A narrative review of current and emerging MRI safety issues: What every MRI technologist (radiographer) needs to know

Abstract

Magnetic resonance imaging (MRI) has been traditionally regarded as a safe imaging modality due to the absence of ionising radiation. However, MRI is a source of potential hazards with a variety of risks including, but not limited to, those associated with the various electromagnetic fields used for imaging. All MRI technologists (radiographers) require sound knowledge of the physical principles of the MRI scanner and must understand the associated safety risks and how to avoid adverse events from occurring. MRI technologists now assume more responsibility in clinical decision-making, and their knowledge base has consequently had to expand significantly. In addition, rapid advancements in MRI technology and other correlated areas such as medical implant technology, and the associated increase in MRI safety issues, place increasing demands on the MRI technologist to constantly keep abreast of current and future developments. This article reviews current and emerging MRI safety issues relevant to the three MRI electromagnetic fields and highlights the key information that all MRI technologists should be fully cognisant of to ensure competent and safe practice within the MRI environment.

Keywords: Adverse Events < General; Contraindications < General; Magnetic Resonance Imaging < Discipline; Medical Imaging < General; Patient care < General; Radiographer < Medical Imaging; Research - review < General.

Figure 1

Examples of projectile accidents in the MRI environment: (A) oxygen cylinder, (B) stretcher bed, (C) wheelchair, (D) floor buffer. (Images courtesy of, and reprinted with permission from, Frank G. Shellock, Ph.D., www.MRIsafety.com).

Figure 2

Icons used in the ASTM F2503‐20 standard for MR safety category labelling: (A) MR Safe, items that pose no known risk or hazard in the MRI environment; (B) MR Conditional, implants and devices demonstrate no hazard in the MRI environment, but only when prescribed conditions for safe use are adhered to; (C) MR Unsafe, implants and devices should never be brought into the MRI environment.

Figure 3

Example of vendor spatial gradient magnetic field map: 3T Skyra scanner. (Courtesy of Siemens Healthineers).

Figure 4

Examples of RF induced burns: (A) fourth‐degree burn immediately after MRI examination on a 5‐week‐old baby, caused by an MR Unsafe pulse monitor. This resulted in amputation of the forearm (B) burn resulting from an MR Unsafe pulse oximeter on the finger, post‐escharotomy (C) second‐degree burn after MRI examination from invisible metallic microfibres in clothing (D) first‐degree burn around a tattoo after MRI. (Images courtesy of, and reprinted with permission from, Frank G. Shellock, Ph.D., www.MRIsafety.com).