Diagnostic imaging: sustainability and innovation go hand in hand

The diagnostic imaging market is experiencing steady growth. According to Mordor Intelligence, the value will grow by 4.18% per year between 2025 and 2030, reaching $60 billion. As investment increases, the industry faces unprecedented pressure to reduce energy consumption, optimize the use of critical resources like helium, and comply with increasingly stringent regulations on the environmental impact of devices.

Emerging solutions include permanent magnet MRI systems, which eliminate the need for liquid helium, AI that can reduce examination times by up to 60%, and circular economy models for refurbishing medical equipment. 

“Permanent magnet MRI systems (medium field, 0.2-0.4 tesla), a field in which we are pioneers, represent an environmental breakthrough”, explains Giacomo Pedretti, Esaote’s Marketing Manager. “These systems require no helium (whereas a traditional MRI consumes around 2,000 liters a year - Ed.) and reduce energy costs by 90%,” 

Originally designed for musculoskeletal diagnosis, these solutions differ from conventional high-field MRIs with superconducting magnets (1.5 tesla as a hospital standard or 3 tesla for certain purposes requiring greater detail, such as neuroimaging and advanced research) also due to their “sustainable” nature. A sustainable approach therefore suggests that conventional MRI, which consumes ten times more energy and uses scarce resources such as helium, should only be used for those examinations, typically in hospitals, that require them - such as high-resolution oncology imaging. 

In most clinical settings, however, musculoskeletal examinations are among the most common. Here, permanent magnet MRI systems are more appropriate, they offer excellent diagnostic quality at a lower operating cost, thus meeting the requirements in terms of diagnostic efficiency and cost per examination. With the latest innovations, these systems are also gaining ground in neurology (for claustrophobic patients) and interventional radiology. They offer several advantages: they are less expensive to install and operate than superconductive scanners, making them more accessible to hospitals and clinics with limited budgets. This makes these MRI systems the optimal solution in countries where access to energy is limited.
“When we developed and launched the first open MRI system in 1992,” Pedretti explains, “no such system existed on the global market. As far as the concept is concerned, we were guided by the need to help those who suffer from claustrophobia and who, for this reason, cannot undergo examination in a closed system (in the so-called “tube”). For example, children undergoing an MRI scan often require anesthesia due to their fear of confined spaces. With an open MRI, this is no longer necessary”. 

“Today,” he continues, “open MRI systems are also proving valuable results in the evaluation of neurological conditions because of their ability to acquire images of both healthy and pathological tissue with differential contrast. In general, low-field neurological MRI is performed primarily for screening purposes and as an initial evaluation of the most common brain disorders, such as trauma, headache, and cognitive impairment”. 

Open MRI systems are also increasingly used for interventional purposes, thanks in part to their lack of ionizing radiation. 

This is a clear example of how environmental sustainability and improved access to diagnostics go hand in hand.

Looking ahead, research is progressing and promises to deliver major innovations in the sustainability field by 2030.

Magnesium diboride (MgB₂), a superconductor with relatively higher operating temperatures than conventional materials such as NbTi and Nb₃Sn, could reduce helium consumption in conventional high-field MRI by up to 70% by 2030. This is possible by reducing the need for cryogenic cooling, with the prospect of developing closed-loop systems or alternatives such as hydrogen cooling. In addition, MgB₂ is less expensive and could make high-field magnets more affordable.

At the same time, using graphene in permanent magnets could increase the field strength up to 0.5 tesla, improving the image quality of mid-field resonances. Due to its high conductivity and mechanical strength, graphene has the potential to reduce weight and production costs compared to traditional materials such as neodymium or samarium cobalt. This could expand the use of MRI systems into larger settings such as ambulances, primary care clinics, and remote areas, where it is currently limited.
Artificial intelligence is playing a growing role in the industry, from shortening scan times to optimizing energy and resource consumption.

Some of the most advanced developments include the use of AI-based algorithms (deep learning or deep neural networks) and signal processing techniques for data reconstruction such as Compressed Sensing.

Compressed Sensing techniques make it possible to obtain high-quality images by acquiring only a portion of the necessary data and then using advanced mathematical models to reconstruct the missing information. This results in a 20-50% reduction in scan time, leading to a decrease in energy consumption and improved comfort for the patient.

This is supported by studies starting with Lustig et al. (2008); see also Hirsch et al. (2020) and the most recent (2024) Reducing the Energy Consumption of Magnetic Resonance Imaging and Computed Tomography Scanners: Integrating Ecodesign and Sustainable Operations from the American National Renewable Energy Laboratory (NREL).

Deep neural networks, on the other hand, are trained on huge datasets of MRI images and can reduce scan times while reconstructing images with less noise and greater detail, making it possible to use MRI with an even lower magnetic field than conventional ones.

At the ECR Congress held in Vienna in March 2025, Esaote unveiled the “e-SPADES” AI platform, developed in collaboration with the Amsterdam University Medical Center and AIRS Medical, which can reduce total examination time by up to 60% compared to conventional scan time, while delivering unprecedented image quality. 

Artificial intelligence is also critical in image post-processing, where it can improve resolution, enhance anatomical detail, and reduce motion artifacts, a common problem with pediatric patients or those who have difficulty standing still. This is particularly useful in the field of neurology, where AI enables the early detection of brain injury, stroke, and neurodegenerative diseases with unprecedented accuracy. This is another benefit that comes with inclusivity and accessibility.

Artificial intelligence is paving the way for automated diagnosis, with systems capable of autonomously interpreting MRI images and providing radiologists with advanced decision support. In the future, this could lead to significant improvements in reporting times, increased diagnostic accuracy, and increased accessibility of MRI, even in settings where there is a shortage of specialists.

European regulations are increasingly driving manufacturers to prioritize sustainability.

EU Regulation No. 2017/745 on medical devices (Medical Device Regulation, “MDR”) imposes not only increased safety and performance requirements but also increased responsibilities on all players in the supply chain. In view of the restrictions on hazardous substances imposed by the REACH regulations, this approach is prompting the gradual elimination of compounds, including phthalates, PAHs, and heavy metals, from electronic components. REACH regulates the registration, evaluation, authorization and restriction of chemicals, requiring manufacturers to report the use of certain substances and to ensure that they do not pose a risk to human health or the environment. “We decided to develop a Life Cycle Assessment - LCA platform to efficiently manage the great complexity of exchanging information with the supply chain promptly” explains Massimo Polignano, Esaote’s Chief Quality Officer.

The WEEE Directive 2012/19/EU also requires manufacturers to ensure that 95% of materials in end-of-life equipment are properly disposed of, encouraging modular designs that make repairs and upgrades easier.

ISO 14001 certification for environmental management systems is being adopted by a growing number of manufacturers, while initiatives such as the “Manifesto for Sustainable Molecular Imaging” of the Italian Association of Nuclear Medicine and Molecular Imaging promote appropriate use by means of validated clinical guidelines.

These also include EN 60601, a series of international standards that define essential requirements for the safety and essential performance of medical devices, including aspects of electromagnetic compatibility and environmental sustainability, and EN ISO 14971, which provides guidance on the application of risk management to medical devices to help manufacturers identify and control potential risks associated with using their products. But also: IEC62304, concerning Software life cycle processes; IEC62366-1 usability engineering and ISO10993 for biocompatibility.

Transitioning to sustainable medical imaging requires a systemic approach, one that integrates technological innovation, regulatory compliance, and cultural change through close collaboration between the public and private sectors.

While solutions like AI optimization and permanent magnets offer immediate benefits, the real challenge lies in redefining organizational models to strike a balance between accessibility, diagnostic accuracy, and environmental responsibility. Integrating ESG criteria into business strategy can create competitive advantages, paving the way for a paradigm where sustainability and medical innovation become synergistic rather than antithetical.