six different cities, having the same tests done over and over, until the NFL finally decided to have players tested at one place and provide all teams with the same information."

Prior to settling on Indianapolis, the Combine would travel from city to city. In 1987, the Indianapolis Colts hosted the event with such efficiency that NFL administrators decided the Combine should stay put. Since then, the week after the NFL Pro Bowl finds Methodist Hospital's staff bracing itself for 4 long days processing athletes from across the country.

Although it started small—the first year's Combine produced only three MRIs—the event's growth has been substantial. This year, 330 athletes were examined, and 348 MRIs were performed.

Imaging studies account for only part of a rigorous physical to which each athlete is subjected and are performed only on individuals who have suffered an injury at some point in their football careers.

"Any time a player has any sort of musculoskeletal injury or neurological injury, we're going to check that out very, very closely," said Dickey, who notes that the nature of the sport translates to some sort of imaging exam being performed on almost every contender. "We very seldom do an MRI on the kickers, because they don't have as much contact, but that's about the extent of it, because everybody else gets pretty beat up."

Performing MRIs on these highly conditioned men presents some unique complications. "The biggest challenge we have is that a lot of the players are just huge human beings, so we find it very difficult to get them into the scanner, which compromises our ability to perform these diagnostic tests," Dickey explained. Many of the players also struggle with claustrophobia, so some of them are examined using one of the hospital's open magnets.

Numeric values are assigned to the results from each exam, resulting in a cumulative score that enables the NFL team physicians and trainers to rate players, which helps determine the NFL's professional interest in them. Because results can change the course of each athlete's future, it is not uncommon for the MRIs, CTs, and x-rays to reveal a host of undisclosed injuries, such as knee, shoulder, neck, and back ailments.

"We also find things nobody had any idea about, something asymptomatic that could have caused problems later," Dickey said. "Just about every year, we discover things like lung and bone tumors and renal tumors—things the athlete didn't realize he had, but that will definitely change his draft status."

Each year, Methodist Hospital employs 14 different 1.5T MRI systems—manufactured by GE Healthcare (Waukesha, Wis) and Siemens Medical Solutions (Malvern, Pa). But this year's Combine helped break in the health care facility's new Magnetom Trio from Siemens Medical, a 3T magnet that came online the week before players started arriving. The hospital's scanner is the only 3T magnet in the state solely devoted to clinical use.

"We were hearing from our clinicians that they wanted us to upgrade to a 3T magnet, which definitely has some advantages as far as image quality," Dickey said. For example, the Trio produces higher-resolution scans for neurophysiology studies in less time than its lower-field counterparts. "We added the 3T to provide the highest-quality imaging available to our patients."

Read the ACR's report in full.

Siemens, IMRIS Offer Ceiling-Mounted MRI

Siemens Medical Solutions (Malvern, Pa) and IMRIS Inc (Winnipeg, MB, Canada) have signed a global original equipment manufacturer (OEM) agreement to incorporate IMRIS's iMotion—the company's ceiling-mounted surgical imaging systems that are used in neurosurgical, spinal, and soft-tissue procedures—into Magnetom Espree and Magnetom Symphony MRI Systems.

The ceiling-mounted Magnetom Espree with IMRIS iMotion is installed at three locations to date: Foothills Hospital in Calgary, Alberta; Children's Hospital in Boston; and Wilkes-Barre General Hospital in Wilkes-Barre, Pa (shown here).

"The magnet is suspended from the ceiling on an MRI-safe crane. The magnet can then be moved from room to room," explained Ed Gunning, marketing manager of cardiac and interventional MRI in the MRI division of Siemens Medical. This ability allows the advanced technology to be present in multiple locations. Additionally, the combination of Siemens Medical's diagnostic technology and IMRIS's surgical innovations help surgeons remove diseased tissue more efficiently, reduce damage to healthy tissue, and decrease visits to the operating room (OR) for subsequent surgeries.

Added IMRIS President David Graves, "The challenge of having an MRI system solely in the OR is that it can be costly and could take medical facilities years to recoup their investment. By offering a system that can be used in the OR as well as the diagnostic-imaging department, a facility can realize a significantly improved return on investment. This need is filled with iMotion by providing advanced MRI technology in either department at any time, in minutes."

IMRIS originally approached Siemens Medical for this partnership due to Siemens Medical's technology and system design, according to Gunning. The Espree became the system of choice because of the scanner's large opening (70 cm). The testing took place mostly in IMRIS's factory in Canada with assistance from Siemens Medical's staff.

—M. Said