Operational Costs of 4D Flow MRI: A Break-Even Analysis

Aortic hemodynamics derived from MR angiography (MRA) with four-dimensional flow MRI (4DF) have shown many advantages for risk stratification and treatment planning. However, clinical adoption has been limited to academic medical centers due to high costs, long scan and post-processing times, and low reimbursement. We quantify the initial profit margins and breakeven points under case scenarios of MRA only and MRA + 4DF for a theoretical community imaging center with one MR scanner and one post-processing software license based on estimates for costs, resource utilization, and reimbursement. Our calculations can be used by centers considering adopting 4DF. We show that long scan times and high resource utilization limit the financial viability of MRA+4DF outside of high-volume academic medical centers. Additional efforts are needed to incentivize adoption in community settings, including accelerated 4D flow imaging techniques to minimize scan times and higher reimbursement rates.