Diana L. DiGiorgi: MRI safety and you

Is magnetic resonance imaging safe for everyone? This is a question we have been asked a number of times over the years. The answer is no. There are some people who should not have this procedure. MRI is a powerful medical tool that plays a critical role in early disease detection, diagnosis and treatment. It is a complicated process that involves a radio frequency pulse passing through strong magnetic fields.

As one MRI technician has written, “The biggest and most important component in an MRI system is the magnet. Metal objects can become dangerous projectiles if they are taken into the scan room. For example, paperclips, pens, keys, scissors, hemostats, stethoscopes and any other small objects can be pulled out of pockets and off the body without warning, at which point they fly toward the opening of the magnet (where the patient is placed) at very high speeds, posing a threat to everyone in the room.”

It can be dangerous for patients who have implants such as metallic fragments in the eye, pacemakers, aneurysm clips in the brain, even some magnetic dental implants, to be near the MRI’s strong magnetic field. Most orthopedic implants and metal staples in most parts of the body are fine, but should be made known to health care providers.

According to the MRI technician, “Each time we encounter a patient with an implant or metallic object inside his/her body, we investigate thoroughly to make sure it is safe to scan them. Some patients are turned away because it is just too dangerous.”

A recent survey by the National Council on Aging found that more than 90 percent of physicians agreed that MRI may be risky for patients with certain electronic implantable devices, such as pacemakers, and very few will order MRIs for these patients. NCOA surveyed older adults, caregivers, and health care providers to evaluate their knowledge and awareness of medical imaging safety.

The survey focused on electronic implantable devices. NCOA concluded from the study that “communication about the safety of medical imaging for patients with these devices is often inadequate.”

Older people with devices like pacemakers, the NCOA stated, “need better information on the benefits and risks of medical imaging. Our aim is to highlight the results of this survey to increase awareness and facilitate a more productive dialogue between patients, caregivers, and health care providers.”

According to NCOA, after the age of 65, a person’s chance of needing medical imaging doubles, and between 50 and 75 percent of patients with electronic implantable devices will likely need medical imaging over their device’s lifetime. The survey found that nearly one third of patients and more than half of caregivers did not recall being informed that they or the person they care for might not be eligible for some forms of medical imaging at the time the device was implanted.

The survey also found that three in 10 patients with an electronic implantable device have had an MRI despite the risks, and of this group nearly 20 percent reported experiencing problems with their device afterwards.

The physicians surveyed by NCOA reported using clinical guidelines often. Nearly all the doctors surveyed wanted more education on medical imaging and electronic implantable devices to help ensure awareness of critical guidelines. The doctors said that electronic implantable devices should not be regarded as safe for medical imaging simply because they are labeled as “modern” or “recently manufactured.”

The Institute for Magnetic Resonance Safety, Education and Research has issued guidelines for screening patients for magnetic resonance procedures that state: “WARNING: Certain implants, devices, or objects may be hazardous to you and/or may interfere with the MR procedure (i.e., MRI, MR angiography, functional MRI, MR spectroscopy). Do not enter the MR system room or MR environment if you have any question or concern regarding an implant, device, or object. Consult the MRI Technologist or Radiologist BEFORE entering the MR system room. The MR system magnet is ALWAYS on.”

There is a section in the guidelines that identifies various implants, devices, and objects as hazardous to the patient undergoing the MR procedure or that may produce an artifact that could interfere with the interpretation of that procedure.

Any individual who has been told they need an MRI should check with their doctor or specialist to resolve any concerns they have regarding safety.

Easton Journal contributor Diana DiGiorgi is executive director Old Colony Elder Services, which serves 20 towns in Massachusetts' Plymouth County as well as Avon, Easton and Stoughton. The organization’s mission is to provide services that will support the dignity and independence of elders by helping them maximize their quality of life; live safely and in good health; and, prevent unnecessary or premature institutionalization. For more information call (508) 584-1561 or visit the Web site at www.oldcolonyelderservices.org.