Motion on MRI disproportionately affects elderly patients, men, obese individuals, and Black patients -- regardless of care setting, according to a study published January 23 in Academic Radiology.
This finding underscores the importance of accounting for motion risk factors in scheduling, prescan counseling, and positioning protocols, wrote a team led by Takeshi Yokoo, MD, PhD, of the University of Texas Southwestern Medical Center in Dallas.
"Addressing these patterns through workflow design is important for promoting equitable, high-quality MRI across diverse patient populations," the group noted.
MRI is a first-line imaging modality for many conditions, Yokoo and colleagues explained. But it's also one of the most difficult exams for patients to tolerate, as they are asked to stay still in an enclosed space and for some body parts, to hold their breath. It's not surprising that patient motion during MR imaging is common, with estimates ranging from 8% to 30% of all exams. This phenomenon creates "motion artifacts" that can degrade image quality, and "may not only interfere with detection of lesions and their characterization but may create false or misleading findings," the group wrote.
To address the issue, the team conducted a study that included data from 68,517 consecutive MRI reports from 2022 at two U.S. health systems, one university-based and the other a "safety net" facility. The researchers defined "motion" as any mention of the phenomenon in the report and extracted clinical and sociodemographic characteristics from the hospitals' electronic health records.
Overall, the group found that older, male, Black, and obese patients had higher odds of motion on MR imaging:
- Emergency and inpatient studies had higher odds ratios (OR) of motion compared to the reference OR for outpatient exams (emergency OR, 2.55, and inpatient OR, 3.26).
- Older age was associated with motion on MRI imaging, with an OR of 1.91 in those 85 years and older compared with the reference OR for those between the ages of 19 and 34.
- Men had higher odds of motion on MRI imaging than women, with an OR of 1.14 compared with the reference OR for women.
- Black patients had higher odds of motion on MRI imaging than white patients, with an OR of 1.18 compared to the reference OR for their white counterparts.
- Obesity was associated with greater odds of motion on MRI imaging: Class II (moderate-to-severe obesity) had an OR of 1.11, while class III (formerly known as "morbid obesity") had an OR of 1.48 (both compared with the reference OR of "normal" weight).
The team suggested that "socio-structural factors are likely shaping patient experiences rather than a biological explanation for increased motion," noting that the study's results "underscore the need for further efforts to make MRI more tolerable for patients and disseminate technologies to overcome motion artifacts, while still delivering the necessary diagnostic information."
"Our findings also suggest an opportunity for patient-centric precision imaging strategies, such as individualized protocol optimization and pre-scan interventions (e.g., tailored instructions, comfort-focused positioning, and abbreviated protocols for frail or elderly patients)."
Access the full study here.
