Imaging Innovations Are Off to the Races

Digital motion x-rays. Pocket-sized ultrasound scanners that plug into smartphones. Open, rotating MRI machines.

While most recent imaging innovations are related to advanced software solutions such as improved scanning techniques or machine-learning technologies, hardware is also becoming more versatile in enabling many clinical applications that were previously difficult to address.

Humans are certainly benefiting from these innovations, but as it turns out, so are horses. Leg injury and lameness have always been a major concern for dedicated horse owners. Accurate orthopedic diagnoses are difficult to make from external examinations alone. Standing limb imaging was historically limited to ultrasound and radiography, with advanced imaging modalities, (MRI and CT), only performed on horses in a laterally recumbent position. The clinical benefit of which was often outweighed by the increased danger posed in the requirement for general anesthesia, which carries inherent complications in an animal the size of a horse.

Horse owners, veterinarians and scientists collaborated to find a better way. As one of the early pioneers in the field, Dr. Nick Bolas contributed to the development of the world’s first MRI scanner for standing horses. He and the award-winning company, Hallmarq Veterinary Imaging, installed the first standing equine MRI scanner in the UK in 2003 and made a major change in the hardware in 2007, transforming image quality.  This technological breakthrough means that horses need only be lightly sedated, so they’ll remain still, while the MR scanner captures anatomical images in the natural standing position.  The result is that the use of Hallmarq’s standing equine MRI can help identify the specific cause of lameness in over 90% of cases, where MRI is appropriate.

Since then, they have continued to collaborate with users to improve the system with yearly software upgrades provided to over 100 systems installed across the globe. For example, imaging sequences are carefully optimized in association with their users before release, and all systems have the same sequences. This contrasts with many human scanners which have many adjustable parameters. In this way, it is not only easier to pick an appropriate sequence, but all Hallmarq sequences are the same, so it is easier to learn how to interpret them and compare images from different sites.

Of course, increasing access to an MRI scanner can present a challenge. So Hallmarq innovated to reduce those barriers allowing for a subscription program, modular room option and an unparalleled comprehensive support program around the system.

The modular installation can be set up within an existing building or outside within a movable container.

Room configuration
Room configuration

Module configuration - exterior
Module configuration – exterior
Module configuration - interior
Module configuration – interior

Instead of purchasing the system outright, clients pay for a single use case or a longer-term subscription service. “Our technology makes MRI accessible both in price and geographical location to a far larger number of horse owners than the previous versions of MRI were able,” says Dr. Bolas. “Technically, we have tried to make both its use and image interpretation as simple as possible. All imaging parameters are optimized and specific to horses, as opposed to being repurposed from human MRI applications.”

Dr. Steve Roberts, Hallmarq’s CTO, emphasizes the importance of comprehensive customer feedback and incorporating state-of-the-art computing technologies. “Our main aims have been to reduce scan times, continue improving the image quality, add additional scanning options, and simplify the user experience.” He adds that while some veterinarians are hesitant to introduce advanced technology in their practice, they appreciate the clinical benefits to their clients, and take advantage of the remote interpretation support they receive from radiologists as an extension of their services. The operators also benefit from Hallmarq’s unique remote monitoring software that enables proactive service and co-piloting of their system – giving them additional confidence in running the system.

Technological advancements in medical imaging are so abundant that it may seem, at times, like a race. Ultimately, the end goal is to deliver high-quality imaging services to benefit patients, whether they walk on two legs or four.

Co-Author: Lynn Bender (

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