(This article has been updated with a correction.)
A new group of experts in magnetic resonance safety have created a credentialing test for technologists and radiologists aimed at reducing adverse events like the so-called missile effect, when the machine's powerful magnetic field sucks an object into the scanner at high speed.
The not-for-profit American Board of Magnetic Resonance Safety says existing guidelines are too device-specific, assess organizations rather than individuals and lean toward “polite suggestions” rather than strict standards.
The group plans to provide tailored, more granular guidance and testing to the technologist who administer MRIs and to the radiologists with the legal responsibility for safety of the exam.
“The overwhelming majority of the accidents can be prevented with the tools we have today,” said Tobias Gilk, a radiology and MRI consultant serving on the ABMRS board of directors. “But we have to put those tools in the hands of the people who are administering these exams.”
In a Joint Commission sentinel event alert issued in 2008 (PDF), the hospital accrediting body noted various examples of ways patients can be injured in the MRI suite. They include the missile effect; burns on patients whose implants or surgical staples heat during the MRI process; and hearing damage from noises generated by the scanner. On Friday, the Joint Commission updated its MRI safety requirements for hospitals (PDF). They require hospitals to verify staff qualifications, including ongoing education and training, and perform annual checks of the equipment to ensure hospitals are managing the risks.
The American College of Radiology's panel on MRI Safety began offering guidance on magnetic resonance safe practices in 2002. That panel, which last updated its recommendations in 2013 in the Journal of Magnetic Resonance Imaging (PDF), offers recommendations for personnel qualifications and training, reporting of the events and the naming of a magnetic resonance medical director to ensure the safe practice guidelines are maintained.
According to the ABMRS, what has been missing from the equation, however, is a way to ensure the effectiveness of competency training on MRI safety. For ABMRS certification, frontline users would be quizzed not only on basic technical knowledge about magnetic resonance but also asked to determine how to proceed in certain scenarios, such as patients with implants who need MRIs. “We want to make sure they have the knowledge base to address all the risks unique to the MR environment,” Gilk says.
The ABMRS is made up of domestic and international experts, including Dr. Emanuel Kanal, director of magnetic resonance services at the University of Pittsburgh. He previously served as chair of the American College of Radiology's panel on MRI safety. The group began ruminating on the certification process last year and anticipates a final version, as well as estimates on the costs, to be available in the spring. First administration of the test is expected in June.
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(This article has been updated to indicate that the American College of Radiology's panel on MRI Safety began offering guidance on magnetic resonance safe practices in 2002.)