What’s New in the Patient Safety World
October 2016
MRI Safety: There’s an App for That!
One of the questions addressed before anyone gets an MRI scan is whether the patient has any sort of implant or device or foreign body that may be adversely affected by the magnetic fields. Sounds simple, doesn’t it? Don’t we just look at a list of those items that would contraindicate an MRI scan?
Well, it is not so simple. Dr. Emanuel Kanal, director of MR services at University of Pittsburgh
Medical Center and a well-known expert on MRI safety issues, has developed the MR
Safety Implant Risk Assessment app on the IOS (iPhone) platform to address
the multiple factors involved. A recent interview with him on AuntMinnie.com,
the popular radiology website, discussed the details and intricacies of the app
(Ridley
2016).
Factors affecting
the safety during MRI include not only the type of implant but also its
location, the type of MRI scan being done, the part of the body being imaged,
the strength of the magnet and other issues of configuration of the MRI
machine, and other considerations such as the location of the various energy
sources relative to the patient’s location in the MRI suite. Kamal notes that
what is safe in one system may not be safe in another. Moreover, a patient
might safely have one part of the body imaged by MRI but not another.
Importantly, some patients may be being denied potentially helpful MRI scanning
that could be safely performed given the correct type of study and equipment.
The intended
audience for the app is MR technologists, radiologists, or MR physicists and it
requires technical knowledge about MRI. Kamal describes the app as a teaching
tool in addition to its practical utility in determining whether a patient can
be safely imaged by MR. Kamal, who is also a licensed pilot, describes the
checklist format that forces the user to consider all the potential safety
concerns before concluding that the patient may have the MR study safely
performed.
The interview is
worth your reading and you should make sure that those involved in your MRI
unit know about the nature and availability of the app. But the interview was
enlightening even for those of us lacking the technical MR expertise. As a
neurologist, I highly suspect after reading it that there have been instances
where I referred patients for alternative imaging modalities when an MRI
actually could have been performed safely.
Speaking of safety in the MRI suite, we should also note that a coalition of societies and organizations dealing with MRI has proposed a delineation of responsibilities for the management of MRI facilities (Calamante 2016).
Some of our prior columns on patient safety issues related to MRI:
- February 19, 2008 “MRI
Safety”
- March 17, 2009 “More on MRI Safety”
- October 2008 “Preventing Infection in MRI”
- March 2009 “Risk of Burns during MRI Scans from Transdermal Drug Patches”
- January 25, 2011 “Procedural
Sedation in Children”
- February 1, 2011 “MRI Safety Audit”
- October 25, 2011 “Renewed Focus on MRI Safety”
- August 2012 “Newest MRI Hazard: Ingested Magnets”
- October 22, 2013 “How
Safe Is Your Radiology Suite?”
- October 21, 2014 “The
Fire Department and Your Hospital”
- August 25, 2015 “Checklist
for Intrahospital Transport”
- August 2016 “Guideline
Update for Pediatric Sedation”
References:
Ridley EL. Mobile App Spotlight: Kanal's MR safety implant risk tool. AuntMinnie.com 2016; August 24, 2016
http://www.auntminnie.com/index.aspx?sec=sup&sub=mri&pag=dis&ItemID=114953
Apple iTunes store. Kanal's MR Safety Implant Risk Assessment (app).
https://itunes.apple.com/us/app/kanals-mr-safety-implant-risk/id1114168862
Calamante F, Ittermann B, Kanal E, The Inter-Society Working Group on MR Safety and Norris D. Recommended responsibilities for management of MR safety. JMRI 2016; Early View 3 Jun 2016
http://onlinelibrary.wiley.com/doi/10.1002/jmri.25282/epdf
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