Advanced Ultrasound and MRI Coming to the Region in 2011

In 2011, Leonen, Newsletter, Volume 3 Issue 1 by Addison Clark

3D/4D ultrasound advancements, and a powerful 3 Tesla (3T) magnetic resonance imaging (MRI) unit, will be introduced to the Fredericksburg area in 2011 through the combined efforts of Mary Washington Healthcare and Radiologic Associates of Fredericksburg (RAF). Both technologies will provide more detailed images for diagnosis and treatment, and will reduce patient exam times, said Ed Swager, CEO of RAF.

3D/4D Ultrasound

In addition to serving Mary Washington Healthcare’s two local hospitals and their own private vascular center, RAF physicians provide radiology services to four outpatient imaging centers that are part of Medical Imaging of Fredericksburg (MIF): MIF on the Mary Washington Hospital campus, the Imaging Center for Women, Medical Imaging at Lee’s Hill, and Medical Imaging of North Stafford. MIF facilities are converting their 14 2D ultrasound units to 3D/4D units this year and adding another 3D/4D unit.

Compared with the relatively flat appearance of 2D ultrasound images, 3D shows depth and contours within the body, revealing a virtual anatomical view, while 4D delivers real-time, dynamic images. According to Swager, the new technology offers several distinct benefits:

  • Enhanced imaging of abnormalities in fetal hearts, bones, and the placenta; gynecological cysts; tumors; conditions affecting the kidney, liver, or bowels; and many diseases. Enhanced images not only aid referring physicians in diagnosing conditions and patients in visualizing their disease; they can improve treatments in several medical specialties.
  • More comprehensive images than 2D ultrasound, enabling studies with more clinical information to be performed in less time, reducing patient wait times.
  • Accelerated workflow, using software that automatically captures existing patient data so less re-keying of patient information is needed.

[box] “…this technology
helps physicians
guide exact needle placement
to a level not experienced before.”[/box]

“3D/4D ultrasound can determine the volume of breast tumors more precisely, and skin tumor infiltration to better define the margins of a tumor,” Swager noted. “When used during biopsies, this technology helps physicians guide exact needle placement to a level not experienced before. That’s a real advantage.”

Swager added that while some local businesses offer 3D ultrasound of fetuses as “keepsake” images for expectant parents, outpatient imaging facilities served by RAF provide 3D/4D ultrasound only for diagnostic and treatment purposes. The long term affects of ultrasound on a fetus have not yet been fully evaluated. In addition, the American College of Radiology and U.S. Food and Drug Administration do not support the use of ultrasound images for anything other than healthcare purposes.


Medical Imaging at Lee’s Hill has the area’s only true open MRI. Now, adding to the open MRI and existing complement of 1.5T MRI systems, MIF will go live with the latest in 3T MRI technology and suite design. The 3T, now being installed at MIF on the Mary Washington Hospital campus, will be the most powerful of its kind between Richmond and Northern Virginia.

“The 3T provides faster scans with greater detail of patient anatomy and disease,” Swager said. Because current MRI quality is already above an acceptable level, 3T can be used to reduce imaging time by half compared with the 1.5T MRI. This can be important when imaging a patient who is in intense pain and has difficulty lying still, for example. When improved image quality is a greater concern, as in certain brain studies and musculoskeletal studies of the knee, 3T can provide twice the imaging detail in the same time as a 1.5T MRI scan. 3T MRI studies also can be adjusted to provide both benefits, for example, 50% improvement in detail in 50% less time.

3T also minimizes the brightness of body fat, which can hide an abnormality. The more detailed images possible with 3T enable patients to receive less contrast agent, an advantage when imaging patients with renal failure or similar conditions, Swager noted.

One particularly intriguing feature of the 3T MRI, that MIF will be installing, is its “propeller” software. “Patients are frustrated when motion interferes with a study,” Swager said. “If any part of the body moves in the scan, the propeller software compensates for the movement to remove or reduce the effect of motion on the image.”

This feature will be especially useful when image quality is affected by the movement of young children and those whose conditions prevent them from remaining still.

Referring Physician Technology

RAF is leveraging technology advances not only for patient imaging, but also for more effective, efficient communications with referring physicians, Swager said.

For example, RAF in collaboration with Mary Washington Healthcare information services is implementing the Primordial application at referring physicians’ offices that request it. The application provides referring physicians live, on-line communication with RAF radiologists, regardless of the hour, to discuss imaging findings, procedures, and questions. The application can also be set up to schedule appointments at imaging centers.

Referring physicians who would like to view an online tutorial about the system can visit

For more information, contact Ed Swager at or call him at (540) 361-1000.


Pictured above is RAF Radiologist Ryan P. Leonen, MD, uses an ultrasound with current 2D imaging capabilities. The units will be converted  to 3D/4D capabilities this year.