Dr. Emanuel Kanal MD, FACR, FISMRM, MRMD, MRSE, AANG
Founder and Past Chair, American Board of MR Safety (ABMRS); Developer/Author, MagnetVision™ MR Safety app; Director, Magnetic Resonance Services; Professor of Radiology and Neuroradiology, Department of Radiology, University of Pittsburgh Medical Center.
Since roughly 2014 there has been a substantial global awakening of interest in all matters pertaining to MR safety by predominantly the practitioners of MRI, namely, MR technologists/radiographers. As a result, we will likely see the following activities in MR safety in 2018:
1. An increased focus of MR safety on the part of radiologists and perhaps even MR physicists, largely as a result of the continued increased focus and attention on this topic by MR technologists/radiographers who continue to lead the drive for professional growth and focus on this topic.
2. With the recent CMS relaxation of reimbursement criteria for cardiovascular implanted electrical devices (CIED) there will be a notable surge in requests for MR scans of patients with various CIEDs that are not labeled for MR scanning. This will generate substantial pressures on radiology personnel to accept device patients for MRI scans – personnel who are not familiar with how to do so safely. This, in turn, will further increase awareness and interest in formal MR safety education and ABMRS credentialing among US radiologists and technologists alike.
3. On a similar note, I predict that 2018 will usher in a budding international interest in formal MR safety accreditation/certification for MR radiographers, which might even awaken interest in formal MR safety education and certification among radiologists and physicists worldwide.
4. With the explosion of new implantable medical and non-medical devices and implants there will be increasing demand for standardization in approaches to implant MR safety evaluation and assessment, as well as demand for more objective analysis and assessment of risk quantification. 2018 will see the introduction of new software tools that will propel the entire MR community worldwide into more standardized approaches to risk quantification, analysis, and clinical decision making for patients with implants, devices, and foreign bodies.
5. For better AND for worse, the public’s eye has now been sharply focused on gadolinium-based contrast agent safety and the topic of retained/residual gadolinium. The recent FDA meeting on this issue, the recent well-publicized activities and lawsuit by Chuck and Gena Norris, and the recent FDA announcements regarding mandatory patient education regarding residual gadolinium promise to make 2018 a year filled with questions from our patients regarding GBCA usage, type, and dosing. This, in turn, will stimulate more formal educational efforts for at least US radiologists regarding this topic, and significant new research in this field will doubtless be forthcoming during this year.