Additional information should be added

MR Safety Screening

Section must be rewritten

• Participant must fill out MRI Safety Screening form at the interview/SCID session and at the MRI scan session
• Make sure to review MRI safety concerns with the subject, also let them know that they can end the scan at any time (squeeze ball), let them know that the scanner is very loud (make sure the earbuds are really in!)
• Have the subject remove his/her belt, any jewelry at all, anything in their hair, pockets, wrist, etc
• ALL metal (MR-safe or unknown) implants need to be checked.
• If you are acquiring documentation for technologist/Clinical Director review, you need:
  • Participant to sign a healthcare release authorizing the sharing of private health information to you
  • Surgical note from the implantation. Highlight anything in the document that could indicate a metal piece was used
  • Manufacturer’s information on the implant and whether or not it is safe at the field strength you are using for the scan (1.5T/3T/4T)
• If you know the material is MR-safe (e.g. dental work), you still need to check that the implant will not cause an artifact during scanning. You need to obtain the following:
  • Location information (e.g. ask participant to identify on dental chart)
  • Implantation information (to make sure that nothing not MR-safe is holding down the implant)
  • Review and approval from the physicist that this item in this location will not be an issue during the particular scan he or she is running (e.g. if you are scanning the liver, the dental work might not matter)
• The scanners have weight limits, but the most important thing is the size of the bore (girth of the subject is extremely important for this assessment):
  • 3T scanner
    • Weight limit: 350lbs (someone of that size has never been able to fit into the scanner)
    • Bore size: 15″ table to top x23″side to side
  • 4T scanner
    • Bore size: Inner bore diameter is 22 inches.  This equates to an inner circumference of 69 inches (maximum girth of subject successfully scanned at 4T is 52 inches).
  • Significant risks may exist for people with:
    • Cardiac pacemakers
    • Metal clips on blood vessels (also called stents)
    • Artificial heart valves
    • Artificial arms, hands, legs, etc.
    • Brain stimulator devices
    • Implanted drug pumps
    • Ear implants
    • Eye implants or known metal fragments in eyes
    • Exposure to shrapnel or metal filings (wounded in military combat, sheetmetal workers, welders, and others)
    • Other metallic surgical hardware in vital areas
    • Certain tattoos with metallic ink (please tell us if you have a tattoo)
    • Certain transdermal (skin) patches such as NicoDerm (nicotine for tobacco dependence), Transderm Scop (scopolamine for motion sickness), or Ortho Evra (birth control), or metal-containing IUDs
  • If you are unsure whether the subject has any of these items in your body, you should know that most would have been implanted as part of a surgical procedure. So, trying to have the subject remember any past operations may help. Subjects should also be asked whether you have any implanted devices or history of exposure to shrapnel or metal filings, and if so, they may not be able to participate in the study. It’s important to ask if they have ever worked with metal before, and if they have, if they wore eye protection AND if they ever suffered an injury (especially to the eyes). It’s also helpful to know if they have had MRI scans since that time.
  • MR Implant/Device Documentation Review Steps:
    • In order to scan anyone who has a metal implant or device, please follow the steps listed below.
    • Ask the PI if the implant (with the self-reported knowledge you have from the participant or the collaborator: e.g. implant location, material, previous MRIs) will affect his/her scans (based on the acquisition, voxel placement, type of scanning, etc.).
    • NOTE: For implants that are known not to be safe at 3T or conditionally safe at 3T and conditions cannot be met, subjects should be excluded.
    • Obtain the following documents to submit to the reviewer (required for review and approval)
      • Implant location, material, previous MRIs
      • Surgical note regarding the implant operation
      • Requires SIGNED healthcare release form to release the documents from the subject to the RA
      • Make/model of the implant (can be derived from the surgical note)
      • Manufacturer’s implant/device brochure
      • Manufacturer’s implant/device statement of MRI safety and previous safety studies
      • If the subject has previously had MRI scans safely with the surgical implant (anecdotal evidence not acceptable alone, but helpful to know for implant/device review and approval)
      • Check MRIsafety.com by Dr. Shellock if an implant is MRI safe. Check for any “conditions” (i.e. conditionally safe within specified SAR limit) and inform the reviewer and scanner operator of any “conditions.”
      • Coil information (e.g. transmit/receive) and body part being scanned
    • To obtain these documents, it is simplest for the subject to contact the surgeon’s office to obtain the surgical note and then forward the note to MIC staff (after having signed the release form). However, it is also possible for an RA to do so (subject would have to sign release form prior to RA contacting surgeon’s office to request medical records).After obtaining the surgical note and any other documentation provided by medical records/the subject/collaborating RA, the McLean RA should review all documentation for the following:
      • Verify where the implant is located
      • What implant was used
      • Ensure no other metal implants, clips, staples, etc. were placed during the surgical procedure.
      • (Highlight all applicable information) for implant/device review and approval
      • If this information was not already provided, contact the implant manufacturer to inquire about the MRI safety of the implant (e.g. a brochure or product information guide citing studies done at 1.5T or 3T where the implant was scanned safely).
    • It may be difficult to find information regarding 4T safety, but check Google and/or the Partners library resources.
    • To obtain approval for the scanners, forward the documentation to the following individuals:
      • For 1.5T or 3T approval, submit all documentation to Kathleen Thangaraj or any of the MRI techs. The techs may either sign off on the documentation or forward the review to Dave Olson, Clinical Director of the MIC.
      • For 4T approval, submit all documentation to Dave Olson.
    • If the implant(s) is approved for conditional scanning at 3T/4T, confirm with PI and/or scan operator that the scan will be performed within the “X” conditions.
    • NOTE: All documentation must be initialed and dated with the date of review and the reviewer. The reviewer should note whether the implant/device is safe at 1.5T/3T/4T and whether there are any additional conditions that must be met during scan.

FORP Set Up

To be supplied.

MRI Prescription Glasses

• Usually located at the 3T scanner
• Try to arrive 5-10 minutes early in order to sort these out, if needed
• Prescription ranges from 0.5-6.0 (weakest RX to be confirmed)
• Use “screen saver” wipes to wipe off your fingerprints prior to giving to the subject
• To use, simply select the RX lenses and “pop” them into the frame
• There should be an eye test sheet located near the MRI glasses case
• There is a login/logout book on the shelf above the iSCAN computer to log use