Exhibit Hall | Forum 6
Purpose: Safe magnetic resonance (MR) scanning of patients with active implants is typically governed by the manufacturer. In manufacturer manuals, the conditions for safe scanning are specified by the manufacturer for the implant of interest. Under certain circumstances, the benefit of scanning a patient outside of the approved conditions (i.e., off-label) outweighs the risks involved with the scan. Off-label scanning requires a thorough review and discussion of risks and protocol modifications before proceeding. This study discusses the unreimbursed time cost associated with off-label scanning of patients with active implants.
Methods: For each phase of the device review workflow, a questionnaire was filled out at the time of review by the relevant stakeholder (MR Safety Expert (MRSE), MR Safety Officer (MRSO), or Physics Assistant). Included in the questionnaire was estimated time in minutes to complete the required task related to assessment and scanning. Summary statistics were calculated.
Results: Sixty patient scans were assessed by the workflow questionnaire and referred for off-label review. Twenty of 60 scans were approved and scanned by the time of this analysis. Median MRSO time was 50 minutes (interquartile range (IQR) 35 minutes), median MRSE time was 105 minutes (IQR 63 minutes), and median physics assistant time was 43 minutes (IQR 30 minutes). All MRSO time was during pre-scan preparation. All physics assistant time was during scanning. Median MRSE pre-scan time was 48 minutes (IQR 41 minutes) and median MRSE scanning time was 45 minutes (IQR 37 minutes).
Conclusion: While integral to patient care, assessing and scanning patients with active implants off-label in MR is a substantial and unreimbursed time cost. The utilization of MRSOs and physics assistants can reduce the burden placed on MRSEs.
Not Applicable / None Entered.