E2802. Workflow to Determine the MRI Safety and Compatibility of Implants and Medical Devices
Authors
Steffen Sammet;
University of Chicago Medical Center
Christina Sammet;
Rush University Medical Center
Background
The purpose of this exhibit is to give an overview on how to determine the MRI safety and compatibility of an implant or a medical device. MRI safety considerations when scanning patients with implants or medical devices includes the knowledge of MRI safety labeling for implants, medical devices and other equipment. Before scanning a patient with and implant or device the device information needs to be documented in the medical record and a consultation with a physician is necessary for any risk/benefit decisions. Even non-ferromagnetic implants can cause heating due to eddy currents that propagate in metals exposed to oscillating magnetic fields Therefore, it may be necessary to optimize MRI parameters for the presence of this implant. A proper preparation of each patient before an MRI examination is necessary to avoid burns even for patients without implants.
Educational Goals / Teaching Points
A decision matrix on how to determine the MR safety will be provided for implants that are not listed in the literature or in on-line resources. This decision matrix includes a step-by-step analysis to determine the MR safety. The responsibilities of MR Safety Officers and MR Medical Directors in the decision process will be discussed. For MR conditional devices examples of scan conditions such as static magnetic field strength, specific absorption rate (SAR), maximum spatial field gradient and dB/dt limitations will be demonstrated. Also, potential restrictions on the types of coils will be shown. A practical guideline on how to improve the safety of patients with implants will be provided. This guideline includes regular MRI safety training for staff, comprehensive MR screening forms and thorough patient evaluations, patient interviews before the examination and proper patient positioning, and constant visual and audio monitoring during the examination.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
All personnel working in the MR environment need to be trained with a comprehensive MRI safety course. For new employees who will work in the MR environment, this course should be included in the employee orientation program and be repeated annually. The MRI safety training should include the presentation of technical and medical background of MRI safety. Detailed screening procedures of patients with a questionnaire for ferromagnetic objects, implants, devices, body piercing, allergies to MRI contrast agents, kidney disease, pregnancy, breast feeding and also the screening of patients that have a history injuries by a metallic foreign body such as bullets, shrapnel, or other type of metallic fragments help to avoid severe accidents in an MRI suite. It is important that medical personal entering the MRI scanner room to evaluate the patient, administer medications or interventions need to be trained in emergency procedures in an MRI suite.
Conclusion
Regular MRI safety training for staff, comprehensive screening forms and thorough patient evaluations, patient interviews before the examination, proper patient positioning, and constant visual and audio monitoring during the examination will improve the safety of patients and staff.
