What Is an Open MRI?

An open MRI is a magnetic resonance imaging scanner designed with an open architecture — either a C-shaped or wide-bore configuration — that reduces the enclosed, tunnel-like feeling associated with traditional (closed-bore) MRI machines. Instead of lying inside a narrow cylindrical tube, patients in an open MRI system have more visual and physical space around them, making the procedure more tolerable for people who experience claustrophobia, anxiety in confined spaces, or discomfort in standard scanners.

Traditional MRI scanners use a narrow cylindrical bore — typically 60–70 cm in diameter — that surrounds the patient completely during the scan. For many people, this is fine. But a meaningful portion of the population finds the enclosed space distressing enough to require sedation or to decline the scan entirely. Open MRI systems were developed specifically to address this limitation. The tradeoff is magnetic field strength: open systems generally operate at lower field strengths than standard closed scanners, which affects image resolution and diagnostic capability for certain clinical applications.

Understanding what an open MRI can and can't do — and when it's the right choice versus when a standard scanner is necessary — matters both for patients making decisions about their care and for MRI technologists and radiologists who work with different scanner types. The MRI machine guide covers the full range of scanner types and how magnet design affects clinical performance.

Types of Open MRI Systems

Open MRI isn't one single design — it describes a category of scanners that share the goal of reducing patient enclosure. The two main configurations each have different clinical implications.

True open (C-shaped) MRI uses a vertically oriented magnetic field generated by two horizontal magnet plates — one above and one below the patient — with open sides in all four directions. Patients lie between the magnets with unobstructed views to either side. This design provides the most open experience and is best for patients with severe claustrophobia, large body habitus, or patients who need a companion present during the scan.

The limitation is field strength: true open systems typically operate at 0.3–0.7 Tesla, compared to 1.5T or 3T for standard closed systems. Lower field strength means longer scan times and lower signal-to-noise ratio, which can reduce image quality for complex diagnostic tasks like brain tumor characterization or small joint evaluation.

Wide-bore MRI maintains the cylindrical tunnel design but uses a larger bore diameter — typically 70 cm versus the standard 60 cm — and a shorter tunnel length. Wide-bore systems can operate at 1.5T or 3T field strengths, providing full diagnostic image quality while accommodating larger patients and those with mild-to-moderate claustrophobia. Wide-bore systems are a common compromise in clinical practice: they're significantly more comfortable than standard closed systems while maintaining the image quality needed for most diagnostic applications. Most major scanner manufacturers (Siemens, GE, Philips) offer wide-bore 1.5T and 3T systems as standard product lines.

Open MRI Cost and Insurance Coverage

Open MRI pricing varies considerably by region, facility type, body part scanned, and whether gadolinium contrast is required. Without insurance, cash-pay prices typically range from $500 to $1,500 for common studies — lumbar spine, knee, shoulder, brain. This is generally comparable to or slightly higher than equivalent studies at closed-bore facilities, because the capital cost of some open MRI systems is higher per field-strength unit than conventional designs.

With insurance, MRI imaging benefits typically apply regardless of whether the scanner is open or closed — your plan covers an MRI scan, not a specific scanner type. However, there are a few insurance-related considerations specific to open MRI. First, the imaging center must be in-network for your plan. Open MRI facilities are sometimes smaller independent practices rather than large hospital radiology departments, which may affect in-network status.

Verify network participation before scheduling. Second, some insurance plans require prior authorization for MRI, and the authorization is typically for the anatomical region and clinical indication — not for a specific scanner type. Your ordering provider should be able to obtain authorization that applies to an open MRI scan.

Medicare covers MRI scans when medically necessary regardless of scanner type. For Medicare beneficiaries, the distinction between open and closed MRI shouldn't affect coverage determination. Medicaid coverage varies by state but generally mirrors Medicare's approach. If you're covered by Medicaid and are seeking an open MRI specifically for medical necessity reasons (e.g., you cannot complete a standard scan), document the clinical rationale clearly in the ordering provider's notes — this strengthens the coverage justification.

Cash-pay and self-pay rates at dedicated outpatient imaging centers are often significantly lower than hospital-based radiology departments, which carry higher facility fees. If you're paying out of pocket, call multiple imaging centers in your area for cash-pay pricing. Many facilities offer prompt-pay discounts or financial assistance programs for uninsured or underinsured patients.

Imaging center prices for the same study at the same location can vary by $500 or more depending on whether you use insurance billing versus cash payment — it's worth comparing. Some open MRI facilities also offer shorter scheduling wait times than hospital-based radiology departments, which can matter when a diagnosis is time-sensitive.

The cost-sharing calculation matters for some patients: if your deductible is high and you've already met it for the year, in-network imaging is essentially free at the point of service. If you haven't met your deductible, you're paying the contracted rate until you reach the threshold. For high-deductible plan holders who haven't met their deductible, cash-pay rates at outpatient imaging centers sometimes beat the insurance-contracted price. Run the numbers for your specific situation before assuming insurance always saves money on imaging.

Open MRI vs. Closed MRI: Image Quality and Clinical Applications

The central tradeoff between open and closed MRI is field strength — and field strength directly affects image quality. Higher field strength generates stronger signal, which translates to sharper images, faster scan times, and better performance on demanding protocols like spectroscopy, perfusion imaging, and high-resolution joint or brain imaging.

For many common clinical applications — knee and shoulder arthroscopy planning, lumbar spine evaluation, routine brain screening, pelvis and abdomen imaging — a 1.5T wide-bore system provides fully adequate diagnostic image quality that a radiologist can interpret with confidence. For specialized applications — small lesion characterization, brain tumor staging, fetal MRI, cardiac MRI, prostate cancer staging with multiparametric protocol — a 3T closed system provides meaningful advantages that may affect diagnostic confidence and clinical decision-making.

Radiologists reading scans from lower-field open systems are accustomed to adjusting their interpretation accordingly. They know the tradeoffs of the system and account for the inherently lower signal-to-noise ratio in their evaluation. In many community radiology settings, 0.7T or 1.0T open MRI is used for routine musculoskeletal and neurological screening because it's adequate for the clinical question being asked and serves a patient population that couldn't complete a closed scanner exam.

When a specific clinical question genuinely requires higher field strength — suspected small pituitary adenoma, multiparametric prostate MRI, certain cardiac MRI protocols — the ordering physician or radiologist may recommend a standard closed 1.5T or 3T system despite a patient's preference for open MRI. In these cases, anxiolytic medication (a short-acting benzodiazepine) before the scan is often a practical middle ground for claustrophobic patients who need the diagnostic quality of a closed system. The decision should be made collaboratively between the patient, ordering provider, and radiologist based on what diagnostic information is genuinely needed.

Metal implant considerations apply equally to open and closed MRI. MRI safety screening — checking for ferromagnetic implants, pacemakers, cochlear implants, and other contraindicated devices — is required regardless of which type of scanner is used. The open architecture of the scanner doesn't change the fundamental physics of RF energy and magnetic field interactions with implanted devices. Safety screening protocols are identical.

What to Expect During an Open MRI Scan

The preparation and process for an open MRI is similar to a standard MRI, with a few differences that reflect the different scanner design. Before the scan, you'll complete a standard MRI safety screening questionnaire — asking about implants, pacemakers, aneurysm clips, metal fragments, and other contraindications. You'll change into a gown or wear metal-free clothing. If your scan requires contrast, an IV line will be placed before you enter the scan room.

In a true open (C-shaped) system, you'll lie on a table that slides between the two magnet plates. The sides remain open, giving you a clear view of the room and the MRI technologist. Some true open systems are designed for upright scanning, in which case you'll sit in a chair positioned between the magnets. In a wide-bore system, you enter a larger-diameter tunnel — the overall experience is similar to a standard MRI but with noticeably more room around you.

MRI scans produce loud rhythmic knocking and buzzing sounds from the gradient coils during the imaging sequences. This is the same in open and closed systems — earplugs or headphones are provided. Open systems may be slightly quieter because the gradient coils are less tightly configured, but the acoustic signature is similar. If you have noise sensitivity in addition to claustrophobia, communicate this to the technologist in advance.

Scan times for open MRI may be longer than equivalent closed-system protocols. Lower field strength requires longer acquisition times to accumulate adequate signal. A lumbar spine exam that takes 30 minutes in a 3T closed scanner might take 45–60 minutes in a 0.7T open system. This is normal and expected — it doesn't indicate a problem. Understanding this before your appointment helps you come prepared to lie still for a potentially longer exam than you might expect.

After the scan, there's no recovery time and no restrictions unless contrast was used (in which case you'll typically be observed for 15–20 minutes before discharge). Results are read by a radiologist and sent to your ordering provider, typically within 24–48 hours for routine studies and within hours for urgent clinical situations.

If you're nervous about your upcoming scan, call the imaging center ahead of time. Many radiology departments offer pre-scan phone consultations where a technologist walks you through exactly what will happen — the sounds, the duration, when you'll need to hold still, and what options you have if you feel uncomfortable mid-exam. Knowing there's a clear exit strategy (you can stop the scan at any point) helps many patients complete the exam without anxiety. Open MRI facilities are often more experienced with anxious patients than high-volume hospital radiology departments and may have more time to accommodate individual needs.

Open MRI for MRI Technologists: What You Need to Know

MRI technologists working with open systems face specific technical and patient care considerations that differ from standard closed-bore practice. Understanding these nuances is part of ARRT MRI certification content and is practically important for technologists rotating between different scanner types in a multi-modality imaging department.

Field homogeneity — the uniformity of the magnetic field across the imaging volume — is more challenging to achieve in open magnet designs than in closed superconducting systems. Lower homogeneity increases susceptibility artifacts and can degrade image quality for fat suppression techniques, susceptibility-weighted imaging, and spectroscopy. When setting up protocols on open systems, technologists may need to adjust acquisition parameters — longer repetition times, different bandwidth settings — to compensate for field characteristics that differ from closed-bore scanners.

Gradient performance on open MRI systems is generally lower than high-field closed systems, meaning gradient slew rates and maximum gradient amplitudes are reduced. This extends minimum echo times and limits certain ultra-fast pulse sequences (e.g., EPI-based DWI or fMRI) that rely on fast gradient switching. For diffusion-weighted imaging specifically, open systems may produce more geometrical distortion and lower resolution compared to 1.5T or 3T closed systems — something technologists should document and radiologists should account for in interpretation.

Patient communication and positioning are especially important in open MRI work. Open system patients are often anxious about their imaging experience — they've specifically sought out open MRI for a reason, which means patient-centered communication is critical.

Explain the sounds, tell the patient what to expect at each step, give them a means to communicate (squeeze ball or intercom), and check in at regular intervals during long protocols. Scan time in open systems is often longer due to lower SNR efficiency, and patients who are slightly anxious may become significantly distressed if they're left without communication for a 45-minute lumbar spine exam.

Coil positioning in open C-shaped systems requires different techniques than closed-bore work. Some surface coils designed for closed systems don't function correctly in the vertically oriented field of a true open magnet. Technologists must use coils specifically designed or validated for their scanner model. Positioning aids and foam supports are also essential in open systems since patients often have more freedom to shift position — maintaining reproducible positioning for comparison studies or interventional procedures requires deliberate setup.

The MRI scan guide covers scanning protocols across multiple body regions in more detail. For technologists preparing for the ARRT MRI certification exam, open MRI content appears primarily within the magnet design and physics sections rather than as a standalone topic — understanding field strength implications, gradient limitations, and artifact patterns in different magnet configurations is part of the core physics curriculum.