Purpose
There is a lot of confusion about whether to scan patients with different types of metal in their bodies, to the extent that patients are often refused MRI scans. In order to assess the scope of the problem and allow targeted designing of educational programs, we conducted a survey on MRI safety amongst radiologists from varying geographies.
Methods and materials
An anonymous questionnaire with 11 clinical situations was circulated digitally amongst ~5,000 radiologists. Questions comprised of MRI scanning dilemmas faced by us in real practice, where an MRI was eventually performed after extensive literature search. Situations included those related to total knee replacements (TKR), VP shunts, bullet injuries, shrapnel injuries, tattoos, baclofen pumps, intra-uterine devices (IUD), sternal wires, coronary stents and cardiac valves. Responses were scored and appropriate analysis performed.
Results
206 radiologists, from 94 cities, with mean experience of 11.92 years (SD: 9.04; range 0 to 50), completed the survey. The average score was 6.53/11 (SD: 2.03, range 1 to 11), with 4 having perfect score. Radiologists performed worst in situations related to arms and explosives - bullet in close relation to vertebral canal (28%) and potentially pregnant woman with bomb shrapnel (29%), and best in situations with a child with an Omaya reservoir with VP shunt (88%) and woman with an IUD (76%). 70%...
Conclusion
We note a trend wherein radiologists seem to adopt a conservative approach and avoid MRI in situations where it can be safely performed, denying patients optimum care. Radiologists need to be systematically educated about situations where MRI can and cannot be done in a clinical setting - situational education being one approach. We demonstrate the need for conducting dedicated training programs on the safety of MRI for practicing radiologists. Many patients who are denied critical MRI scans can benefit from such programs.
Personal information and conflict of interest
S. Rajan; NEW DELHI, DELHI/IN - nothing to disclose V. Mahajan; New Delhi/IN - nothing to disclose H. Mahajan; New Delhi/IN - Other at Director, Mahajan Imaging Pvt Ltd Research collaboration, General Electric Company Research collaboration, Koninklijke Philips NV Research collaboration, Qure.ai Research collaboration, Predible Health V. K. Venugopal; New Delhi, DELHI/IN - Consultant at CARING - Other at Research collaboration, General Electric Company Research collaboration, Koninklijke Philips NV Research collaboration, Qure.ai Research collaboration, Predible Health
References
1.Kim, S. J. & Kim, K. A. Safety issues and updates under MR environments. Eur J Radiol 89, 7–13 (2017).
2.Expert Panel on MR Safety et al. ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging 37, 501–530 (2013).
3.Cross, N. M., Hoff, M. N. & Kanal, K. M. Avoiding MRI-Related Accidents: A Practical Approach to Implementing MRSafety. J Am Coll Radiol 15, 1738–1744 (2018).
4.Aissani, S., Laistler, E. & Felblinger, J. MR safety assessment of active implantable medical devices. Radiologe 59,...