Doctors are worried that running out of the element could threaten MRIs

A global helium shortage has doctors worried about one of the most essential, and perhaps unexpected, uses for natural gas: MRIs.

Strange as it may seem, the lighter-than-air element that gives balloons their buoyancy also powers vital medical diagnostic machinery. An MRI cannot operate without some 2,000 liters of ultra-cold liquid helium keeping its magnets cool enough to operate. But helium – a non-renewable element found deep in the earth’s crust – is running out, leaving hospitals wondering how to plan for a future with a much scarcer supply.

“Helium has become a big concern,” said Mahadevappa Mahesh, professor of radiology at Johns Hopkins School of Medicine in Baltimore. “Especially now with the geopolitical situation.”

Helium has been a volatile commodity for years. This is especially true in the United States, where a Texas-based federal helium reserve is shrinking as the government tries to transfer ownership to private markets.

Until this year, the United States relied on Russia to ease tight supply. A huge new facility in eastern Russia was supposed to supply almost a third of the world’s helium, but a fire last January derailed the timeline. Although the facility could resume operations any day, the war in Ukraine has essentially halted trade between the two countries.

Today, four of the top five U.S. helium suppliers ration the element, said Phil Kornbluth, president of Kornbluth Helium Consulting. These providers are prioritizing the healthcare sector by reducing helium allocations to less essential customers.

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“Helium is definitely allocated,” said Donna Craft, regional construction manager for Premier Health, which contracts helium suppliers for some 4,000 hospitals. “We probably don’t blow up balloons in the gift shop anymore.”

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Hospitals have yet to cancel patient MRIs or shut down the machines. They did, however, see helium costs rise at an alarming rate — perhaps as much as 30%, Kornbluth guessed. But with no end in sight for the helium shortage, the future of MRI remains uncertain.

“An essential commodity”

MRI, short for Magnetic Resonance Imaging, has been a staple of healthcare since the 1980s. The massive machines provide high-resolution images that allow doctors to see details in organs, bones and tissues which may not show up on X-rays.

“You get these sharp images and you can make out soft tissue,” said Dr. Scott Reeder, head of MRI at the University of Wisconsin School of Medicine and Public Health. “It’s at the heart of a lot of things we do in modern medicine.” MRIs help doctors diagnose brain tumors, strokes, spinal cord injuries, liver disease and cancer. 3D images, experts say, are irreplaceable.

Instead of relying on X-rays, which emit traces of radiation to look inside the body, MRIs use magnetic fields and radio waves. When a person is still inside the tube-like magnetic field, the atoms in their body align with strong magnetic currents. Pulses of radio waves then tell the machine’s sensors where the tissues are, and the machine restores its image.

MRI scanner at Altona Children's Hospital in Hamberg, Germany, Au,.  2022. (Marcus Brandt/dpa/picture alliance via Getty Images file)

MRI scanner at Altona Children’s Hospital in Hamberg, Germany, Au,. 2022. (Marcus Brandt/dpa/picture alliance via Getty Images file)

Keeping the magnetic current of a superconducting MRI requires extreme cold. That’s where helium comes in: With a boiling point of minus 452 degrees Fahrenheit, liquid helium is the coldest element on Earth. Pumped inside an MRI magnet, helium lets the current flow without resistance.

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“Helium is how the magnet exists permanently,” Mahesh said. “It’s an essential commodity.”

At any one time, an MRI machine contains about 2,000 liters of liquid helium, although suppliers must replenish any helium that evaporates. Mahesh estimates that an MRI machine uses 10,000 liters of liquid helium over its lifetime. (According to GE Healthcare, a maker of the machines, that lifespan is 12.8 years.) In 2015, there were approximately 12,000 machines in the United States, making MRI one of the largest consumers of helium in the world, far above balloon shops.

By contrast, spectators have about 400,000 cubic feet of helium to thank for hanging all the tractor-trailer-sized balloons in Macy’s Thanksgiving Day Parade. Converted to liquid form, this helium would only keep about two MRIs operational for their lifetime.

No quick fix

The problem is that no other element is cold enough for MRI. “There is no alternative,” said Craft, of Premier Health. “Without helium, MRIs should stop.”

Manufacturers like GE Healthcare and Siemens Healthineers recognize this vulnerability. “We are concerned about the shortages in the helium market,” said Ioannis Panagiotelis, marketing director of MRI at GE. “Every industry and hospital with an MR system has been affected.”

GE and Siemens are both developing MRIs that require less liquid helium. Siemens recently introduced one requiring only 0.7 liters and, according to Panagiotelis, GE has rolled out a machine “1.4 times more efficient than previous models”. These technologies are not widely available, however, and replacing the country’s 12,000 MRI machines – each weighing up to 50,000 pounds – is anything but a quick fix. Meanwhile, hospitals continue to install additional conventional MRI scanners to meet the demand for diagnostic exams.

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“The problem is that the shortage is getting so acute that we can’t install new scanners,” Reeder said. The University of Wisconsin, he said, plans to open a new cancer center with two MRIs. “When we install these systems, what will happen if there is no helium?”

Mahesh said Johns Hopkins is also adding another MRI to its fleet, and it will be the same “workhorse scanner” as its other 22 machines.

While doctors dread the worst possible scenarios, the scientists using liquid helium for research are already there. When vendors began rationing this summer, Harvard University physicists Amir Yacoby and Philip Kim shut down about half of their labs’ projects. On the other side of the country, the University of California, Davis reported that one of its helium suppliers had cut its allowances in half, including for medical purposes.

“Scarcity motivates us to find ways to do the same experiments without liquid helium,” Yacoby said. Forced innovation can predict what is to come for MRIs, and it may be a need, shortage or no shortage.

“There is only a finite amount of helium in the earth’s crust,” Kim said. “Once it evaporates, it’s completely lost in space.”

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