Looking towards the future of MRI in Africa

Johnes Obungoloch: The low field MRI systems we are developing have a lot of potential – not as an alternative, but to fill the gap that traditional MRI systems cannot fill in African countries in the foreseeable future. This is an important distinction: low field MRI will be able to augment health care technology provision. There are also initiatives to acquire MRI systems. Most healthcare services should be provided by the government, but the private sector tends to take this over. Still, there are initiatives by different governments to acquire MRI systems. I think an important angle is how you get the technology to the people and how you make people aware of it. That is work that Udunna is doing with CAMERA and the current ISMRM African chapter.

Udunna Anazodo: A key part of CAMERA’s framework is advocacy. We are advocating to national governments, funding agencies, device manufacturers, and imaging communities to work together to make scanners more available and join us in training and retaining many local experts. We advocate to funding agencies who have provided long-term support to Africa to fund healthcare delivery, training, and research, to now fund MRI when they provide money to Africa. Most healthcare services provided by the government rely on funding from outside Africa to run, and these usually gets diverted to maternal and childcare, and infectious disease. But cancer, stroke, heart disease are at the bottom of the priority list. We have recently started a podcast [ to promote MR research and practice in Africa and give clinicians and researchers an opportunity to highlight their work.

CAMERA’s recent Scan with Me (SWiM) training program is another example of industry partnerships to upskill imaging technologists on best practices for image acquisition, including protocol optimization. Siemens Healthineers, Erlangen, Germany and Canon Medical Systems, USA provided free hands-on demonstrations to SWiM participants on how to acquire high quality images on their scanners, to close gaps in scanner application training. Thanks to this valuable vendor support, the SWiM technologists were able to adapt existing MRI protocols on their scanners and tailor them to produce high quality images at significantly shorter scan times (50% reduction in some cases), improving their clinical workflow and ability to provide care to more people. These scan protocols are available for anyone, anywhere in the world to freely use, particularly those in low-resource settings [ SWiM and other CAMERA training initiatives, such as SPARK, are not only linking device manufacturers and imaging software providers directly with health centres in Africa, but they are also more importantly connecting centres together and with basic scientists within countries and across the continent, to enable a collaborative environment for MRI to thrive. With this type of strong communication and collaboration, policies, and training solutions are feasible to advance MRI in Africa. For example, Dr Kwikima participated in SPARK and learned alongside radiology, neurosurgery, and oncology residents, as well physics and computer science students from 12 African countries on how to build AI models for brain tumour segmentation on MRI. The network established among disciplines and countries has spurred collaborative research including curation of larger brain MRI data for future AI applications and development of a recommended guideline for brain tumour imaging in Africa, which Dr Kwikima is leading.

Last year, the Own Your Future Mentorship (OYFM) program at CAMERA was established, to empower emerging clinicians and researchers to see a stable, steady career in MRI in Africa, which could help retain talent. OFYM is focused on radiology residents and fellows, and physicists and biomedical engineers interested in MRI. It taps into the network that CAMERA built including MRI experts across the world to help mentor and train a large pool of mentees. The program uses monthly seminar series and regular one-on-one mentoring to transfer clinical, physics (including research), and entrepreneurship skills. The goal is to guide early career clinicians and researchers to build and sustain successful careers within Africa, supported by the network of fellow mentees across the continent and imaging experts from around the world. Up to 80% of attendees to the seminar series reported improvement in their knowledge and skills on the topic. The one-on-one mentoring is set to begin this Spring, and a pilot run of the OYFM focused mentoring approach was successful completed and resulted in a recent publication on brain imaging between OYFM Mentee, Dr Afolabi Ogunyele, a radiology resident at a Nigerian teaching hospital, and OYFM Mentor, Prof. Vera Keil, a renowned Neuroradiologist from Amsterdam University Medical Center, The Netherlands⁶.

These initiatives will cumulatively improve MRI access in Africa, especially through retention of local expertise. People often leave Africa because they have been trained but can’t apply their knowledge because of problems with infrastructure. They go elsewhere where they can use their knowledge, typically in the Global North. CAMERA is committed to continue to train and mentor a critical mass of people in Africa who will be skilled to train others and form intra- and cross-country networks to sustain valuable MRI care in the region.

Ugumba Kwikima: Participating in the SPARK Academy really opened my eyes as a clinician. I gained a lot of knowledge regarding artificial intelligence in the diagnosis and management of brain tumours, and reading about AI now after gaining this knowledge has enabled me to brainstorm about new directions.