ACR panel chair offers advice on making MR safety a reality, Part II

Jul 22, 2002

The guidelines recommend having an MR safety director. Is that full-time job? Who is best qualified for it?

We stated that the MR safety officer should be trained to level 2 status. They should be very knowledgeable in MR safety issues. It is my opinion that this could be delegated to whomever the site chooses, including a physician, a technologist, a nurse, a physicist. All of those are fair game.

This is not a full-time job. I think it’s safe to say that I am probably more involved in MR safety issues than any other physician on the face of the planet today. Yet clearly, I have many other duties and responsibilities that I’m expected to perform and maintain as well.

The white paper also suggests that technologists certified by the American Registry of Radiologic Technologists be assigned to the MR room. As there is an RT shortage in the U.S. right now, how crucial is this point?

I very much appreciate that there’s a shortage. I have barely enough technologists at my own institution. But would you want to have an MR scan done by a truck driver? I know of a mobile MR unit where the driver does the scans. Should the receptionist be allowed to do the scan? Yes, we have that shortage, but does that mean we should allow drivers and receptionists to do the scans?

There are minimum standards that we look to and a certification process is routinely understood to present a minimum bar, a minimum threshold people are expected to pass.

The objective was to have a well-established and respected organization certify technologists in their understanding of basic anatomy in this area, and their understanding of the MR modality. The ARRT was therefore a natural choice by our panel for minimal certification of MR technologists.

Please note that we did not specifically say MR sub-certified. That was entertained and rejected at least, in part, because of the shortage situation. At the very least, we thought we could ask for registered technologists to deal with this technology.

Ideally, they would be sub-certified and sub-trained in MR specifically. That means they have certain familiarity with patient handling; that means they understand some of the risks; that they almost certainly have some familiarity with sedation procedures and what have you and practices of patient care.

There are indeed some people who have not come through the formal pathway that are superb and knowledgeable MR technologists. And I do commiserate and feel for them. It is in our own best interest that the system finds other pathways to accommodate them. Until those are in place (however), to reject minimum standards because they are not a 100% perfect solution is a mistake.

What’s the next step for the committee with regard to the white paper and future MR safety efforts?

The first thing I’d like to focus on -- and this is just my opinion, nothing has been formalized with the group -- is to address specific pediatric needs and requirements for MR safety and see if anything needs to be modified or issued as a subset for them.

In addition, (we’re) listening to the feedback and seeing if there is anything that needs to be updated or changed (in the current guidelines), based on the directions in which the industry is heading. We anticipate formally reviewing these guidelines probably within the next 12 months.

There also was a commentary that was published along with our publication. Unfortunately, it misunderstood many of the points being made in the guidelines. A formal response to that commentary has been prepared and is being finalized by the panel.

By Shalmali Pal
AuntMinnie.com staff writer
July 23, 2002

To address specific MR-related questions to Dr. Emanuel Kanal, visit www.drkanal.com or email him at [email protected].

MRI safety Web sites

MRIsafety.com

Magnetic Resonance Safety Site

Pocket Guide to MR Procedures and Metallic Objects: Update 2001, June 24, 2002

Pillow proves potentially perilous in MR procedure, September 26, 2001

Of missiles and metallic objects: How to avoid MRI-related hazards, August 21, 2001