E5503. Review of MRI Conditional Labeling for Implanted Medical Devices
  1. Christina Sammet; Rush University
  2. Steffen Sammet; University of Chicago
Pacemakers, stimulators, cochlear, and other active implants present unique challenges in MRI imaging. Balancing the risks and benefits of MRI in the setting of active implants involves input of the radiologist, ordering provider, medical physicist, and MRI staff. The MRI conditional labeling for these devices can be sometimes complex and intimidating to those unfamiliar with the process of clearing medical devices for MRI. This exhibit takes a case-based approach to explore the process of identifying active implant models, researching their associated MRI conditional labels, and discussing the risk versus benefit of scanning the implant. When MRI is deemed appropriate, a description of the process to comply with device labeling that requires stricter than normal scan operation mode, will be discussed.

Educational Goals / Teaching Points
1) Learn to identify the manufacturer and model of several common active implants. 2) Learn to find and interpret the MRI conditional labeling associated with these implants. 3) Learn the process of balancing the risk to the patient with the benefit that the MRI will have to care management. 4) In cases where MRI is deemed appropriate, learn to understand the process to conduct the MRI consistent with the manufacturer safety labeling, especially in circumstances where the label is stricter than normal operation mode.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will discuss MRI safety with respect to several specific active implant devices. The first case will discuss active pacemakers and remnant/orphaned pacer wires from a pacer placed during surgery. The second case will discuss both active vagal nerve stimulators and remnant/orphaned vagal nerve stimulator wires. The third case will discuss cochlear implants and workflow for assessing make, model, compatibility, and MRI appropriateness for the increasing number of patients presenting with cochlear implants.

Implant safety in MRI is increasingly complex as implanted medical devices become more common and often use sophisticated electronic sensor and stimulator technology. Fortunately, device manufacturers have started to label these devices for compatibility with MRI. This case-based review of the process to safely triage and scan patients with active implants in MRI may help build confidence in interpreting the labels and incorporating these workflows in the clinical practice.