MR Safety, An Issue of Magnetic Resonance Imaging Clinics of North America

1st Edition, Volume 28-4 - October 23, 2020
Editor: Robert E Watson
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 5 9 3 8 - 0
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 5 9 4 2 - 7

This issue of MRI Clinics of North America focuses on MR Safety and is edited by Dr. Robert E. Watson. Articles will include: Key elements of clinical MRI safety; Standardized… Read more

MR Safety, An Issue of Magnetic Resonance Imaging Clinics of North America

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This issue of MRI Clinics of North America focuses on MR Safety and is edited by Dr. Robert E. Watson. Articles will include: Key elements of clinical MRI safety; Standardized approaches to MR safety assessment of patients with implanted devices; Performing MRI safely in patients with implanted electronic devices: cardiac electronic implanted devices and neurostimulators; Implanted devices: SAR considerations for common diagnostic examinations; Testing of commonly implanted devices for MR conditional labelling; MR safety in the 7T environment; Physics of MR safety; MRI safety considerations of gadolinium based contrast agents: gadolinium retention and nephrogenic systemic fibrosis; MRI safety: Siting and zoning considerations; Elements of effective patient screening to improve safety in MRI, including use of ferromagnetic detection systems; MRI safety in the interventional environment; MRI Safety: Pregnancy and Lactation; MR safety: Computer MRI simulations for testing of electronic devices; and more!

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
CME Accreditation Page
Foreword
Preface
Key Elements of Clinical Magnetic Resonance Imaging Safety: It Takes a Village
Key points
Introduction: magnetic resonance imaging safety: the scope of the problem
It takes a village
The key components of the magnetic resonance safety management structure
Preventing thermal injuries
Preventing projectile injuries
Implant malfunction
Acoustic injury
Summary
MR Imaging Safety: Siting and Zoning Considerations
Key points
Introduction/background
Physical environment MR safety existing literature
Aims of this paper
Discussion
Physical environment MR safety interventions preventing access of unscreened individuals
Physical environment MR safety interventions for unscreened objects
Physical environment MR safety interventions for known ferromagnetic/MR conditionally limited objects
Physical environment MR safety interventions for radiofrequency heating
Physical environment MR safety interventions for cryogen safety
Timeliness of physical environment MR safety interventions (construction, renovation, equipment upgrades)
Essential nature of physical environment MR safety as a part of comprehensive MR safety
Summary
Elements of Effective Patient Screening to Improve Safety in MRI
Key points
Terminology
Elements of effective patient screening to improve safety in magnetic resonance rationale
Risks
Physical layout and workflow
Screening procedure for patients and research subjects
Preprocedure screening
Researching and clearing of implants and devices
Day of the examination screening
Screening immediately prior to zone 4
Nonpatient/subject screening
Short-term or episodic screening
Long-term access for staff
Alternative screening methods
Equipment and supplies
Summary
Clinics care points
MR Imaging Safety Considerations of Gadolinium-Based Contrast Agents: Gadolinium Retention and Nephrogenic Systemic Fibrosis
Key points
Introduction
Chemical properties and stabilities of gadolinium-based contrast agents
Biodistribution
Retention of gadolinium in central nervous system tissues
Retention of gadolinium in non–central nervous system tissues
Speciation
Toxicology
Clinical effects of gadolinium-based contrast agents exposure
Clinical importance of gadolinium retention in humans
Potential at-risk populations
Summary
Magnetic Resonance Safety: Pregnancy and Lactation
Key points
Introduction
Magnetic resonance safety considerations during pregnancy
Magnetic resonance safety considerations during lactation
Summary
The Physics of Magnetic Resonance Imaging Safety
Key points
Introduction
Static magnetic field
Time-varying radiofrequency magnetic field
Discussion
Standardized Approaches to MR Safety Assessment of Patients with Implanted Devices
Key points
Introduction
Energies/fields
Description of associated risks
Spatial location of energies/fields and, therefore, risks
Standardizing the approach to MR safety assessment for patients with implants, devices, and foreign bodies
Summary
MR Safety: Active Implanted Electronic Devices
Key points
Introduction
Safety challenges of MR and scanning active implanted electronic devices
Scanning of patients with specific active implanted electronic devices
Summary
Practical Aspects of MR Imaging Safety Test Methods for MR Conditional Active Implantable Medical Devices
Key points
Introduction
Relevant facts to counter misconceptions about MR imaging safety testing of active implantable medical devices
MR imaging and active implantable medical devices interactions: potential safety hazards (per ISO/TS 10974)
Test methods addressing potential safety hazards caused by MR imaging and active implantable medical devices interaction: pulse generator + leads
MR imaging safety assessments with electromagnetic modeling
Summary
Magnetic Resonance Safety in the 7T Environment
Key points
Introduction
Forces caused by static magnetic fields and magnetic field gradients
Effects caused by high resonant frequencies at 7T
Practical considerations
Summary
MR Imaging Safety in the Interventional Environment
Key points
Introduction
Planning and building for interventional MR imaging
Zoning for the interventional MR imaging suite
Equipment
Anesthesia
Surgical instruments
Interventional MR imaging surgical adjuncts and therapeutic devices
Personnel and training
Patient screening, preparation, resuscitation, and transport safety specifics in the interventional MR imaging setting
Leadership, management, and vigilance
MR Imaging Safety Events: Analysis and Improvement
Key points
Introduction
Summary