The 2005 Australian MRI safety survey

OBJECTIVE. The purpose of this study was to ascertain current MRI safety practices in Australia regarding permanent pacemakers, temporary pacing wires, cerebral aneurysm clips, implants of unknown MRI safety status, and use of metal detectors, with respect to adherence to published guidelines. MATERIALS AND METHODS. A questionnaire was distributed to more than 100 MRI facilities in Australia. RESULTS. Ninety-two responses, representing 102 MRI systems, were received. Respondents from approximately one in 15 sites were aware they had inadvertently imaged a patient who had a permanent pacemaker ( eight patients). One of these episodes led to a death. Use of modified request forms, on which referring physicians are asked for MRI safety information, was incomplete (48/90 facilities). Four facilities deliberately imaged pacemaker patients. Seventy-seven of 89 facilities responded that they do not image patients with temporary pacing wires. Aneurysm clips were accepted by most sites (71/91), and only one site associated with a neurosurgical service refused such patients. Seventy of 71 facilities required written identification of the clip type. Most (77/90) of the sites reported delays due to the unknown MRI safety status of implants. Only four of 92 sites reported routine use of a metal detector. The guidelines of the American College of Radiology and of the Royal Australian and New Zealand College of Radiologists were equally influential (38% each). Only 10 of 90 respondents reported use of external audits of safety processes. CONCLUSION. Ongoing vigilance is required for avoiding MRI of patients with pacemakers, particularly when information from the patient is unreliable or unobtainable. Requiring referring physicians to provide MRI safety information may help to minimize risk.