SMRT Signals • June 2017 • Vol.6 Issue 2

Volume 20; Numbers 4, 5, and 6

We are pleased to present the SMRT Educational Seminars, Volume 20, Numbers 4, 5 and 6. These are the 80th, 81st and 82nd accredited home studies developed by the SMRT, exclusively for SMRT members. The accreditation is conducted by the SMRT acting as a RCEEM (Recognized Continuing Education Evaluation Mechanism) for the ARRT. Category A credits are assigned to each home study, which can be used to maintain one’s ARRT advanced registry. SMRT Home Studies are also approved for AIR (Australian Institute of Radiography), NZIMRT (New Zealand Institute of Radiation Technology) and CPD Now (The College of Radiographers, United Kingdom) continuing professional development (CPD) activities.

Two peer-reviewed articles make up Volume 20 #4 including “Recommended Responsibilities for Management of MR Safety” and “Guidelines for Documentation and Consent for Nonclinical, Nonresearch MRI in Human Subjects.” The first article aims to outline specific duties for each of the recommended positions in a MR department managing MR safety in either clinical or research imaging including the MR Medical Director or MR Research Director, MR Safety Officer, and MR Safety Expert. As the authors state “The motivation for generating this document was the enactment of the EU-directive on physical agents (electromagnetic fields, Directive 2013/35/EU), which defines exposure limits to electric and magnetic fields in the work place.” This is a well-organized and detailed document that can be utilized in all MR departments both research and clinical, to ensure that a comprehensive MR safety program is in place and fully maintained.

The second article discusses an area in which many in the MR community may be engaged but have not fully thought through the potential liabilities especially in the event of an accident. The authors explain “There are many circumstances where MRI in human subjects falls into a gray zone that constitutes neither research nor clinical imaging. This leads to tremendous uncertainty as to whether these activities should be performed as part of an IRB approved protocol, or whether any form of informed consent is even necessary.” Although this may or may not be a small percentage of the imaging that takes place at any MR facility, policies and procedures should be in place to ensure that scan subjects for nonclinical, nonresearch MRI examinations are fully aware the potential risks.

One peer-reviewed article comprises Volume 20 #5: “MRI Interactions of a Fully Implantable Pressure Monitoring Device.” Introduced by the authors “An implantable long-term pressure monitor has many potential applications including the monitoring of intracranial pressure (ICP) of hydrocephalus patients, intraocular pressure of glaucoma patients, bladder pressure of neurogenic bladder dysfunction patients, intraarterial pressure of hypertension patients, and ventricular or aorta pressure of heart failure patients.” The article describes the prototype device, its design and safety testing, fully examining the potential risks from the static magnetic field, induced heating, effects on device function, and artifacts. “The demand for magnetic resonance imaging (MRI) techniques in diagnostic medicine is on the rise due to its lack of ionizing radiation and ongoing improvements with soft-tissue contrast and resolution. It is important that a new clinical device does not exclude potential patients from these existing diagnostic technologies, particularly for the hydrocephalus population, where patient management is reliant on medical imaging of ventricle size.” Understanding all the potential effects on biomedical devices in patients undergoing MR examinations is crucial for the MR community to maintain a safe environment at all times.

The final home study issue Volume 20 #6 is the peer-reviewed article “The Physics of MR Safety.” The ability to consistently apply MRI safety policies and procedures comes from clear comprehension of the fundamental physics and principles. If it doesn’t make sense, it is extremely difficult to buy into it and thereby supporting it, let alone convincing others of its importance. As the authors explain “The main risks associated with magnetic resonance imaging (MRI) have been extensively reported and studied; for example, everyday objects may turn into projectiles, energy deposition can cause burns, varying fields can induce nerve stimulation, and loud noises can lead to auditory loss. This present review article is geared towards providing intuition about the physical mechanisms that give rise to these risks.” This peer-reviewed article provides the necessary detail of the underlying physics and interactions for each of the critical areas in MRI safety.

A special thank you to Vera Kimbrell, B.S., R.T., FSMRT, from Boston, Massachusetts, USA for acting as the Expert Reviewer for Volume 20, Numbers 4, 5 and 6.

Thanks also to Heidi Berns, M.S., R.T.(R)(MR), FSMRT, Chair of the SMRT RCEEM Ad-hoc committee from Coralville, Iowa, USA and all those who participate on this committee by reviewing the home studies for accreditation. Finally, many thanks to Kerry Crockett, Associate Executive Director, Mary Keydash, Director of Marketing, Sally Moran, Director of IT and Web, Barbara Elliott, SMRT Coordinator, John Celio, IT Coordinator, and the entire staff in the Concord, California, USA office of the ISMRM and SMRT for their insight and long hours spent supporting these educational symposia.

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