Robert E. Watson Jr., MD, PhD, Chair of the American College of Radiology® (ACR®) Committee on Magnetic Resonance (MR) Safety, contributed this piece.
The unique fields in MRI contribute to an environment that is considered one of the most dangerous in healthcare. Ferromagnetic objects can become dangerous projectiles, there is risk of severe burns and the MRI fields can interact in dangerous and unpredictable ways with implanted medical devices. Maintaining MR safety is critically important and deeply impacts all stakeholders in the MR community including, most importantly, our patients and frontline staff. Several recent high-profile MR safety accidents have again focused attention on the need for extremely well-designed safety policies and procedures that are followed rigorously at all times.
The role of the ACR Committee on MR Safety, and its periodically updated ACR Manual on MR Safety, is to provide ongoing assessment of significant changes in the field and recommendations for designing and maintaining a top-notch contemporary MR safety program.
All in the MRI community are aware of the challenges we face due to the relative shortage of MRI technologists. Our MRI technologists are our frontline defense in MR safety and can essentially be thought of as our “goalies” as they provide the final and most critical barrier to ensuring the safety of our patients in this challenging environment. This draft manual is written with our technologists particularly in mind, in an effort to ensure their safety and give them the tools to thrive in a safe environment.
The new manual builds on the invaluable efforts of our predecessors and includes substantial new content, as well as new MR Safety recommendations. To enhance readability and instructional value, it has been reorganized into chapter format, with chapter-specific references. In addition, we’ve incorporated more illustrative figures and “Key Points” boxes.
Many different staff with different job classifications and roles must converge in a coordinated way to ensure an overall safe MR practice. As such, the intent of the manual is to provide radiologists, technologists, physicists, nurses, anesthesia personnel, administrators and others an effective template to do that. These MR safety principles apply to clinical diagnostic imaging and research settings as well as rapidly expanding atypical MR settings (e.g. interventional MR, PET/MR, linear accelerator MR, PET/MR). The manual can also be a resource for patients, research participants and healthcare personnel outside of MRI.
We hope this manual effectively provides the necessary tools and recommendations to help ensure safety for all in our evolving and challenging MR practices. Having said that, we are keenly interested in feedback from the MR community. All members of the MR community are invited to submit feedback on the manual as a whole, as well as on several changes, including:
- Updated MR personnel training levels and associated level-specific elements of MR safety training.
- Updated MR personnel staffing recommendations, including routine, emergency and remote scanning scenarios.
- Updated guidance about “full stop/final check” processes in routine and emergency/complex situations with associated elements of final patient/subject preparation.
- Expanded and updated information related to objects, equipment and implanted devices; recommendations to help minimize projectile risk with use of pocketless attire for MR personnel and tethering of external equipment in Zone III/Zone IV.
- New MR Risk Assessment Appendix as it pertains to management of patients with implanted devices with unclear MR conditions for safe scanning.
- New extensive checklist of elements to consider onsite MR safety policies and standard operating procedures patterned on the ACR MR safety checklist required for ACR MR-accredited facilities.
Please join us in enhancing quality and safety for our colleagues and patients, and submit your comments by Friday, April 14, for consideration.
Thank you for all you do to ensure MR safety.