How to Ensure You Receive the Safest Possible MRI

When you are referred by your doctor to undergo an MRI examination, it’s natural to wonder about the effects this will have on your body, how useful the results of the examination will be in charting the course of your care, and how the procedure might or might not go as planned, or as you hoped or expected. These are valid concerns not to be dismissed.

Remember that MRI is an extremely safe procedure when performed by trained experts. There is no exposure to ionizing radiation, only radio waves and magnetic fields. Claustrophobia can be an issue, but is much more manageable now with modern scanners with immersive sound and video equipment. Finally, there are rare and isolated instances of MRI accidents that are often publicized. These incidents are exceptionally unusual, especially when MRI is performed by a reputable institution with personnel trained to perform and interpret examinations with a well-defined, anticipatory approach to safety.

How should an institution be thinking about MRI safety?

There are two fundamental elements to consider for MR safety:

  • Patient Risk Assessment —The imaging team should be closely considering what the risks to you as an individual patient might be. Would kidney health contraindicate gadolinium as a contrast medium? Do you have any incompatible metal implants or devices? Are you anxious regarding the examination? What do you need on the day of the study to have a positive and useful MRI experience?
  • Completion of the right exam, safely, the first time with diagnostic results—It has been said in radiology that quality is the extent to which the right procedure is done the right way at the right time, and is accurately communicated to the patient and the referring physician. MRI is a safe procedure, but should be performed correctly and individualized to your situation. Radiologists who oversee MRI examinations should use the most up-to-date protocols available to tailor examinations carefully using your personal medical information. One size does not fit all.

What are the hallmarks of safety for any institution that performs MRI?

When assessing your imaging site, look for those institutions that take a proactive approach to safety. Some institutions assess their patients for MRI risk only if patient risk has already been established. It is much safer to prospectively assess risk, as is our policy at UCSF. The institution you choose should also be prepared for problems that arise during the procedure. For example, what protocols are in place if a patient reacts adversely to a contrast agent?

Look also for institution-based policies and protocols. The American College of Radiology and other medical groups have prepared safety policies that many institutions adopt as their own. There’s nothing wrong with that, but an extra level of oversight is achieved in those institutions that write and continually update their own safety policies and procedures based on the daily experiences of their teams. The institution you choose should be learning every day how to keep patients healthy and safe while providing useful MRI results, and applying that learning to their practice.

 

Christopher Hess, MD, PhD, is associate professor and chief of Neuroradiology at the University of California, San Francisco. He completed his PhD in electrical engineering at the University of Illinois in 1998, M.D. at the University of Illinois in 2002, radiology residency at UCSF in 2007, and neuroradiology fellowship in 2008. Dr. Hess also serves as associate chair for quality and safety and associate director of the T32 Program in the Department of Radiology and Biomedical Imaging. Dr. Hess’s research focus is on the translational application of MR imaging techniques to vascular disease, brain development and degeneration, and epilepsy, especially using diffusion imaging and ultra-high-field MRI.

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