School of MRI > Courses 2017 > MR Safety
MR Safety

October 5-7, 2017
The course has been confirmed.

Course organiser:
Siegfried Trattnig

Local organiser:
Nadia Oberhofer, Bolzano/IT

Course venue:
Ospedale di Bolzano
Via Lorenz Böhler 5
39100 Bolzano

Preliminary faculty:

D. Beitzke, K. Bräuner, J. Felblinger, L. Hanson, A. Jones, M. Krssak, A. Melzer,  G. Schaefers, F. Schick,  H. Thomsen, S. Trattnig

Course duration:
Thursday morning – Saturday noon

Please click here to download the programme of the course.

This course is limited to 35 participants!

The aim of this course:
The aim of the course is to provide a systematic overview of the risks connected to superconductive clinical MR systems. It will cover both patient safety and personnel safety. The potential  hazards related to the 3 different electromagnetic fields used in MR (the static magnetic field, the switched gradient field and RF field) will be presented and experienced in practical sessions. Another important aspect are the standards of MR Safety and compatibility testing in active as well as non-active implants, with a focus on a training in clinical strategies how to handle implant safety issues in the MR environment, enhance patients safety and improve the MR workflow in daily routine. Special aspects such as cardio-vascular implants and MR Safety issues in interventional MR will be presented, too. The most recent developments and risks of Gadodolinium-based MR contrast agents will be covered. Additionally an introduction to risk management in clinical MR systems will be given. The course will provide a combination of lectures and practical training sessions in smaller groups.

Participation requirements:

The target group can be subdivided into the following two categories:
Health care personnel: radiologist, radiological technologist, physician, ongoing MR safety expert and Safety Officer, occupational physician
Other personnel: medical physicists, MR researcher, hospital safety manager, maintenance manager

Learning Objectives

Introduction to Construction and Function of MRI Scanner

•Update on MR scanner components
•Update on MR basics

A Systematic Overview on MR Interactions with Magnetic and Electrically Conductive Materials

•Characteristics of the static magnetic field inside and around a clinical MR system
•Forces and torques acting on magnetic materials in static magnetic fields
•Characteristics of the radiofrequency electromagnetic transmitter field and of the gradient field
•Induction of electrical  currents by time varying electrical and magnetic RF fields in conductive structures and tissue

Risks in MRI I:
Static Bo Field, Dangers Due to Superconductors

•Value of the static magnetic field around the magnet
•Exposure limits for static magnetic fields
•Potential risks for human exposure to static magnetic fields
•Dependence of physiologic  effects  on relevant parameters of the static magnetic field
•Potential risks of superconducting magnets

Risks in MRI II:
MR Gradients and RF

•Exposure limits for low frequency gradient fields
•Potential risks for humans with gradient fields
•Exposure limits for high frequency RF fields
•Potential risks of high frequency RF fields
•Dependency of SAR from the static magnetic field

Implant Testing and Safety Considerations
•Active definitions of MR Safety and terms
•Standards of MR Safety and compatibility testing
•Presentation of standard test methods
•Simulation of RF heating using human models
•MR Labelling of active and non-active implants with respect to static magnetic and switched gradient magnetic fields and RF fields

MR-Safety Considerations in a Clinical Environment
•How to prepare the patient for the MR examination
•To learn about the impact of different implants on clinical MRI
•To understand the patient related MR safety issues without implants (burning incidents)
•To be aware of emergency situations in the scanner room

Implant Problems and Optimisation: Researching Implants

•Impact of implants on clinical MRI and financial consequences
•Strategies of improvement, workflow
•Effective research of MRI-conditions of implants
•MR Conditionals pacemaker
•Fixed Parameter mode

Cardiovascular Implants and Cardiac Pacemarkers in MRI
•Risks and subsequent limitations of MR imaging after stents and stent graft implantation
•The risks of conventional,´old´cardiac pacemarker implantation
•Newest guidelines of MR safety after stent and pacemaker implantation

MR Safety Issue in interventional MR
• Principles of Interventional MRI and intraoperative MRI
• Potential risks for clinicians and patients
• Technical requirements for safe Interventional MRI and intraoperative MRI
• Limitations of visualisation and tracking of interventionaldevices
• How to avoid reaching exposure limits during interventions
• Examples from clinical and pre-clinical studies

Contrast Agents
•Chemical caracteristics of Gd chelates
•Risks of Nephrogenic Systemic Fibrosis
•Evaluation of renal function
•Allergic reactions with Gd chelates
•New developments of Gd based contrast agents

EU Directive and MR Worker Training
•MRI in the context of European health and safety legislation
•Existing national and international EMF exposure guidelines and standards
•EC standard 60601-2-33
•The Physical Agents (EMF) Directive: state of play and possible future developments

Risk Management in MR
•Risk assessment
•Instruments for risk management (reporting, root cause analysis,…)
•Strategies for risk reduction in MR
•Considerations regarding ferromagnetic detectors and the commitment to a ferrous-free MR environment

Practical Session I
System-Related MR Safety

The goal is to give the participants a hands-on experience of the potentially dangerous interactions of metallic objects with the intense static magnetic field: inspection of the safety precautions of the MR site and MR-related alarms, the controlled access zone, experience with attraction forces and torque (ferromagnetic objects) and effect of Lenz law (all metallic objects) due to the static magnetic fringe field, movement of "MR compatible" ear prosthesis; practical issues with ferromagnetic detectors, practical aspects related to maintenance and cleaning staff.

Practical Session II
Patient-Related MR Safety

This session is focused on safe patient handling in MR patient interview and correct MR clothing; patient screening for metal objects and implants; examination of anaesthetized patients; handling metal objects and appropriate labelling of necessary equipment in the MR environment; patient positioning: how to avoid rf-burns, hearing protection, patient communication and alarm system; ambient emergency situations including fire and quench; management of accompanying person/parents; patient form and informed consent, patient emergency; issues related to RF stimulation, PNS and 1st controlled operation mode.

Practical Session III
RF Heating

Participants will experience the RF heating issue with an experiment. The goal is to understand the parameter complexity related to SAR and to know the necessities for interpretation of the RF part of the MR labelling of devices/items.

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