DOI:10.2214/AJR.07.5403
AJR 2007; 188:887
© American Roentgen Ray Society
See Your AJR Online for Comprehensive New ACR MRI Safety Guidelines
Robert J. Stanley
Editor in Chief
rstanley{at}uabmc.edu
Although the print version of this article will not appear until the
June 2007 issue of AJR, the ARRS and AJR Websites
(www.arrs.org
and
www.ajronline.org)
now provide free access to the third and most comprehensive version of the
American College of Radiology's Guidance Document for MR Safe Practices: 2007
[1]. The first American College
of Radiology white paper on MR safety appeared in the June 2002 issue of the
AJR. This first report was produced by a blue-ribbon panel of experts
chaired by Emanuel Kanal, MD, and covered all areas related to MR safety. A
second version of the report, which appeared in the May 2004 issue of the
AJR, provided an update and revisions. The current report is the
product of a significantly expanded panel of experts that includes academic
and community practice radiologists and representatives of anesthesiology,
cardiology, medical physics, MR technology, MR nursing, architecture, legal
counsel, the Food and Drug Administration, and numerous related disciplines.
Dr. Emanuel Kanal again serves as the chair of this distinguished panel.
In comparison with the earlier white papers on MR safety, this third
version is substantially more comprehensive, related to the growth in the
types, field strengths, and uses of MRI devices and MR contrast agents, prior
experience with adverse events, greater knowledge about the behavior of
ferrous and nonferromagnetic materials in the MR area, improvements in patient
safety and screening measures, and management of emergencies that could
introduce personnel untrained in MR area requirements. The material contained
in this report represents the unanimous consensus of all members of the panel,
and not simply a majority opinion.
Included are recommendations on imaging pregnant patients, pediatric
screening and sedation issues, the safety of accompanying family or personnel,
and relevant physical principles associated with high magnetic fields, to name
a few. The section on MR contrast agent use is very current, including
information on the association of certain gadolinium-based MR contrast agents
with the recently described nephrogenic systemic fibrosis in patients with
impaired renal function.
Appended are very useful forms including a safety screening form and MR
hazard checklist, as well as MR facility safety design guidelines. Specific
safety analyses of all of the related MR zones and cryogen handling are also
included. In essence, the document is a mandatory onsite safe practice
guideline for all users of MR equipment. We are most grateful for the
opportunity to publish this comprehensive report.
In addition, the April issue of the AJR includes a unique
historical perspective on how the mindset of scientists and physicians was
prepared for the introduction of X-radiation and its diagnostic and
therapeutic roles at the turn of the last century
[2]. When I first read the
manuscript, I was concerned that the topic might be too far removed from the
usual contents of the AJR. However, since we are still celebrating
our AJR centennial (1906-1907) with commemorative articles, I decided
that this fascinating review of the antecedents of radiology and radiotherapy
would be most appropriate and enjoyed by our readership. The advances in the
biosciences that took place in the 18th and 19th centuries, with the evolving
role of electricity and ultraviolet light into the medical sphere, prepared
the minds of physicians and scientists alike to be receptive to this amazing
discovery of Roentgen. We are grateful to Dr. Aronowitz for providing us with
this most enlightening review of medical history.
References
- Kanal E, Barkovich AJ, Bell C, et al. ACR guidance document for MR
safe practices: 2007. AJR 2007; 188:epub ahead of print,
wwwajronline.org
- Aronowitz JN. Ethereal fire: antecedents of radiology and
radiotherapy. AJR 2007;188
: 904-912[Abstract/Free Full Text]
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